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HomeMy WebLinkAboutWR Dunkin, Simplex Grinnell, General Piping - $2,141,588.17 fr2, Disbursement Instructions Regions Bank hereby is instructed to make a disbursement of Loan Proceeds from the.Borrower Loan Account to(or for the account of)Borrower in:(a)the amount of the'Total Due"line in the"Amount of Current Authorized Disbursement"column below;and(b)accordance with the terms and conditions of the Agreement,the other Loan Documents,and the Disbursement Instructions. Description of Work Percent Amount of Scheduled Complete or Amount of Prior Current . Value.or Contract Contract Amount Authorized Authorized Amount Owed Disbursement Disbursement ?MI fqn+-s Pre t'ttu4ftr mW ti;, t (cr _ 2,D071807,21 , f:,t,.∎in,,nT; 40 it, Mr1,1i' 1�33,`790,gt] Grand Total _ 1. 2 5{8 ,17" Total NA • _ 01,,=fl,_ El CRC has inspected the portions of the PAC Equipment completed by Borrower to confirm the Percent Complete in the applicable column above. 13 CRC either has received or waived receipt of conditional lien waivers and othersubmittals required to be made by Borrower in connection with a disbursement of Loan Proceeds from the Borrower Loan Account to(or for the account of)Borrower. All terms used in these Disbursement Instructions without definition shall have the meaning ascribed thereto in that certain Loan Agreement(Detention and Foundation),dated as of August 14,2009,by and between Lender and Carmel Garage Development Company,LLC.,as amended by that certain Amendment to Loan Agreement,dated January 28,2010 y and between the same parties. Dated: !d�S/D CITY OF CARMEL REDEV LOPME T OMMISSION By �►�t. Printed Lt'S SOLOS Title eXeW7/ar , ul6-C7l A • Draft WR Dunkin, Simplex Grinnell, and General Piping Up Through November 2009 WR Dunkin $ 1,066,194.50 Simplex Grinnell $ 390,364.00 General Piping $ 551,248.71 Amount Requested $ 2,007,807.21 December 2009 WR Dunkin $ 53,200.00 Simplex Grinnell $ 76,965.00 General Piping $ 3,615.96 Amount Requested $ 133,780.96 Overall Amount Requested $ 2,141,588.17 Draft PAC Elevators and Doors (WR Dunkin) Up Through November 2009 IPC Amounts through application 19 Completed and Stored to date $ 1,122,310.00 Retention held (based on 5% retention) $ 56,115.50 Paid to date $ 1,066,194.50 Amount Requested $ 1,066,194.50 December 2009 IPC Amount for application 20 Completed and Stored to date $ 56,000.00 Retention held (based on 5% retention) $ 2,800.00 To be paid $ 53,200.00 Amount Requested $ 53,200.00 Overall Amount Requested $ 1,119,394.50 Draft PAC Elevators, Lifts Doors 11/30/09 Contractor Equipment Contract Total Completed to Date Remaining Balance WR Dunkin steel doors and frames - M $ 73,000.00 $ 71,500.00 $ 1,500.00 steel doors and frames - L $ 33,000.00 $ 24,550.00 $ 8,450.00 flush wood doors - M $ 39,000.00 $ 780.00 $ 38,220.00 flush wood doors- L $ 15,000.00 $ - $ 15,000.00 stile and rail wood doors- M $ 127,000.00 $ - $ 127,000.00 stile and rail wood doors- L $ 34,000.00 $ 2,540.00 $ 31,460.00 sound control doors and windows - M $ 352,000.00 $ 9,000.00 $ 343,000.00 sound control doors and windows- L $ 50,000.00 $ - $ 50,000.00 over coiling doors-M $ 20,750.00 $ - $ 20,750.00 over coiling doors - L $ 2,850.00 $ - $ 2,850.00 aluminum framed entraces/storefronts- M $ 176,000.00 $ 29,520.00 $ 146,480.00 aluminum framed entraces/storefronts - L $ 69,700.00 $ - $ 69,700.00 interior aluminum doors and frames- M $ 17,000.00 $ 340.00 $ 16,660.00 interior aluminum doors and frames- L $ 6,000.00 $ - $ 6,000.00 revolving door entrances - M $ 69,000.00 $ 1,380.00 $ 67,620.00 revolving door entrances- L $ 9,500.00 $ - $ 9,500.00 electric traction elevators-engineering $ 157,200.00 $ 157,200.00 $ - electric traction elevators- material/equipment $ 452,000.00 $ 452,000.00 $ - electric traction elevators - L $ 186,000.00 $ 58,000.00 $ 128,000.00 hydraulic elevator-engineering $ 69,500.00 $ 69,500.00 $ - hydraulic elevator- material/equipment $ 183,000.00 $ 183,000.00 $ - hydraulic elevator- L $ 63,000.00 $ 63,000.00 $ - wheelchair lift- material/equipment $ 48,000.00 $ - $ 48,000.00 wheelchair lift- permits $ 2,200.00 $ - $ 2,200.00 wheelchair lift- L $ 14,000.00 $ - $ 14,000.00 Total $ 2,268,700.00 $ 1,122,310.00 $ 1,146,390.00 Amount Completed $ 1,122,310.00 Draft PAC Elevators, Lifts Doors 12/31/09 Contractor Equipment Contract Total Previously Completed Completed this Period Completed to Date Remaining Balance WR Dunkin steel doors and frames-M $ 73,000.00 $ 71,500.00 $ - $ 71,500.00 $ 1,500.00 steel doors and frames-L $ 33,000.00 $ 24,550.00 $ - $ 24,550.00 $ 8,450.00 flush wood doors-M $ 39,000.00 $ 780.00 $ - $ 780.00 $ 38,220.00 flush wood doors-L $ 15,000.00 $ - $ - $ - $ 15,000.00 stile and rail wood doors-M $ 127,000.00 $ - $ - $ - $ 127,000.00 stile and rail wood doors-L $ 34,000.00 $ 2,540.00 $ - $ 2,540.00 $ 31,460.00 sound control doors and windows-M $ 352,000.00 $ 9,000.00 $ - $ 9,000.00 $ 343,000.00 sound control doors and windows-L $ 50,000.00 $ - $ - $ - $ 50,000.00 over coiling doors-M $ 20,750.00 $ - $ - $ - $ 20,750.00 over coiling doors-L $ 2,850.00 $ - $ - $ - $ 2,850.00 aluminum framed entraces/storefronts-M $ 176,000.00 $ 29,520.00 $ - $ 29,520.00 $ 146,480.00 aluminum framed entraces/storefronts-L $ 69,700.00 $ - $ - $ - $ 69,700.00 interior aluminum doors and frames-M $ 17,000.00 $ 340.00 $ - $ 340.00 $ 16,660.00 interior aluminum doors and frames-L $ 6,000.00 $ - $ - $ - $ 6,000.00 revolving door entrances-M $ 69,000.00 $ 1,380.00 $ - $ 1,380.00 $ 67,620.00 revolving door entrances-L $ 9,500.00 $ - $ - $ - $ 9,500.00 electric traction elevators-engineering $ 157,200.00 $ 157,200.00 $ - $ 157,200.00 $ - electric traction elevators-material/equipment $ 452,000.00 $ 452,000.00 $ - $ 452,000.00 $ - electric traction elevators-L $ 186,000.00 $ 58,000.00 $ 56,000.00 $ 114,000.00 $ 72,000.00 hydraulic elevator-engineering $ 69,500.00 $ 69,500.00 $ - $ 69,500.00 $ - hydraulic elevator-material/equipment $ 183,000.00 $ 183,000.00 $ - $ 183,000.00 $ - hydraulic elevator-L $ 63,000.00 $ 63,000.00 $ - $ 63,000.00 $ - wheelchair lift-material/equipment $ 48,000.00 $ - $ - $ - $ 48,000.00 wheelchair lift-permits $ 2,200.00 $ - $ - $ - $ 2,200.00 wheelchair lift-L $ 14,000.00 $ - $ - $ - $ 14,000.00 Total $ 2,268,700.00 $ 1,122,310.00 $ 56,000.00 $ 1,178,310.00 $ 1,090,390.00 Amount Completed $ 56,000.00 Draft PAC Fire Protection (Simplex Grinnell) Up Through November 2009 Total Contract Amounts through application 13 Completed and Stored to date $ 421,362.00 Retention held $ 30,998.00 Paid to date $ 390,364.00 Amount Requested $ 390,364.00 December 2009 Total Contract Amount for application 14 Completed and Stored to date $ 76,965.00 Retention held $ - To be paid $ 76,965.00 Amount Requested $ 76,965.00 Overall Amount Requested $ 467,329.00 Draft PAC Pumps and Plumbing (General Piping) Up Through November 2009 IPC Amounts through application 14 Completed and Stored to date $ 580,261.80 Retention held (based on 5% retention) $ 29,013.09 Paid to date $ 551,248.71 Amount Requested $ 551,248.71 December 2009 IPC Amount for application 15 Completed and Stored to date $ 3,615.96 Retention held (no retention held this period) $ - To be paid $ 3,615.96 Amount Requested $ 3,615.96 Overall Amount Requested $ 554,864.67 Draft PAC Elevators, Fire Protection and Pumps 11/30/09 Contractor Equipment Contract Total Completed to Date Remaining Balance General Piping Sewage Ejector/Triplex Pumps - L $ 26,640.00 $ 25,308.00 $ 1,332.00 Sewage Ejector/Triplex Pumps - M $ 167,273.00 $ 167,273.00 $ - Domestic Pumps - L $ 4,440.00 $ 1,776.00 $ 2,664.00 Domestic Pumps - M $ 27,066.00 $ 27,066.00 $ - Plumbing Fixtures - L $ 54,840.00 $ 5,484.00 $ 49,356.00 Plumbing Fixtures - M $ 111,082.00 $ 111,082.00 $ - Water Heater- L $ 4,080.00 $ 408.00 $ 3,672.00 Water Heater- M $ 62,669.00 $ 62,669.00 $ - HVAC Pumps - L $ 6,120.00 $ 5,936.40 $ 183.60 HVAC Pumps - M $ 28,061.00 $ 28,061.00 $ - HVAC Equipment $ 120,532.00 $ 114,505.40 $ 6,026.60 Storm Water Control Panel $ 30,693.00 $ 30,693.00 $ - Total $ 643,496.00 $ 580,261.80 $ 63,234.20 Amount Completed $ 580,261.80 Draft PAC Elevators, Fire Protection and Pumps 12/31/09 Contractor Equipment Contract Total Previously Completed Completed this Period Completed to Date Remaining Balance General Piping Sewage Ejector/Triplex Pumps-L $ 26,640.00 $ 25,308.00 $ - $ 25,308.00 $ 1,332.00 Sewage Ejector/Triplex Pumps-M $ 167,273.00 $ 167,273.00 $ - $ 167,273.00 $ - Domestic Pumps-L $ 4,440.00 $ 1,776.00 $ - $ 1,776.00 $ 2,664.00 Domestic Pumps-M $ 27,066.00 $ 27,066.00 $ - $ 27,066.00 $ - Plumbing Fixtures-L $ 54,840.00 $ 5,484.00 $ - $ 5,484.00 $ 49,356.00 Plumbing Fixtures-M $ 111,082.00 $ 111,082.00 $ - $ 111,082.00 $ - Water Heater-L $ 4,080.00 $ 408.00 $ - $ 408.00 $ 3,672.00 Water Heater-M $ 62,669.00 $ 62,669.00 $ - $ 62,669.00 $ - HVAC Pumps-L $ 6,120.00 $ 5,936.40 $ - $ 5,936.40 $ 183.60 HVAC Pumps-M $ 28,061.00 $ 28,061.00 $ - $ 28,061.00 $ - HVAC Equipment $ 120,532.00 $ 114,505.40 $ 3,615.96 $ 118,121.36 $ 2,410.64 Storm Water Control Panel $ 30,693.00 $ 30,693.00 $ - $ 30,693.00 $ - Total $ 643,496.00 $ 580,261.80 $ 3,615.96 $ 583,877.76 $ 59,618.24 Amount Completed $ 3,615.96 1) ---stAIA Document 6702/CMaT" - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#4050 Cannel APPLICATION NO:020 Distribution to: Commission Performing Arts OWNER:X One Civic Square 777 3rd Ave. S.W. PERIOD TO:December 31,2009 CONSTRUCTION MANAGER:X Cannel,IN 46032 Cannel,IN 46032 ARCHITECT:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:May 08,2008 CONTRACTOR:X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 Anderson,IN 46018 FIELD: CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Applicatio %r Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts ha ..i• .y ' e Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Paymen were issued fry.,payments eceived from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown - • •now 4s. 2.NET CHANGE BY CHANGE ORDERS $ -333,924.00 -' ':: ^ ' D ' , INC. 3.CONTRACT SUM TO DATE(Line 1±2) $ 11,901,076.00 " i �✓ Date: December 10,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 7,947,984.00 St. e of:Indiana 5.RETAINAGE: County of:Madis. a. 5 %of Completed Work Subscribed and sworn to before (ColumnD+EonG703) $ 595,053.80 me this 10th day of December 20 b. 0 %of Stored Material Notary Public:Martha A.Carpenter 7 09 77,/% 1 SI (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 595,053.80 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 7,352,930.20 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 6,921,983.70 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 430,946.50 AMOUNT CERTIFIED $ 43O 9q6.5O 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 4,548,145.80 CONSTRUC • .P''''7" ER: By: ,,,,,- Date: 23016 2009 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AR 'ITEC . Total changes approved in previous months by Owner$ 426,406.00$ 0.00 By: /, /_ Date: (U 1 I Total approved this Month $ 0.00$ 760,330.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 426,406.00$ 760,330.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ -333,924.00 AIA Document G702/CMa Tig-1992.Copyright O 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 14:55:53 on 12/11/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1667463476) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO % FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED (G_C) APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) TRAILER CONNECTOR ALLOWANCE- TRAILER 140H0 CLEANING 19,169.00 12,183.00 761.00 0.00 12,944.00 67.53% 6,225.00 1,066.10 ALLOWANCE-SITE 14010 SIGNAGE/SAFETY_ 22,000.00 10,839.00 0.00 0.00 10,839.00 49.27% 11,161.00 1,055.90 ALLOWANCE- 14070 GENERAL LABOR 320,000.00 207,705.00 8,377.00 0.00 216,082.00 67.53% 103,918.00 17,948.40 ALLOWANCE- TEMPORARY FENCE 140K0 MODIFICATIONS 5,000.00 4,008.00 0.00 0.00 4,008.00 80.16% 992.00 400.80 ALLOWANCE-#2 140L0 OR#53 STONE 37,900.00 18,856.00 0.00 0.00 18,856.00 49.75% 19,044.00 1,885.60 ALLOWANCE- WAREHOUSE 140M LEASE/LAYDOWN 0 /PARKING 500,000.00 9,427.00 490,573.00 0.00 500,000.00 100.00% 0.00 942.70 ALLOWANCE- PARKING LOT INSTALL/MAINTAI 140N1 N 100,000.00 55,324.00 25,000.00 0.00 80,324.00 80.32% 19,676.00 5,532.40 ALLOWANCE- MAINT.-OFF SITE STAGING/PARKIN 140N2 G 35,000.00 6,987.00 283.00 0.00 7,270.00 20.77% 27,730.00 685.50 ALLOWANCE- PARKING LOT REMOVE/REFURBI 14000 SH 100,000.00 2,745.00 0.00 0.00 2,745.00 2.75% 97,255.00 274.50 ALLOWANCE- 140P0 HAUL/DISPOSE 25,000.00 14,794.00 0.00 0.00 14,794.00 59.18% 10,206.00 1,479.40 AlA Document G703"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be 2 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G-C) FINISH (IF VARIABLE APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) OFFICE/STORAGE TRAILER L TEMPORARY TOILETS/WASHIN 01503 G STATIONS-M 41,800.00 32,600.00 1,000.00 0.00 33,600.00 80.38% 8,200.00 2,860.00 TEMPORARY TOILETS/WASH N 01504 G STATIONS-L 7,600.00 6,050.00 150.00 0.00 6,200.00 81.58% 1,400.00 555.00 FIRE PROTECTION/EME 01505 RG.STATIONS-M 19,300.00 19,300.00 0.00 0.00 19,300.00 100.00% 0.00 1,930.00 FIRE PROTECTION/EME 01506 RG.STATIONS-L 4,000.00 3,400.00 0.00 0.00 3,400.00 85.00% 600.00 310.00 FURNISFI/MAINTA 01507 IN TRASH CANS-M 6,000.00 6,000.00 0.00 0.00 6,000.00 100.00% 0.00 600.00 FURNISH/MAINTA 01508 IN TRASH CANS-L 40,000.00 27,500.00 1,200.00 0.00 28,700.00 71.75% 11,300.00 2,350.00 TEMPORARY ROAD/MAINTENA 01510 NCE 148,000.00 132,600.00 0.00 0.00 132,600.00 89.59% 15,400.00 12,220.00 TEMPORARY FENCING- REMOVE/RELOCA 01520 TE 15,800.00 15,800.00 0.00 0.00 15,800.00 100.00% 0.00 1,580.00 TEMPORARY 01521 FENCING-GATES 6,500.00 6,500.00 0.00 0.00 6,500.00 100.00% 0.00 650.00 TEMPORARY FENCING- 01522 SCREENING 8,744.00 8,744.00 0.00 0.00 8,744.00 100.00% 0.00 874.40 TEMPORARY 01523 BARRIERS-M 6,800.00 6,800.00 0.00 0.00 6,800.00 100.00% 0.00 680.00 01524 TEMPORARY 7,500.00 7,500.00 0.00 0.00 7,500.00_ 100.00% 0.00 750.00 AIA Document G703'"'-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 4 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO % FINISH (1F VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED (G-C) APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) HOIST-STAIR 2- RENTAL/OPERATI 1547.2 ON 242,500.00 0.00 0.00 0.00 0.00 0.00% 242,500.00 0.00 HOIST-STAIR 2- 1547.3 DISMANTLE 5,500.00 0.00 0.00 0.00 0.00 0.00% 5,500.00 0.00 HOIST-ROOM 100- 1548.1 SET UP 95,000.00 95,000.00 0.00 0.00 95,000.00 100.00% 0.00 9,500.00 HOIST-ROOM 100- RENTAL/OPERATI 1548.2 ON 211,000.00 182,750.00 4,500.00 0.00 187,250.00 88.74% 23,750.00 16,975.00 HOIST-ROOM 100- 1548.3 DISMANTLE 2,500.00 0.00 0.00 0.00 0.00 0.00% 2,500.00 0.00 HOIST- ALLOWANCE-SET 1549.1 UP 75,000.00 0.00 0.00 0.00 0.00 0.00% 75,000.00 0.00 HOIST- ALLOWANCE- RENTAL/OPERATI 1549.2 ON 88,000.00 0.00 0.00 0.00 0.00 0.00% 88,000.00 0.00 HOIST- ALLOWANCE- 1549.3 DISMANTLE 2,500.00 0.00 0.00 0.00 0.00 0.00% 2,500.00 0.00 01556 TRASH CHUTES-M 52,000.00 47,300.00 0.00 0.00 47,300.00 90.96% 4,700.00 4,490.00 01557 TRASH CHUTES-L 58,000.00 34,000.00 4,000.00 0.00 38,000.00 65.52% 20,000.00 2,500.00 GENERAL CLEAN 01560 UP-M 5,000.00 3,440.00 300.00 0.00 3,740.00 74.80% 1,260.00 314.00 GENERAL CLEAN 01561 UP-L 60,000.00 39,600.00 3,000.00 0.00 42,600.00 71.00% 17,400.00 3,560.00 01562 FINAL CLEANING 65,000.00 0.00 0.00 0.00 0.00 0.00% 65,000.00 0.00 EXCAVATIONBA 02110 CKFILL-SUMPS-M 12,019.00 12,019.00 0.00 0.00 - 12,019.00 100.00% 0.00 1,201.90 02111 EXCAVATIONBA 25,000.00 25,000.00 0.00 0.00 25,000.00 100.00% 0.00 2,500.00 AIA Document G703'"'-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA° Document,or any portion of it,may result in severe civil and criminal penalties,and will be 6 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) MISCELLANEOUS 05511 METALS-M 441,000.00 260,550.00 150,000.00 0.00 410,550.00 93.10% 30,450.00 13,615.00 MISCELLANEOUS 05512 METALS-L 275,000.00 162,250.00 100,000.00 0.00 262,250.00 95.36% 12,750.00 8,094.30 INTERIOR ROUGH 06100 CARPENTRY-M 31,000.00 10,320.00 0.00 0.00 10,320.00 33.29% 20,680.00 372.00 INTERIOR ROUGH 06101 CARPENTRY-L 44,000.00 13,640.00 0.00 0.00 13,640.00 31.00% 30,360.00 484.00 FOUNDATION WATERPROOFING 07110 -M 5,100.00 5,100.00 0.00 0.00 5,100.00 100.00% 0.00 510.00 FOUNDATION WATERPROOFING . 07111 -L 6,600.00 6,600.00 0.00 0.00 6,600.00 100.00% 0.00 660.00 07210 DUCT LINERS-M 97,000.00 97,000.00 0.00 0.00 97,000.00 100.00% 0.00 9,700.00 07211 DUCT LINERS-L 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00% 0.00 1,120.00 07810 FIRESTOPPING-M 24,000.00 16,800.00 0.00 0.00 16,800.00 70.00% 7,200.00 1,680.00 07811 FIRESTOPPING-L 16,000.00 12,200.00 0.00 0.00 12,200.00 76.25% 3,800.00 1,220.00 JOINT SEALANTS- 07910 M 35,000.00 0.00 0.00 0.00 0.00 0.00% 35,000.00 0.00 JOINT SEALANTS- 07911 L 80,000.00 0.00 0.00 0.00 0.00 0.00% 80,000.00 0.00 STEEL DOORS& 08110 FRAMES-M 73,000.00 71,500.00 0.00 0.00 71,500.00 97.95% 1,500.00 6,230.00 STEEL DOORS& 08111 FRAMES-L 33,000.00 24,550.00 0.00 0.00 24,550.00 74.39% 8,450.00 825.00 FLUSH WOOD 08140 DOORS-M 39,000.00 780.00 0.00 0.00 780.00 2.00% 38,220.00 78.00 FLUSH WOOD 08141 DOORS-L 15,000.00 0.00 0.00 0.00 0.00 0.00% 15,000.00 0.00 STILE&RAIL 08143 WOOD DOORS-M 127,000.00 0.00 0.00 0.00 0.00 0.00% 127,000.00 0.00 AIA Document G703TM-1992.Copyright O 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 8 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. User Notes: (1650865743) A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRE O Y AND STORED TO (G%°C) FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) GLAED ALUM. CURTAIN WALLS- 08441 L 148,000.00 6,000.00 5,500.00 0.00 11,500.00 7.77% 136,500.00 0.00 08710 HARDWARE 525,000.00 446,000.00 0.00 0.00 446,000.00 84.95% 79,000.00 .18,800.00 INTERIOR , 08810 GLAZING-M 11,000.00 220.00 0.00 0.00 220.00 2.00% 10,780.00 22.00 INTERIOR 08811 GLAZING-L 8,000.00 0.00 0.00 0.00 0.00 0.00% 8,000.00 0.00 FIRE PROTECTION 10440 SPECIALTIES-M 7,580.00 0.00 0.00 0.00 0.00 0.00% 7,580.00 0.00 FIRE PROTECTION 10441 SPECIALTIES-L 1,800.00 0.00 0.00 0.00 0.00 0.00% 1,800.00 0.00 10450 KNOX BOX 650.00 0.00 0.00 0.00 0.00 0.00% 650.00 0.00 LOADING DOCK 11130 EQUIPMENT-M 18,500.00 16,475.00 0.00 0.00 16,475.00 89.05% 2,025.00 1,647.50 LOADING DOCK 11131 EQUIPMENT-L 3,800.00 2,200.00 0.00 0.00 2,200.00 57.89% 1,600.00 220.00 ELEC.TRACTION ELEVATORS- 14210 ENGINEERING _ 157,200.00 157,200.00, 0.00 0.00 157,200.00 100.00% 0.00 15,720.00 ELEC.TRACTION ELEVATORS- MATERIAL/EQUIP 14211 MENT 452,000.00 452,000.00 0.00 0.00 452,000.00 100.00% 0.00 40,000.00 ELEC.TRACTION 14212 ELEVATORS-L 186,000.00 58,000.00 56,000.00 0.00 114,000.00 61.29% 72,000.00 0.00 HYDRAULIC ELEVATOR- 14241 ENGINEERING 69,500.00 69,500.00 0.00, 0.00 69,500.00_ 100.00% 0.00 6,950.00 HYDRAULIC ELEVATOR- 14242 MATERIAL/EQUIP 183,000.00 183,000.00 0.00 0.00 183,000.00 100.00% 0.00 18,300.00 AlA Document G703""-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 10 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. User Notes: (1650865743) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (C'-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) GRAND TOTAL $11,901,076.00 $7,555,054.00 $392,930.00 $0.00, $7,947,984.00 66.78% $3,953,092.00 $595,053.80 • AIA Document G703""—1992.Copyright m 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be 12 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:53:10 on 12/11/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1650865743) b 122231 o ,,a *AIA Document G7021CMa TM — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#4050 Cannel APPLICATION NO:019 Distribution to: Commission Performing Arts OWNER:X One Civic Square 777 3rd Ave. S.W. PERIOD TO:November 30,2009 CONSTRUCTION MANAGER:X Carmel,IN 46032 Carmel, IN 46032 ARCHITECT:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:May 08,2008 CONTRACTOR:X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD: Anderson,IN 46018 OTHER: CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO Architects CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for 'ayment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have b :..• : the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued anu4ayments r=ceived from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown herein%ii ow due. 2.NET CHANGE BY CHANGE ORDERS $ 426,406.00 CO WA: p of-: /' li N '(N, C. 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,661,406.00 I y: ,dietiv`(j/ iltilk'_ Date: November 13,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 7,555,054.00 St. - c Indiana 5.RETAINAGE: County of:Madis I. a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 633,070.30 me this 13th day of November, 2009 b. 0 %of Stored Material Notary Public:Martha A.Carpenter (Column F on G703) $ 0.00 My Commission expires:January 08, 017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 633,070.30 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 6,921,983.70 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 6,556,145.70 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. oO 8.CURRENT PAYMENT DUE $ 365,838.00 AMOUNT CERTIFIED $ 3(0S 10' 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application an on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 5,739,422.30 CONSTRUC I• MA •G: c• By: f �._ S Date: l(. 24 2.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECTil ?[J( Total changes approved in previous months by Owner $ 426,406.00$ 0.00 By: 1 Date: 1` J�" • -J, Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 426,406.00$ 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 426,406.00 AIA Document G702/CMa"'—1992.Copyright O 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 11:30:07 on 11/13/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. User Notes: (879589715) ! AIA Document 6703 TM - 1992 Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO:019 containing Contractor's signed certification is attached. APPLICATION DATE: 11/10/2009 In tabulations below,amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 11/30/2009 ARCHITECT'S PROJECT NO:25310 A B C D E _ F G H I - WORK COMPLETED TOTAL MATERIAL COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO % FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED DATE (G-C) (C-G) RATE) APPLICATION (NOT IN D OR E) (D+E) (D+E+F) PERFORMANCE 01010 BOND 106,000.00 106,000.00 0.00 0.00 106,000.00 100.00% 0.00 10,600.00 MOBILIZE/DEMOB 01015 ILIZE 29,000.00 15,000.00 0.00 0.00 15,000.00 51.72% 14,000.00 1,500.00 SUPERVISION/CO 01020 ORDINATION 361,000.00 296,800.00 12,000.00 0.00 308,800.00 85.54% 52,200.00 28,480.00 GENERAL 01025 CONDITIONS-M 380,000.00 286,000.00 16,000.00 0.00 302,000.00 79.47% 78,000.00 27,000.00 GENERAL 01026 CONDITIONS-L 98,000.00 75,000.00 5,000.00 0.00 80,000.00 81.63% 18,000.00 7,000.00 ALLOWANCE- STONE 140A0 WALKWAY 8,500.00 0.00 0.00 0.00 0.00 0.00% 8,500.00 0.00 ALLOWANCE- TEMPORARY 140B0 HANDRAIL 38,000.00 27,769.00 0.00 0.00 27,769.00 73.08% 10,231.00 2,776.90 ALLOWANCE- TEMPORARY DOORS/FRAMES/H 14000 ARDWARE 10,000.00 0.00 0.00 0.00 0.00 0.00% 10,000.00 0.00 140D0 ALLOWANCE-ICE 13,500.00 2,289.00 0.00 0.00 2,289.00 16.96% 11,211.00 207.10 ALLOWANCE- 140E0 SECURITY 31,000.00 0.00_ 0.00 0.00 0.00 0.00% 31,000.00 0.00 ALLOWANCE- 140E0 DUMPSTERS 191,700.00 44,037.00 6,831.00 0.00 50,868.00 26.54% 140,832.00 3,987.90 140G0 ALLOWANCE- 34,000.00 22,170.00 0.00 0.00 22,170.00 65.21 % 11,830.00 2,200.00 AIA Document G703T"'-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 1 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY % NO. WORK VALUE PREVIOUS STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G_C) (D+E) (NOT IN D OR E) (D+E+F) (C-G) RATE) TRAILER CONNECTOR ALLOWANCE- TRAILER 140H0 CLEANING 19,169.00 11,305.00 878.00 0.00 12,183.00 63.56% 6,986.00 1,066.10 ALLOWANCE-SITE 14010 SIGNAGE/SAFETY 22,000.00 10,559.00 280.00 0.00 10,839.00 49.27% 11,161.00 1,055.90 ALLOWANCE- 140J0 GENERAL LABOR 320,000.00 195,706.00 11,999.00 0.00 207,705.00 64.91 % 112,295.00 17,948.40 ALLOWANCE- TEMPORARY FENCE 140K0 MODIFICATIONS 5,000.00 4,008.00 0.00 0.00 4,008.00 80.16% 992.00 400.80 ALLOWANCE-#2 140L0 OR#53 STONE 37,900.00 18,856.00 0.00 0.00 18,856.00 49.75% 19,044.00 1,885.60 ALLOWANCE- WAREHOUSE 140M LEASE/LAYDOWN 0 /PARKING 500,000.00 9,427.00 0.00 0.00 9,427.00 1.89% 490,573.00 942.70 ALLOWANCE- PARKING LOT INSTALL/MAINTAI 140N1 N 100,000.00 55,324.00 0.00 0.00 55,324.00 55.32% 44,676.00 5,532.40 ALLOWANCE- MAINT.-OFF SITE STAGING/PARKIN 140N2 G 35,000.00 6,987.00 0.00 0.00 6,987.00 19.96% 28,013.00 685.50 ALLOWANCE- PARKING LOT REMOVE/REFURBI 14000 SH 100,000.00 2,745.00 0.00 0.00 2,745.00 2.75% 97,255.00 274.50 ALLOWANCE- 140P0 HAUL/DISPOSE _ 25,000.00 14,794.00 0.00 0.00 14,794.00 59.18% 10,206.00 1,479.40 AIA Document 0703""-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 2 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO ÷-% FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED DATE (G C) (C-G) RATE) APPLICATION (NOT IN D OR E) (D+E) (D+E+F) UNSUITABLE MATERIAL ALLOWANCE-6 OZ.GEOTECH 140Q1 FABRIC 4,700.00 3,207.00 0.00 0.00 3,207.00 68.23% 1,493.00 320.70 ALLOWANCE- 140Q2 TENSAR GEOGRID 8,500.00 - 0.00 0.00 0.00 0.00 0.00% 8,500.00 0.00 ALLOWANCE-#2 140R0 STONE 26,200.00 10,275.00 0.00 0.00 10,275.00 39.22% 15,925.00 1,027.50 ALLOWANCE- CABLE PASS- 140S0 THRU(FOH) 6,456.00 0.00 0.00 0.00 0.00 0.00% 6,456.00 0.00 ALLOWANCE- CABLE PASS- 140T0 THRU(BOH) 5,165.00 0.00 0.00 0.00 0.00 0.00% 5,165.00 0.00 ALLOWANCE- 140U CABLE PASS- O THRU(FLOOR) 17,217.00 0.00 0.00 0.00 0.00 0.00% 17,217.00 0.00 ALLOWANCE- TEMPORARY ELEVATOR 140V0 USAGE 200,000.00 0.00 0.00 0.00 0.00 0.00% 200,000.00 0.00 ALLOWANCE- 140W DONOR 0 RECOGNITION 100,000.00 0.00 0.00 0.00 0.00 0.00% 100,000.00 0.00 GENERAL 140X0 ALLOWANCE 400,000.00 5,980.00 0.00 0.00 5,980.00 1.50% 394,020.00 598.00 ALLOWANCE-AS- 140Y0 BUILD/CAD 5,000.00 0.00 0.00 0.00 0.00 0.00% 5,000.00 0.00 FIELD OFFICE/STORAGE 01501 TRAILER-M 16,400.00 13,700.00 500.00 0.00 14,200.00 86.59% 2,200.00 1,320.00 01502 FIELD 5,500.00 4,250.00 200.00 0.00 4,450.00 80.91 % 1,050.00 405.00 AIA Document G703T"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 3 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PPRRESENTL.Y COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) OFFICE/STORAGE TRAILER L TEMPORARY TOILETS/WASHIN 01503 G STATIONS-M 41,800.00 30,600.00 2,000.00 0.00 32,600.00 77.99% 9,200.00 2,860.00 TEMPORARY TOILETS/WASHIN 01504 G STATIONS-L 7,600.00 5,750.00 300.00 0.00 6,050.00 79.61 % 1,550.00 555.00 FIRE PROTECTION/EME 01505 RG.STATIONS-M 19,300.00 19,300.00 0.00 0.00 19,300.00 100.00% 0.00 1,930.00 FIRE PROTECTION/EME 01506 RG.STATIONS-L 4,000.00 3,250.00 150.00 0.00 3,400.00 85.00% 600.00 310.00 FURNISH/MAINTA 01507 IN TRASH CANS-M 6,000.00 6,000.00 0.00 0.00 6,000.00 100.00% 0.00 600.00 FURNISH/MAINTA 01508 IN TRASH CANS-L 40,000.00 25,500.00 2,000.00 0.00 27,500.00 68.75% 12,500.00 2,350.00 TEMPORARY ROAD/MAINTENA 01510 NCE 148,000.00 127,600.00 5,000.00 0.00 132,600.00 89.59% 15,400.00 12,220.00 TEMPORARY FENCING- REMOVE/RELOCA 01520 TE 15,800.00 15,800.00 0.00 0.00 15,800.00 100.00% 0.00 1,580.00 TEMPORARY 01521 FENCING-GATES 6,500.00 6,500.00 0.00 0.00 6,500.00 100.00% 0.00 650.00 TEMPORARY FENCING- 01522 SCREENING 8,744.00 8,744.00 0.00 0.00 8,744.00 100.00% 0.00 874.40 TEMPORARY 01523 BARRIERS-M 6,800.00 6,800.00 0.00 0.00 6,800.00 100.00% 0.00 680.00 01524 TEMPORARY 7,500.00 7,500.00 0.00 0.00 7,500.00 100.00% 0.00 750.00 AlA Document G703" -1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 4 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO % FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED (0_C) APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) BARRIERS-L _ TEMPORARY 01530 ENCLOSURES-M 10,800.00 10,800.00 0.00 0.00 10,800.00 100.00% 0.00 1,050.00 TEMPORARY 01531 ENCLOSURES-L 14,000.00 14,000.00 0.00 0.00 14,000.00 100.00% 0.00 1,360.00 SCAFFOLDING- SET UP/CONSUMABLE 01540 S 398,000.00 395,200.00 2,800.00 0.00 398,000.00 100.00% 0.00 37,620.00 SCAFFOLDING- MONTHLY RENTAL/INSPECTI 01541 ONS 228,000.00 123,500.00 19,000.00 0.00 142,500.00 62.50% 85,500.00 10,450.00 SCAFFOLDING- DISMANTLE/REM 01542 OVE 55,000.00 0.00 0.00 0.00 0.00 0.00% 55,000.00 0.00 STAIR TOWERS- 01543 SETUP 54,000.00 18,000.00 0.00 0.00 18,000.00 33.33% 36,000.00 1,800.00 STAIR TOWERS- MONTHLY 01544 RENTAL 28,500.00 5,500.00 2,000.00 0.00 7,500.00 26.32% 21,000.00 350.00 STAIR TOWERS- 01545 DISMANTLE 6,700.00 0.00 0.00 0.00 0.00 0.00% 6,700.00 0.00 HOIST-EXTERIOR- 1546.1 SET UP 17,000.00 0.00 0.00 0.00 0.00 0.00% 17,000.00 0.00 HOIST-EXTERIOR- RENTAL/OPERATE 1546.2 ON 242,500.00 0.00 0.00 0.00 0.00 0.00% 242,500.00 0.00 HOIST-EXTERIOR- 1546.3 DISMANTLE 5,500.00 0.00 0.00 0.00 0.00 0.00% 5,500.00 0.00 HOIST-STAIR2-SET 1547.1 UP 17,000.00 0.00 0.00 0.00 0.00 0.00% 17,000.00 0.00 AlA Document G703 T'A-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 5 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION DATE (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) HOIST-STAIR 2- RENTAL/OPERATI 1547.2 ON 242,500.00 0.00 0.00 0.00 0.00 0.00% 242,500.00 0.00 HOIST-STAIR 2- 1547.3 DISMANTLE 5,500.00 0.00 0.00 0.00 0.00 0.00% 5,500.00 0.00 HOIST-ROOM 100- 1548.1 SET UP 95,000.00 95,000.00 0.00 0.00 95,000.00 100.00% 0.00 9,500.00 HOIST-ROOM 100- RENTAL/OPERATI 1548.2 ON 211,000.00 176,250.00 6,500.00 0.00 182,750.00 86.61% 28,250.00 16,975.00 HOIST-ROOM 100- 1548.3 DISMANTLE 2,500.00 0.00 0.00 0.00 0.00 0.00% 2,500.00 0.00 HOIST- ALLOWANCE-SET 1549.1 UP 75,000.00 0.00 0.00 0.00 0.00 0.00% 75,000.00 0.00 HOIST- ALLOWANCE- RENTAL/OPERATI 1549.2 ON 88,000.00 0.00 0.00 0.00 0.00 0.00% 88,000.00 0.00 HOIST- ALLOWANCE- 1549.3 DISMANTLE 2,500.00 0.00 0.00 0.00 0.00 0.00% 2,500.00 0.00 01556 TRASH CHUTES-M 52,000.00 46,100.00 1,200.00 0.00 47,300.00 90.96% 4,700.00 4,490.00 01557 TRASH CHUTES-L 58,000.00 29,500.00 4,500.00 0.00 34,000.00 58.62% 24,000.00 2,500.00 GENERAL CLEAN 01560 UP-M 5,000.00 3,140.00 300.00 0.00 3,440.00 68.80% 1,560.00 314.00 GENERAL CLEAN 01561 UP-L 60,000.00 35,600.00 4,000.00 0.00 39,600.00 66.00% 20,400.00 3,560.00 01562 FINAL CLEANING 65,000.00 0.00 0.00 0.00 0.00 0.00% 65,000.00 0.00 EXCAVATIONBA 02110 CKF1LL-SUMPS-M 12,019.00 12,019.00 0.00 0.00 12,019.00 100.00% 0.00 1,201.90 02111 EXCAVATIONBA 25,000.00 25,000.00 0.00 0.00 25,000.00 100.00% 0.00 2,500.00 AIA Document G7O3TM-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects,All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 6 prosecuted to the maximum extent possible under the law.This document was produced by AM software at 11:24:44 on 11/13/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (CT_C) FINISH (IF VARIABLE APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) CKFILL-SUMPS-L EQ _ 02240 SHORING 209,800.00 209,800.00 0.00 0.00 209,800.00 100.00% 0.00 20,980.00 CAST IN PLACE 03301 CONCRETE-M 12,000.00 10,000.00 2,000.00 0.00 12,000.00 100.00% 0.00 1,000.00 CAST IN PLACE 03302 CONCETE-L 40,000.00 35,000.00 5,000.00 0.00 40,000.00 100.00% 0.00 3,500.00 PRECAST PLANKS-12" 03410 HOLLOW CORE 161,000.001 161,000.00 0.00 0.00 161,000.00 100.00% 0.00 16,100.00 PRECAST PLANKS-12" 03411 SOLID 898,000.00 898,000.00 0.00 0.00 898,000.00 100.00% 0.00 89,800.00 PRECAST 03412 PLANKS-6"SOLID 107,000.00 107,000.00 0.00 0.00 107,000.00 100.00% 0.00 10,700.00 PRECAST 03413 TRUCKING 82,000.00 82,000.00 0.00 0.00 82,000.00 100.00% 0.00 8,200.00 PRECAST 03414 ERECTION 186,000.00 186,000.00 0.00 0.00 186,000.00 100.00% 0.00 18,600.00 INTERIOR METAL FABRICATIONS- 05504 SUBMITTALS 102,000.00 102,000.00 0.00 0.00 102,000.00 100.00% 0.00 10,200.00 STEEL STAIRS 05505 WITH RAIL-M 179,000.00 179,000.00 0.00 0.00 179,000.00 100.00% 0.00 14,857.00 STEEL STAIRS 05506 WITH RAIL-L 80,000.00 73,000.00 0.00 0.00 73,000.00 91.25% 7,000.00 6,600.00 05507 LADDERS-M 26,000.00 26,000.00 0.00 0.00 26,000.00 100.00% 0.00. 2,600.00 05508 LADDERS-L 12,500.00 12,200.00 300.00 0.00 12,500.00 100.00% 0.00 1,220.00 CATWALK 05509 FRAMING-M 63,000.00 63,000.00 0.00 0.00 63,000.00 100.00% 0.00 6,300.00 CATWALK 05510 FRAM NG-L 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00% 0.00 1,710.00 AM Document G703'"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 7 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D 1 E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (G_C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) MISCELLANEOUS 05511 METALS-M 441,000.00 136,150.00 124,400.00 0.00 260,550.00 59.08% 180,450.00 13,615.00 MISCELLANEOUS 05512 METALS-L 275,000.00 83,350.00 78,900.00 0.00 162,250.00 59.00% 112,750.00 8,095.00 INTERIOR ROUGH 06100 CARPENTRY-M 31,000.00 8,520.00 1,800.00 0.00 10,320.00 33.29% 20,680.00 372.00 INTERIOR ROUGH 06101 CARPENTRY-L 44,000.00 11,140.00 2,500.00 0.00 13,640.00 31.00% 30,360.00 484.00 FOUNDATION WATERPROOFING 07110 -M 5,100.00 5,100.00 0.00 0.00 5,100.00 100.00% 0.00 510.00 FOUNDATION WATERPROOFING 07111 -L 6,600.00 6,600.00 0.00 0.00 6,600.00 100.00% 0.00 660.00 07210 DUCT LINERS-M 97,000.00 97,000.00 0.00 0.00 97,000.00 100.00% 0.00 9,700.00 07211 DUCT LINERS-L 28,000.00 20,000.00 8,000.00 0.00 28,000.00 100.00% 0.00 1,120.00 07810 FIRESTOPP1NG-M 24,000.00 16,800.00 0.00 0.00 16,800.00 70.00% 7,200.00 1,680.00 07811 FIRESTOPPING-L 16,000.00 12,200.00 0.00 0.00 12,200.00 76.25% 3,800.00 1,220.00 JOINT SEALANTS- 07910 M 35,000.00 0.00 0.00 0.00 0.00 0.00% 35,000.00 0.00 JOINT SEALANTS- 07911 L 80,000.00 0.00 0.00 0.00 0.00 0.00% 80,000.00 0.00 STEEL DOORS& -.. 08110 FRAMES-M (73,000.00 71,500.00 0.00 0.00 , 71,500.00 97.95% 1,500.00 6,230.00 STEEL DOORS& 08111 FRAMES-L 6-3,000A 18,050.00 6,500.00 0.00 24,550.00 74.39% 8,450.00 825.00 FLUSH WOOD 08140 DOORS-M 39,0050 780.00 0.00 0.00 780.00 2.00% 38,220.00 78.00 FLUSH WOOD 08141 DOORS-L : 15,000.00 0.00 0.00 0.00 0.00 0.00% 15,000.00 0.00 ' STILE&RAIL 08143 WOOD DOORS-M 127,000.00 0.00 0.00 0.00 0.00 0.00% 127,000.00 0.00 AIA Document G703TM-1992.Copyright©196 , 1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 8 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. - User Notes: (1429823795) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS ED T BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO % FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED (G_C) APPLICATION (NOT IN D OR E) DATE (C -G) RATE) (D+E) (D+E+F) STILE&RAIL 08144 WOOD DOORS-L 34,000.00 2,540.00 0.00 0.00 ('2,540.00 7.47% 31,460.00 254.00 SOUND CONTROL DOORS& 08347 WINDOWS-M " 32,000.00 9,000.00 0.00 0.00 o;9,000.00 2.56% 343,000.00 900.00 SOUND CONTROL DOORS& 08348 WINDOWS-L 050,000.00) 0.00 0.00 0.00 0.00 0.00% 50,000.00 0.00 OVER COILING - 08355 DOORS-M (20,750.00 0.00 0.00 0.00 0.00 0.00% 20,750.00 0.00 OVERHEAR 08356 COILING DOORS-L 2,850.00 0.00 0.00 0.00 f 0.00 0.00% 2,850.00 0.00 ALUM.FRAMED / ENTRANCES/STOR / , 08410 EFRONTS-M C---- --7-'\)176,000.00 29,520.00 0.00 0.00 29,520.00 16.77% 146,480.00 352.00 ALUM.FRAMED --�� ENTRANCES/STOR 08411 EFRONS-L ( 0.00 0.00 0.00 t 0.00 0.00% 69,700.00 0.00 IN TERIOR ALUM. DOORS& 08413 FRAMES-M Q7,000.00 340.00 0.00 0.00 340.00 2.00% 16,660.00 34.00 INTERIOR ALUM. DOORS& 08414 FRAMES-L 6,000.00 ? 0.00 0.00 0.00 0.00 0.00% 6,000.00 0.00 REVOLVING DOOR 08423 ENTRANCES-M " 69,000.00 1,380.00 0.00 0.00 1,380.00 2.00% 67,620.00 138.00 REVOLVING DOOR 08424 ENTRANCES-L ( 9,500.00 0.00 0.00 0.00 0.00 0.00% 9,500.00 0.00 GLAZED ALU,. CURTAIN WALLS- 08440 M 325,000.00 142,000.00 5,000.00 0.00 147,000.00 45.23% 178,000.00 11,375.00 AIA Document G703" -1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 9 prosecuted to the maximum extent possible under the law.This document was produced by AlA software at 11:24:44 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY PREVIOUS AND STORED TO FINISH (IF VARIABLE NO. WORK VALUE THIS PERIOD STORED DATE (G_C) (C-G) RATE) APPLICATION (NOT IN D OR E) (D+E) _ (D+E+F) MENT HYDRAULIC ELEVATOR- 14243 LABOR 63,000.60 - 63,000.00 0.00 0.00 63,000.00 100.00% 0.00 6,300.00 WHEELCHAIR • LIFT- MATERIAL/EQUIP 14421 MENT (48,000.00' 0.00 0.00 0.00 0.00 0.00% 48,000.00 0.00 WHEELCHAIR 14422 LIFT-PERMITS (2,200.00 0.00 0.00 0.00 0.00 0.00% 2,200.00 0.00 WHEELCHAIR 14423 LIFT-LABOR 0.00) 0.00 0.00 0.00 0.00 0.00% 14,000.00 0.00 CHANGE ORDER 17001 NO. 01 228,000.00 228,000.00 0.00 0.00 228,000.00 100.00% 0.00 450.00 CHANGE ORDER 17002 NO. 02 9,031.00 9,031.00 0.00 0.00 9,031.00 100.00% 0.00 0.00 CHANGE ORDER 17003 NO.03 2,196.00 300.00 0.00 0.00 300.00 13.66% 1,896.00 30.00 17000 CHANGE ORDER 4 NO. 04 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 17000 CHANGE ORDER 5 NO.05 98,741.00 98,741.00 0.00 0.00 98,741.00 100.00% 0.00 9,874.10 17000 CHANGE ORDER 6 NO.06 17,527.00 17,527.00 0.00 0.00 17,527.00 100.00% 0.00 1,400.00 17000 CHANGE ORDER 7 NO. 07 11,292.00 11,292.00 0.00 0.00 11,292.00 100.00% 0.00 1,129.20 17000 CHANGE ORDER 8 NO. 08 44,936.00 44,936.00 0.00 0.00 44,936.00 100.00% 0.00 4,493.60 17000 CHANGE ORDER 9 NO.09 14,683.00 14,683.00 0.00 0.00 14,683.00 100.00% 0.00 0.00 17001 CHANGE ORDER 0 NO. 10 -760,330.00 0.00 0.00 0.00 0.00 0.00% -760,330.00 0.00 AIA Document G703" -1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be 11 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) GLAED ALUM. CURTAIN WALLS- 08441 L 148,000.00 0.00 6,000.00 0.00 6,000.00 4.05% 142,000.00 0.00 08710 HARDWARE 525,000.00 446,000.00 0.00 0.00 446,000.00 84.95% 79,000.00 18,800.00 INTERIOR 08810 GLAZING-M 11,000.00 220.00 0.00 0.00 220.00 2.00% 10,780.00 22.00 INTERIOR 08811 GLAZ1NG-L 8,000.00 0.00 0.00 0.00 0.00 0.00% 8,000.00 0.00 FIRE PROTECTION 10440 SPECIALTIES-M 7,580.00 0.00 0.00 0.00_ 0.00 0.00% 7,580.00 0.00 FIRE PROTECTION 10441 SPECIALTIES-L 1,800.00 0.00 0.00 0.00 0.00 0.00% 1,800.00 0.00 10450 KNOX BOX 650.00' 0.00 0.00 0.00 0.00 0.00% 650.00 0.00 LOADING DOCK 11130 EQUIPMENT-M 18,500.00 16,475.00 0.00 0.00 16,475.00 89.05% 2,025.00 1,647.50 LOADING DOCK 11131 EQUIPMENT-L 3,800.00 2,200.00 0.00 0.00 2,200.00 57.89% 1,600.00 220.00 ELEC.TRACTION ELEVATORS- 14210 ENGINEERING ' 157,200.0 V 157,200.00 0.00 0.00 157,200.00 100.00% 0.00 15,720.00 ELEC.TRACTION ELEVATORS- MATERIAL/EQUIP 14211 MENT 452,000. './ 452,000.00 0.00 0.00 452,000.00 100.00% 0.00 40,000.00 ELEC.TRACTION 00' / 14212 ELEVATORS-L 06,000.0(;)1 36,000.00 22,000.00 0.00 58,000.00 31.18% 128,000.00 0.00 HYDRAULIC ELEVATOR- 14241 ENGINEERING (69,500.00 69,500.00 0.00 0.00 69,500.00 100.00% 0.00 6,950.00 HYDRAULIC ELEVATOR- 14242 MATERIAL/EQUIP 183,000.00 183,000.00 0.00 0.00 183,000.00 100.00% 0.00 18,300.00 A1A Document G703TM-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be 10 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:24:44 on 11/13/2009 under Order No.0754240912 1 which expires on 05/10/2010,and is not for resale. User Notes: (1429823795) 419/4 A :„.....,... IA Document 702/C a" ® 1 992 `5` Kamso %v/ c // , o j' i CT Application and Certificate for Payment Construction Manager-Adviser Edisto .. pp Y g Edit tor �`�on� i 54'6 3s TO OWNER: Carmel Redevelopmt Comm PROJECT: Parcel 7A,#4050 CPA APPLICAfi� NO:018 ' Distribution to: One Civic Square 777 3rd Ave. S.W. 4: OWNER:X Carmel,IN 46032 Cannel,IN 46032 PERIOD TO:October 009,O CONSTRUCTION MANAGER:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:May 0 , 008 ARCHITECT:X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 CONTRACTOR:X Anderson,IN 46018 FIELD: CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued anf iayments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown herein is now due / 2.NET CHANGE BY CHANGE ORDERS $ 426,406.00 CO•` .• irr LEI/. DU • pON, 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,661,406.00 By:" '1j. /sue — !/ Date: October 15,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 7,189,216.00 Stat- of:Indiana / 5.RETAINAGE: County of:Madiso a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 633,070.30 me this' 15th day of October 2009 6/ b. 0 %of Stored Material Notary Public:Martha A.Carpenter;? /G�2 , 1 (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 633,070.30 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 6,556,145.70 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 6,053,399.70 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 0� 8.CURRENT PAYMENT DUE $ 502,746.00 AMOUNT CERTIFIED $ S(U r�2 N(9 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied Initial all figures on this Application an: on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 6,105,260.30 CONSTRUCTIO M• •AG- :• By: 4 /�- i__ Date: /0. r()•n _ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC ,.F Total changes approved in previous months by Owner $ 426,406.00$ 0.00 By: i � �. Date: `� '2,*(2)A Total approved this Month $ 0.00 $ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 426,406.00 $ 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 426,406.00 AIA Document G702/CMah—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 09:45:55 on 10/19/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1652114775) 1AIA Document 7021 aTM ® 19 2 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#4050 CPA APPLICATION NO:017 Distribution to: Comm 777 3rd Ave. S.W. OWNER:X One Civic Square Cannel,IN 46032 PERIOD TO:September 30,2009 CONSTRUCTION MANAGER:X Cannel,IN 46032 P FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:May 08,2008 ARCHITECT:X PO Box 2247 CONTRACTOR:X CONTRACTOR: MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD: Anderson,IN 46018 CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and .e, ents received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 Payment shown herein is ;,: due. 2.NET CHANGE BY CHANGE ORDERS $ 426,406.00 CO td r" W ',1_■ .. to.,IN, C 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,661,406.00 B Date: September 15,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 6,686,470.00 St., . :Indiana aill0": 5.RETAINAGE: County of:Madison a. 5 %of Completed Work Subscribed and sworn to before (Column D+E on G703) $ 633,070.30 me this 15th dayof September, 2009 b. 0 %of Stored Material Notary Public:Martha A. Carpenter //A' &�, (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 633,070.30 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 6,053,399.70 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 5,450,298.30 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 603,101.40 AMOUNT CERTIFIED $ (903 1 V d .4 0 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 6,608,006.30 CONSTRUCTIO MA AGER: By: le.,E .._.G Date: C/ • 5'c,. a 0.,cl CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE T: Total changes approved in previous months by Owner$ 411,723.00$ 0.00 By: ��r �, Date: 10 �� Total approved this Month $ 14,683.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 426,406.00$ 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 426,406.00 AIA Document G702/CMaTu—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 13:57:38 on 09/18/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1800950123) .\ C,, Document G7021C a TM ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#4050 CPA APPLICATION NO:016 Distribution to: Comm. 777 3rd Ave. S.W. OWNER:X One Civic Square Carmel,IN 46032 PERIOD TO:August 31,2009 CONSTRUCTION MANAGER:X Cannel,IN 46032 ARCHITECT:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:May 08,2008 CONTRACTOR:X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD: Anderson,IN 46018 CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO ARCHITECTS OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have bee paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued an/% • ents eceived from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 p•""' - ' r ew due 2.NET CHANGE BY CHANGE ORDERS $ 411,723.00 ONT' • •R: W f DU_ 'ON, . i C. 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,646,723.00 B •�� '—�� � Date: August 19,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 6,055,887.00 - •te of:Indiana 5.RETAINAGE: County of:Madison a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 605,588.70 me this 19th. day of August, 009 f J b. 0 %of Stored Material Notary Public:Martha A.Carpenter!, '-alc it! � 1-/` '-� uL✓ (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 605,588.70 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 5,450,298.30 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 4,861,764.90 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMO (Line 6 from prior Certificate) CERTIFIED. A, r►. 8.CURRENT PAYMENT DUE $ 588,533.40 AMOUNT CERTIFIED $ ;t 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figure on this Application a on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 7,196,424.70 CONSTRUCT! N M By: Date: g Lg. zon CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT r Total changes approved in previous months by Owner $ 411,723.00$ 0.00 By: , ! ':-� Date: 1.6 +'' Total approved this Month $ 0.00 $ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 411,723.00$ 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 411,723.00 AIA Document G702/CMaTM-1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible j under the law.This document was produced by AIA software at 08:35:55 on 08/19/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1951354188) ,... lii/ a Document 6702/CMa TM 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#4050 Carmel APPLICATION NO: 015 Distribution to: Commission Performing Arts OWNER:X One Civic Square 777 3rd Ave. S.W. PERIOD TO:July 31,2008 CONSTRUCTION MANAGER:X Cannel,IN 46032 Carmel,IN 46032 ARCHITECT:X FROM W.R. Dunkin&Son,Inc. VIA CONSTRUCTION SI ILl SEXTON CO.,INC. CONTRACT DATE:May 08,2008 CONTRACTOR:X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD: Anderson,IN 46018 CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO ARCHITECTS OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 paym• - , ere ?•w due. 2.NET CHANGE BY CHANGE ORDERS $ 411,723.00 ONT'14- •-: 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,646,723.00 : Date: "7/7Z/07 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 5,401,961.00 State of: k i 5.RETAINAGE: County of: 0(.) „----i a. 10 %of Completed Work Subscribed and sworn to b forte (Column D+Eon G703) $ 540,196.10 me this "c;,1...)-- day of, 0 3.0-C) b. 0 %of Stored Material Notary Public: C .).�..IN, • _ (Column F on G703) $ 0.00 My Commission expires: hj t.Jl,A..r /6-i I.S.-- Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 540,196.10 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 4,861,764.90 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 4,585,055.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 276,709.90 AMOUNT CERTIFIED $ 276,709.90 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied Initial all figures on this Applicatio .and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 7,784,958.10 CONSTRUC 10 A4y,ER: By: _I Date: 9',24 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHI r• CT Total changes approved in previous months by Owner $ 337,968.00$ 0•00 . 7%3\' A BY� �_� • _,. ti Date: k0 ...tea-�_. Total approved this Month $ 73,755.00$ 0.00 This • rtificat:_-:•: of negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 411,723.00$ 0.00 nam- . ssuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 411,723.00 AIA Document G702/CMaT"—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 09:02:27 on 07/22/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1782860110) 1 - � Document G702/CMaTM ® 19 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:014 Distribution to: Commission Performing Arts Center-BP #4050 OWNER:X One Civic Square 777 3rd Ave. S.W. Cannel,IN 46032 Carmel,IN 46032 PERIOD TO:June 30,2009 CONSTRUCTION.MANAGER:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHEIL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT:X CONTRACTOR: PO Box 2247 MANAGER: CONTRACTOR:X Anderson,IN 46018 PROJECT NOS:25310/2695-4050/2695 FIELD: CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO ARCHITECTS OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have bee aid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issu-I and yments re -' -d from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown •- -in i/%ow d • 2.NET CHANGE BY CHANGE ORDERS T' ` r $ 337,968.00 'T � •R: / D ON, INC),„---' 3.CONTRACT SUM TO DATE(Line 1+2) $ 12,572,968.00 Byj`g Date: 6/17/09 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 5,094,506.00 : • e of:INDIANA 5.RETAINAGE: County of: • I••r, / a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 509,451.00 me this 17th day of June, 2 09 b. 0 %of Stored Material Notary Public:Martha A. Carpenter ' 4-.-, (Column F on G703) $ 0.00 My Commission expires:January 08, 017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 509,451.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 4,585,055.00 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 4,185,933.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 399,122.00 AMOUNT CERTIFIED $ 399,122.00 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application a • on the • tinuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 7,987,913.00 fit/ CONSTRUCT •N M., AG r. By: ti,-,7i. .:� Date: 6,2.6•zCO•7 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: 141 Total changes approved in previous months by Owner $ 239,227.00$ 0.00 By: 'I / Date: Total approved this Month $ 98,741.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 337,968.00$ 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 337,968.00 AIA Document G702/CMan,—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 08:31:50 on 06/18/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (2035632746) *AIA Document G702IC aTM - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,CPA-BP #4050 APPLICATION NO:013 Distribution to: Corn. 777 3rd Ave. S.W. One Civic Square Carmel,IN 46032 OWNER:X Carmel,IN 46032 PERIOD TO:May 31,2009 CONSTRUCTION MANAGER:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT:X CONTRACTOR: PO Box 2247 MANAGER: CONTRACTOR:X Anderson,IN 46018 PROJECT NOS:25310/2695-4050/2695 FIELD: CONTRACT FOR: BP-#4050 General Trades VIA ARCHITECT: CSO ARCHITECTS OTHER: • CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have b�.ti , my the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235 000.00 payment show ere now t 2.NET CHANGE BY CHANGE ORDERS $ 239,227.00 C• p,'R: ! ■ i n nc. j1 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,474,227.00 : _�'' Date: May 18,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 4,651,037.00 $ . - of:Indi. ... 5.RETAINAGE: County of:Madison a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 465,104.00 me this 18th day of May, 21109 411% i b. 0 %of Stored Material Notary Public:Martha A.Carpenter''t/ie.4/1La 4. _I L . (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 465,104.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 4,185,933.00 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their T.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 3,921,597.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) /ERTIFIED. 09„ 8.CURRENT PAYMENT DUE $ 264,336.00 AMOUNT CERTIFIED $ 2,(CAI` 3� � 1, 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this $ Application. don the ontinuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 8,288,294.00 CONSTRUCT •N .•NA BY ;,, . i._ Date: Ste. Z°� 29 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT T: a!l Total changes approved in previous months by Owner $ 239,227.00$ 0.00 !� � •l By: r„ — Date: t�t Total approved this Month $ 0.00 $ 0.00 This 4tificate is -6-i negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 239,227.00 $ 0.00 na •d herein. a uance, payment and acceptance of payment are without prejudice to any rights of the •wner s• ontractor under this Contract. NET CHANGES by Change Order $ 239,227.00 -" AIA Document G702/CMa""'—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 12:56:24 on 05/19/2009 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1651208524) 4. A TM - 1992 Mira Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:012 Distribution to: Commission Performing Arts Center-BP #4050 OWNER: One Civic Square 777 3rd Ave.S.W. Cannel,IN 46032 Cannel,IN 46032 PERIOD TO:April 30,2009 CONSTRUCTION MANAGER:El ARCHITECT:El FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 CONTRACTOR:El CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD:❑ Anderson,IN 46018 CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER:❑ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document 0703,is attached. Certificates for Payment were issued and r.;r'" ents received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 Payment shown herei is now due. 2.NET CHANGE BY CHANGE ORDERS $ 239,227.00 C VII' W '� 40P • 0 . 3.CONTRACT SUM TO DATE(Line 1 ±2) $. 12,474,227.00 By. Date: April 15,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 4,357,330.00 S e of:Indiana 5.RETAINAGE: County of:Madison a. 10 %of Completed Work Subscribed and sworn to before (Column D+E on G703) $ 435,733.00 me this 15TH day of APRIL ' 0 b. 0 %of Stored Material Notary Public:Martha A.Carpenter f4./t 6/1/4b6,,zZel., (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 435,733.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 3,921,597.00 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 3,310,890.30 knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. CO I CD 1 --zrar .7j V 0.0 8.CURRENT PAYMENT DUE $ 610,706.70 J AMOUNT CERTIFIED $4144-1 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application an, on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 8,552,630.00 CONSTRUCTIO MA. •G• r By: l 1 /► Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE own/ Total changes approved in previous months by Owner$ 228,000,00$ 0.00 By: _Age' �_ Date: 1►• Total approved this Month $ 11,227.00$ 0.00 This 'ertific.•negotiable. The AMOUNT CERTIFIED is payable o. y to t e Contractor TOTALS $ 239,227.00$ 0.00 n.-led h- -in. Issuance,payment and acceptance of payment are without prejudice to any rights of e I••ner or Contractor under this Contract. NET CHANGES by Change Order $ 239,227.00 AIA Document G702/CMaTU-1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 09:20:24 on 04/15/2009 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (40356142) 4030 r� Document 6702/COVOarM 1992 r:.„.. m Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:011 Distribution to: Commission Performing Arts Center-BP #4050 OWNER:El One Civic Square 777 3rd Ave.S.W. PERIOD T0:March 31,2009 CONSTRUCTION MANAGER: Cannel,IN 46032 Cannel,IN 46032 ARCHITECT: FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 CONTRACTOR: CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD:❑ Anderson,IN 46018 CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER:❑ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have b-=n paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued an* *ay ceived from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown herein' ow du- 2.NET CHANGE BY CHANGE ORDERS $ 228,000.00 CONT'ct''sf`: ��'� II ' ■ .' S'4 NC. 3.CONTRACT SUM TO DATE(Line 1 +2) $ 12,463,000.00 B /`+�. .., Date: March 18,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 3,678,767.00 S. e of:Indiana /r 5.RETAINAGE: County of:Madison a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 367,876.70 me this 18th day of Marc 0G� � b. 0 %of Stored Material Notary Public:Martha A.Carpenter / 41 (Column F on G703) $ 0.00 My Commission expires:January 07,2017 / Total Retainage(Lines 5a+Sb or Total in Column I of G703) $ 367,876.70 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 3,310,890.30 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,822,595.30 knowledge,information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. �� 1O® 8.CURRENT PAYMENT DUE $ 488,295.00 AMOUNT CERTIFIED $ 1 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this / Application a , on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 9,152,109.70 Uw CONSTRUCTI• MA. •G By: i �. :. Date: 3.2-7 2-Od G] CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: l� Total changes approved in previous months by Owner $ 228,000.00$ 0.00 By: Date: ` 31 . 6 1 Total approved this Month c!S payable only$ 0.00$ 0.00 This Ce . . ne otrable e AMOUNT CERTIFIED is a able onl to the Contractor named ,--• i. Issuance, payment and acceptance of payment are without prejudice to any rights of TOTALS $ 228,000.00$ 0.00 the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 228,000.00 AIA Document G702/CMaTM—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 11:37:05 on 03/18/2009 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (2418624802) 64,02/.04 ® TM ::-W Document G702/CMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:010 Distribution to: Commission Performing Arts Center OWNER: One Civic Square 777 3rd Ave.S.W. PERIOD TO:February 28,2009 CONSTRUCTION MANAGER: Carmel,IN 46032 Carmel,IN 46032 ARCHITECT: El FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 CONTRACTOR: IZI CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD: ❑ Anderson,IN 46018 CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER: ❑ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts h. e been paid by the Contractor for Work for which previous Continuation Sheet,MA Document G703,is attached. Certificates for Payment were issues .nd ,. , ents received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown here'. ' now d e. 2.NET CHANGE BY CHANGE ORDERS $ 228,000.00 C• ' & SON INC._AM 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 12,463,000.00 By: / Date: February 18,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 3,136,217.00 Stati:f.`'Indiana 5.RETAINAGE: County of:Madison / a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 313,62.1.70 me this 18th day of Februar // 2009 b. 0 %of Stored Material Notary Public:Martha A.Carpenter Ll�dG=- / /lam ,wp, (Column F on G703) $ 0.00 My Commission expires:January 07,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 313,621.70 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,822,595.30 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,356,505.10 knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. �[ r- Zg 8.CURRENT PAYMENT DUE $ 466,090.20 AMOUNT CERTIFIED "[�Wr0 l0 44440- 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 9,640,404.70 CONSTRUCTION MANAGER: By: _ rii—r�: Date: -2i 2G(03 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner $ 228,000.00$ 0.00 Total approved this Month By: �� '`�7 Date: Z'2� '0� PP $ 0.00$ 0.00 This Certificate is of ne:•iable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 228,000.00$ 0.00 named herein. I uanc- payment and acceptance of payment are without prejudice to any rights of the Owner or •ontr.• or under this Contract. NET CHANGES by Change Order $ 228,000.00 AIA Document G702/CMa TM-1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 15:38:31 on 02/18/2009 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (3453170488) \� y TM Document G702/C a — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Cannel Regional APPLICATION NO:009 Distribution to: Commission Performing Arts Center Eg One Civic Square 777 3rd Ave.S.W. OWNER: Cannel,IN 46032 Carmel,IN 46032 PERIOD TO:January 31,2009 CONSTRUCTION MANAGER: El VA FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT: CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS: CONTRACTOR: 25310/2695-4050/2695 Anderson,IN 46018 FIELD:❑ CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER: ❑ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts ha • been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issue,`n• pa ents received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown herein' now due. /, 2.NET CHANGE BY CHANGE ORDERS $ 228,000.00 CO. •': -.i •• , /D4 . .ON INC. 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 12,463,000.00 : : i jZ:/��� Date: January 19,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,618,339.00 St. . :Indi.1. /_ -i 5.RETAINAGE: County of:Madison a. 10 %of Completed Work Subscribed and sworn to before o �i (Column D+Eon G703) $ 261,833.90 me this 19TH day of JANUAR/LY �/ 2G��Gt l.�c b. 0 %of Stored Material Notary Public:Martha A.Carpenter (Column F on G703) $ 0.00 My Commission expires:January 07,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 261,833.90 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,356,505.10 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,042,957.70 knowledge,information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE 1-$ 313,547.40 AMOUNT CERTIFIED $313,547.40 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this 1 ,/ Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 10,106,494.90 \' l/ CONSTRUCTION MANAGER: so By: VIII Date: ,)z 10 9 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: '. Total changes approved in previous months by Owner $ 0.00 $ 0.00 By: / Date: / 710/Cart Total approved this Month $ 228,000.00 $ 0.00 This Certificat . no%E egotiabl e AMOUNT CERTIFIED is payable on to the Contractor ' TOTALS $ 228,000.00 $ 0.00 named herei• ssu•;.'e, payment and acceptance of payment are without prejudice to any rights of the Owne ., C.,• 'actor under this Contract. NET CHANGES by Change Order $ 228,000.00 AIA Document G702/CMaTM-1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA5 Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 09:54:46 on 01/19/2009 under Order No.1000358892 1 which expires on 6/3/2009,and is not for resale. User Notes: — (2153912158) WIP .41. P4 AI A MEM Document 6702/CaTM — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,Cannel Regional APPLICATION NO:008 Distribution to: Commission Performing Arts Center OWNER: CEI One Civic Square 777 3rd Ave.S.W. PERIOD TO:December 31,2008 CONSTRUCTION MANAGER: El Carmel,IN 46032 Carmel,IN 46032 ARCHITECT: El FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 CONTRACTOR: CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 Anderson,IN 46018 FIELD: ❑ CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER:❑ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts hay' been ..id by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued .nd :. •nts received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown • ei• is no •1 2.NET CHANGE BY CHANGE ORDERS $ 0.00 Alibi; ..4 11 : /R I 0 4, INC. 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 12,235,000.00Lfddiari�� / Date: 12/15/08 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,269,953.00 St• e of:INDIAN• / 5.RETAINAGE: County of:MADISON a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 226,995.30 me this 15th day of December, 2001 ? b. 0 %of Stored Material Notary Public:MARTHA A.CARPENTER/,d/c? M. c ?'-7.ti (Column F on G703) $ 0.00 My Commission expires:January 08,2009 t%` Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 226,995.30 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,042,957.70 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,453,178.70 knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE 1$ 589,779.00 AMOUNT CERTIFIED $ s t A 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this it Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) '4- $ 10,192,042.30 CONSTRUCTION MANAGER: a By: '._!a` Date: j2/2Zlg CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT ' ' Total changes approved in previous months by Owner $ 0.00$ 0.00 12.22.0. By: ... _ .-.-..., Date: Total approved this Month $ 0.00$ 0.00 This Certific not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00$ 0.00 named he • .r`,suance ,payment and acceptance of payment are without prejudice to any rights of the Ow ; Contractor under this Contract. NET CHANGES by Change Order $ 0.00 AIA Document G702/CMan"—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 10:35:37 on 12/17/2008 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (1183730205) A1 Document 6702/C a" - 19 92 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:007 Distribution to Commission Performing Arts Center OWNER:B One Civic Square 777 3rd Ave.S.W. PERIOD TO:November 30,2008 CONSTRUCTION MANAGER:B Cannel,IN 46032 Cannel,IN 46032 ARCHITECT: B FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 CONTRACTOR:B CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 Anderson,IN 46018 FIELD: CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER: Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information anc belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued ••d payments received from the Owner, and that curren 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown herein is;ow d _ / 2.NET CHANGE BY CHANGE ORDERS $ 0.00 CONT-..,s;- n 1 i& .O'C. 3.CONTRACT SUM TO DATE(Line 1 f 2) $ 12,235,000.00 By.���y V Date: 11/17/08 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,614,643.00 Sta o :INDIANA 5.RETAINAGE: County of:MADI oN a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 161,464.30 me this 17th day of November, 200 / ,. ,'U _.i b. 0 %of Stored Material Notary Public:MARTHA A.CARPENTER 7/(47,72,..4.-", ( at..- 6-'-c-, (Column F on G703) $ 0.00 My Commission expires:January 08,2009 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 161,464.30 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,453,178.70 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of then 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,018,535.40 knowledge, information and belief the Work has progressed as indicated, the quality of the Work it in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 434,643.30 AMOUNT CERTIFIED $434,643.30 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 10,781,821.30 CONSTRUCTION MANAGER: ,I • By �� ' Date: viz [e CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: 11 6/ Total changes approved in previous months by Owner $ 0.00$ 0.00 By: � Date: !Zit Total approved this Month $ 0.00$ 0.00 This Certific • is r . g P Y otiable. The AMOUNT CERTIFIED is ayable onl to Le Contractor TOTALS $ 0.00 $ 0.00 named he a. Is • ce, payment and acceptance of payment are without prejudice to any rights of the Own: or .ntractor under this Contract. NET CHANGES by Change Order $ 0.00 AIA Document G702/CMaN—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA° Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 10:09:50 on 11/17/2008 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (1041027486) • UMW AIA Document G7O2/ TM C a — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:006 Distribution tt Commission Performing Arts Center OWNER: One Civic Square 777 3rd Ave.S.W. PERIOD TO:October 31,2008 CONSTRUCTION MANAGER:E Carmel,IN 46032 Carmel,IN 46032 FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT: CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 CONTRACTOR:£ Anderson,IN 46018 FIELD: [ CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS • OTHER:[ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information an belief the Work covered by this Application for Payment has been completed in accordance with d Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have '.-n paid by the Contractor for Work for which previot Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued .i/payments received from the Owner, and that currel 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment •• • , ein 'ow d ,. 2.NET CHANGE BY CHANGE ORDERS $ 0.00 C. -.,iR: W Dun• in • •n, 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 12,235,000.00 i � Date: 10/20/08 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,131,706.00 St e of: Indian. i -----N+5.RETAINAGE: County of: adi on a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 113,170.60 me this 20th day of October, 2008�G2 /�� b. 0 %of Stored Material Notary Public: Martha A. Carpenter (Column F on G703) $ 0.00 My Commission expires: 1/08/09 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 113,170.60 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,018,535.40 In accordance with the Contract Documents, based on on-site observations and the data comprisin (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner,that to the best of the 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 962,808.30 knowledge,information and belief the Work has progressed as indicated, the quality of the Work in accordance with the Contract Documents, and the Contractor is entitled to payment of tt (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 55,727.10 AMOUNT CERTIFIED $ 55,727.10 Ni 9.BALANCE TO FINISH,INCLUDING RETAINAGE .J (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 11,216,464.60 CONSTRUCTION MANAGER: . By: 114a� Date: /0 •z ,o,,, CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: I Total changes approved in previous months by Owner $ 0.00 $ 0.00 By ' ' Date: t!l! 3' Total approved this Month $ 0.00 $ 0.00 This Certificate is not negotiable. The AMOUNT CER'T'IFIED is payable only to t e Contract( TOTALS $ 0.00 $ 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights ( the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 0.00 AIA Document G702/CMan,—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 08:32:55 on 10/20/2008 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. • User Notes: (2267689668) =' AIA Document G702/CMaTM ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:005 Distribution to: Commission Performing Arts Center OWNER:El One Civic Square 777 3rd Ave.S.W. PERIOD TO:September 30,2008 CONSTRUCTION MANAGER:El Cannel,IN 46032 Cannel,IN 46032 ARCHITECT: El FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHE1L SEXTON CO.,INC. CONTRACT DATE:May 08,2008 CONTRACTOR: ®: CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 FIELD: ❑ Anderson,IN 46018 CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER: ❑ Trades - CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and p.., ents received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 Pa "-_. .!• )/ now due 2.NET CHANGE BY CHANGE ORDERS $ 0.00 (CONT' • aR: , R. unk' . : o 0111.n.rc. 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 12,235,000.00 :y_:41105 ��:i�� / _ Date: 9/16/08 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,069,787.00 : a e of:Indiana API"- - 5.RETAINAGE: County of: 'adis,.n a. 10 %of Completed Work Subscribed and s om to before (Column D+Eon G703) $ 106,978.70 me this 16th day of September/n1 ���� /�9 b. 0 %of Stored Material Notary Public:Martha A.Carpenter sibt,C.lL�. (- (Column F on G703) $ 0.00 My Commission expires:January 08,2009 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 106,978.70 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 962,808.30 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 908,478.90 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE a$ 54,329.40 AMOUNT CERTIFIED $ ti 3� 1.Of t 1 9.BALANCE TO FINISH,INCLUDING RETAINAGE v (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) j (Line 3 less Line 6) $ 11,272,191.70 CONSTRUCTION MANAGER: By: "fit -.._ . Date: 9/Z g �'�' # 111 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: .i' Total changes approved in previous months by Owner $ 0,00$ 0.00 By: �f � _ _ Date: loll T) Total approved this Month $ 0.00$ 0.00 This -rtifica of negotiable. The AMO CERTIFIED is payable only to he Contractor TOTALS $ 0.00 $ 0.00 n. •-d here'•. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owne or Contractor under this Contract. NET CHANGES by Change Order $ 0.00 AIA Document G702/CMan"—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 14:29:39 on 09/16/2008 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (3083591914) ea " ��. Document G702ICMaTM — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,Cannel Regional APPLICATION NO:004 Distribution to: Commission Performing Arts Center OWNER:EI One Civic Square 777 3rd Ave.S.W. PERIOD TO:August 31,2008 CONSTRUCTION MANAGER: Cannel,IN 46032 Cannel,IN 46032 g FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT: CONTRACTOR: PO Box 2247 MANAGER: CONTRACTOR: Anderson,IN 46018 PROJECT NOS:25310/2695-4050/2695 FIELD: ❑ CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER:❑ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts hav, been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued d payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown her-' '. now d 2.Net change by Change Orders $ 0.00 C s,�na W/D S C. 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,235,000.00 Pf�j/yj��prr j= Date: August 18,2008 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,009,421.00 S . e . :Indian. / 5.RETAINAGE: County of:Madis•I a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 100,942.10 me this 18th day of Au us 8 b. 0 %of Stored Material Y g �� ( i �i✓ Notary Public:Martha A.Carpenter (Column F on G703) $ 0.00 My Commission expires:January 08,2009 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 100,942.10 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 908,478.90 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 800,864.10 knowledge,information and belief the Work has progressed as indicated, the quality of the Work.is in accordance with the Contract Documents, and the Contractor is entitled to payment ,9 the (Line 6 from prior Certificate) AMOUNT CER'T'IFIED. 8.CURRENT PAYMENT DUE $ 107,614.80 AMOUNT CERTIFIED $ IV7M ` I/ 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this 5------ Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 11,326,521.10 CONSTRUCTION MANAGER: 8 By: 'tA� Date: O 1290G n� CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC : /", 66L Total changes approved in previous months by Owner $ 0.00$ 0.00 i! ./�o By: a' Date: � G- 1 -es Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERI'lh'ihD is payable only to the Contractor TOTALS $ 0.00$ 000 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order $ 0.00 AIA Document G702/CMaTm—1992.Copyright ©1992 by The American Institute of Architects. All rights reserved. WARNING:This AIA6'Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it;may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law. This document was produced by AIA software at 14:40:32 on 08/18/2008 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (286157438) tit* Document G792IC ar" - 1992 c1r.+ Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,Carmel Regional APPLICATION NO:003 Distribution to: Commission Performing Arts Center El One Civic Square 777 3rd Ave.S.W. OWNER: Carmel,IN 46032 Cannel,IN 46032 PERIOD TO:July 31,2008 CONSTRUCTION MANAGER:lEI FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT:El CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/2695-4050/2695 CONTRACTOR: Anderson,IN 46018 FIELD:❑ CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER:❑ Trades CONTRACTOR'S APPLICATION'FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Pa I. nt were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown he a is now due. 2.Net change by Change Orders $ 0.00 CONTRACTOR: ,• R Du in;)So:t , Inc. 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,235,000.00 By: 14, Date: 7/17/08 4.TOTAL COMPLETED&STORED TO DATE Column G on G703 ( G703) $ 889,849.00 State of:Indiana / 5.RETAINAGE: County of:Madison a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 88,984.90 me this 17th day of July, 2008/ /y / b. 0 %of Stored Material //� / (Column F on Stored Notary Public:Martha A.Carpenter ( G703) $ 0.00 My Commission expires:January 08,2009 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 88,984.90 CERTIFICATE FOR PAYMENT • 6.TOTAL EARNED LESS RETAINAGE $ 800,864.10 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 461,557.80 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment ofth (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 339,306.30 2 AMOUNT CERTIFIED $ 391 (0 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 11,434,135.90 CONSTRUCTION MANAGER: r —3.� By: _ ,.ins t�. Date: D • CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: kir - .Total changes approved in previous months by Owner $ 0.00$ 0.00 By: , ' Date: 0. Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTLFl.ED is payable only o the Contractor TOTALS $ 0.00$ 0.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order $ 0.00 AIA Document G702/CMaTu—1992.Copyright ©1992 by The American Institute of Architects. All rights reserved. WARNING:This AIAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and crimin penalties,and will be prosecuted to the maximum extent possible 1 under the law. This document was produced by AIA software at 15:01:44 on 07/17/2008 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (2317098277) _ . ,,,p, ... A.....,......„...AI • Document G7921CMa" - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,Cannel Regional APPLICATION NO:002 Distribution to: Commission Performing Arts Center OWNER:EI One Civic Square 777 3rd Ave.S.W. PERIOD TO:June 30,2008 CONSTRUCTION MANAGER:El Cannel,IN 46032 Cannel,IN 46032 El FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHELL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT: CONTRACTOR: PO Box 2247 MANAGER: CONTRAC TOR : Anderson,IN 46018 PROJECT NOS:25310/2695-4050/2695 FIELD:❑ CONTRACT FOR: Bid Package#4050-General VIA ARCHITECT: CSO ARCHITECTS OTHER:❑ Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued . d payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 payment shown h- i Ino . e. 2.Net change by Change Orders $ 0.00 CONT+_cy : Du 1/ & ' on, Inc . 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,235,000.00 rigg0Eiag.- l/ � — r Date: 06/18/08 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 512,842.00 S .-- o.Indiana 5.RETAINAGE: County of:Madiso I a. 10 %of Completed Work Subscribed and sw.rn to before (Column D+Eon G703) $ 51,284.20 me this].8th day of June 2 b. 0 %of Stored Material Notary Public:Martha A.Carpenter;�� (Column F on G703) $ 0.00 My Commission expires:January 08,2009 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 51,284.20 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 461,557.80 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 254,545.20 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE 1$ 207,012.60 AMOUNT CERTIFIED $ 2,07,®t2 ADO 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 11,773,442.20 CONSTRUCTION MANAGER: By: i jr` Date: ____4,/,7.r_____2 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner$ 000$ 000 B '°'r By: / Date: Total approved this Month $ 0.00$ 0.00 This Certifica e 1 not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor i 05 TOTALS $ 0.00$ 000 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order $ 0.00 AIA Document G702/CMaTI —1992.Copyright ©1992 by The American Institute of Architects. All rights reserved. WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law. This document was produced by AIA software at 14:29:35 on 06/18/2008 under Order No.1000358892_1 which expires on 6/3/2009,and is not for resale. User Notes: (2277787975) ke -I'= D ocument 6702/CMarM ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment Com PROJECT: Parcel 7A,Cannel Regional APPLICATION NO:001 Distribution to: One Civic Square Performing Arts Center OWNER:El Cannel,IN 46032 Cannel,IN 46032 PERIOD TO:May 13,2008 CONSTRUCTION MANAGER:El FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION SHElL SEXTON CO.,INC. CONTRACT DATE:May 08,2008 ARCHITECT: CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310/08-385/2695 CONTRACTOR: Anderson,IN 46018 FIELD:❑ CONTRACT FOR: Bid Package#4050 VIA ARCHITECT: CSO ARCHITECTS OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for P"yment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 12,235,000.00 Payment show 1- ein is now due. 2.Net change by Change Orders $ 0.00 CONTRACTO•: R I d•'N & tI N, INC. 3.CONTRACT SUM TO DATE(Line 1±2) $ 12,235,000.00 By: if - / '' ,, _ Date: May 20,2008 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 282,828.00 State of:INDIAN:r r 5.RETAINAGE: County of:MADISON a. 10 %of Completed Work Subscribed and sworn to before � (Column D+Eon G703) $ 28,282.80 me this 20th day of May,,e���2:t a_ / b. 0 %of Stored Material Notary Public:Martha A.Carpenter � (Column F on G703) $ 0.00 My Commission expires:January 08,2009 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 28,282.80 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 254,545.20 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 0.00 knowledge,information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 254,545.20 AMOUNT CERTIFIED $254,545.20 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 11,980,454.80 CONSTRUCTION MANAGER: By: INN CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT. `_ Date: �28�0� Total changes approved in previous months by Owner$ 0.00$ 0.00 I'% By: Date: CQ 21pt1 Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00$ 0.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order $ 0.00 AIA Document G702/CMaTM'—1992.Copyright ©1992 by The American Institute of Architects. All rights reserved. WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law. This document was produced by AIA software at 11:54:18 on 05/20/2008 under Order No.1000345948 1 which expires on 3/1/2009,and is not for resale. User Notes: (4006491689) 0 o Document 6702/C�Ma - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A Regional APPLICATION NO: 14 Distribution to: Comm. Performing Arts Center PERIOD TO: ,12-31-2009 OWNER ❑ One Civic Square Carmel, IN 46032 CONSTRUCTION MANAGER gi FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6-20-2009 ARCHITECT ❑ SimplexGrinnell LP Shiel Sexton Co. PROJECT NOS: 2695 / 4280 / CONTRACTOR ❑ 11820 Pendleton Pike Indianapolis, IN VIA ARCHITECT: FIELD ❑ 46236 CSO Architects CONTRACT FOR: Auto Fire Protection ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered:by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment ere issued and paymen s received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $615. 359. 00 payment shown herein is ye w due. 2.Net change by Change Orders $ 4-,601. 00 CONTRACTO.• ,. 3.CONTRACT SUM TO DATE(Line 1±.2) $619 , 960.00 By: / Date: 12-14-2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $498 , 327 .00 State of:Ind Tana Michae . M. 'MacDonald 5.RETAINAGE: County of:Marion a. 5 %of go,in il,itid/\}/gfl/Contract Value Subscribed and sworn to before (Column D+Eon G703) $ 30, 998 . 00 me this 14 tlOy v De c esnbe 20'0'9 b. %of Stored Material Notary Public: 'zGcL — Gt -2-' (Column F on G703) $ 0 . 00 My Commission expires: L //,2 —e5,? -- a 0 e7 9 Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 30 ,998 . 00 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 467 , 329 . 00 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 390 , 364 . 00 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. I_ � 8.CURRENT PAYMENT DUE $ 76,965 . 00 AMOUNT CERTIFIED $ �(X 4 11605°1 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet a are changed to conform with the amount certified.) (Line 31ess Line 6) $1 S2 ,611 . 00 CONST-UCTION G By: 1�i ���u. .. Date: 4449, U EDCTIONS CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: ►, Total changesapproved.in previous months by Owner $4, 601 . 0 $ 0 .00 By: I L,d . _. Date: 01 Total approved this Month $ 0 . 0 $ 0.. 00 This Certificate is not.negotiable. The AMO ER'1'IFJED is payable only to t e Contractor TOTALS $4 , 601 . 0 $ 0 .00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 4, 601-. 00 the Owner or Contractor under this Contract: CAUTION:You should sign an original AIA Contract Document,on.which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702/CMaTM—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. N SimplexGrinnell DETAIL AND CONTINUATION SHEET 0 ° APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 14 o containing Contractor's signed Certification,is attached CARMEL PERFORMING ARTS APPLICATION DATE: 12/15/2009 °o In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 12/31/2009 15► Use Column I on Contracts where variable retainage for line items may apply. PROJECT NO.: 2695-4280 A - B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE APPLICATION THIS STORED AND STORED % TO (IF VARIABLE) (D+E) PERIOD (NOT IN TO DATE (G+C) FINISH RATE D ORE) (D+E+F) (C-G) 30050 Plenum Level $17,179.00 $17,179.00 $0.00 $0.00 $17,179.00 100% $0.00 $0.00 30060 Orchestra Low Level $26,620.00 $26,620.00 $0.00 $0.00 $26,620.00 100% $0.00 $0.00 30070 Orchestra High Level $15,012.00 $13,510.00 $1,502.00 $0.00 $15,012.00 100% $0.00 $0.00 30080 Box Tier Level $31,572.00 $9,471.00 $11,050.00 $0.00 $20,521.00 65% $11,051.00 $0.00 30090 Balcony Low Level $16,328.00 $0.00 $0.00 $0.00 $0.00 0% $16,328.00 $0.00 a 30100 Balcony High Level $34,822.00 $31,340.00 $3,482.00 $0.00 $34,822.00 100% $0.00 $0.00 30110 Attic 50 ft Level $4,333.00 $0.00 $0.00 $0.00 $0.00 0% $4,333.00 $0.00 30120 Attic 66 ft.Level $9,673.00 $0.00 $0.00 $0.00 $0.00 0% $9,673.00 $0.00 30130 Attic 80 ft.level $15,554.00 $0.00 $0.00 $0.00 $0.00 0% $15,554.00 $0.00 >4 w ALLOWANCE $50,000.00 $0.00 $0.00 $0.00 0% $50,000.00 $0.00 vi cn CHANGE ORDERS $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 Change Order 1 RFQ 006 $4,601.00 $4,601.00 $0.00 $4,601.00 100% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 o M .-i co TOTALS $619,960.00 $421,362.00 $76,965.00 $0.00 $498,327.00 80% $121,633.00 $0.00 c C• M SimplexGrinnell 11820 Pendleton Pike,Indianapolis,IN 46236 C U., CD mr rn 0 0 N Ln .-1 N .--1 Fit-AIA @ R � T MOM Document 6702/C a TM 1992 ° � NOV 1 7 2009 Application and Certificate for Payment Construction Manager-Adviser Edition i BYmingoomvussi TO OWNER:Carmel Redevelopment PROJECT: Parcel 7A Regional APPLICATION N0: 13 Distribution to: Comm. Performing Arts Center PERIODIC): 11/30/2009 OWNER ❑ One Civic Square Carmel, IN 46032 CONSTRUCTION MANAGER FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6/20/2008 ARCHITECT ❑ SimplexGrinnell Shiel Sextion Co. PROJECT NOS: I I CONTRACTOR ❑ 11820 Pendleton Pike 2695 4280 Indianapolis, I VIA ARCHITECT: FIELD ❑ CONTRACT FOR: 4236 CSO Architects ❑ Auto Fire Protection CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615, 359 . 00 payment shown herein's no due. 2.Net change by Change Orders $ 4 , 601 . 00 CONTRACT°•• ) / 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 619 9 6.0 . 0 0 By: ^(/1✓Y Date: 11-16-2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ State of: Michael?M MacDonald ( ) 421, 3'62 . 00 5.RETAINAGE: County of:Iariona — • a. 5 %of(jo/ti/,l�tXdp/4.1/Contract Value Subscribed and sworn to before I PAULA Public-ic-Seal I (Column D+Eon G703) $ 30 , 998 . 00 1 Notary of Indiana naal 1 me this 16th of Nov/e�be 2 0 0 9 , State of Indiana 1 b. %of Stored Material Notary Public !\ 0 My Commission Expires Aug 12,2017 (Column F on G703) $ 0 - 00 My Commissi n expires: _i • Total Retainage(Lines 5a+5b or Total in Column I of G703). $ 30 , 998 . 00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ In accordance with the Contract Documents, based on on-site observations and the data comprising 390 , 364_ 00 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 342 , 069 . 30 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. [�Q ry 8.CURRENT PAYMENT DUE $ 48 , 294 . 70 AMOUNT CERTIFIED $ —I V 129 q . 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fr.• the amount applied.Initial all figures on this Application and on the Continuation Sheet t • e changed to conform with the amount certified.) (Line 3 less Line 6) $ 2 2 9 , 5 9 6. 0 0 CONST•` CTION '� A// R: 0-40 By: w.'., ,.eL_�v -� Date: 9 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT �� Total changes approved in previous months by Owner $ 4 , 601 $ 0 By: IrA Date: \ 3 W1 Total approved this Month $ 0 $ 0 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 4 , 601 $ 0 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 4 601 . 00 the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text.appears in RED.An original assures that changes will not be obscured. AIA Document G7021CMaTM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA` Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. Simplex Grinnell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 13 containing Contractor's signed Certification, is attached. CARMEL PERFORMING ARTS APPLICATION DATE: 11/16/2009 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 11/30/2009 Use Column I on Contracts where variable retainage for line items may apply. PROJECT NO.: 2695-4280 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE APPLICATION THIS STORED AND STORED % TO (IF VARIABLE) (D+E) PERIOD (NOT IN TO DATE (G=C) FINISH RATE D OR E) (D+E+F) (C-G) 10000 ADMINISTRATION 10010 Bonds&Insurance $4,380.00 $4,380.00 $0.00 $0.00 $4,380.00 100% $0.00 $0.00 10020 Permits&Fees $500.00 $500.00 $0.00 $0.00 $500.00 100% $0.00 $0.00 10030 Submittals $20,307.00 $20,307.00 $0.00 $0.00 $20,307.00 100% $0.00 $0.00 10040 Drarwing&Drafting Srvices $33,638.00 $33,638.00 $0.00 $0.00 $33,638.00 100% $0.00 $0.00 10050 As Built Drawing Conversion to CAD $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 $0.00 10060 Mobilization $17,910.00 $17,910.00 $0.00 $0.00 $17,910.00 100% $0.00 $0.00 20000 MATERIAL 20010 Underground $2,229.00 $2,229.00 $0.00 $0.00 $2,229.00 100% $0.00 $0.00 20020 Fire Pump $35,920.00 $35,920.00 $0.00 $0.00 $35,920.00 100% $0.00 $0.00 20030 Standpipe $13,218.00 $9,914.00 $0.00 $0.00 $9,914.00 75% $3,304.00 $0.00 20040 Basement $32,772.00 $32,772.00 $0.00 $0.00 $32,772.00 100% $0.00 $0.00 20050 Plenum Level $13,310.00 $13,310.00 $0.00 $0.00 $13,310.00 100% $0.00 $0.00 20060 Orchestra Low Level $18,977.00 $18,977.00 $0.00 $0.00 $18,977.00 100% $0.00 $0.00 20070 Orchestra High Level $12,010.00 $12,010.00 $0.00 $0.00 $12,010.00 100% $0.00 $0.00 20080 Box Tier Level $21,950.00 $21,950.00 $0.00 $0.00 $21,950.00 100% $0.00 $0.00 20090 Balcony Low Level $12,800.00 $0.00 $0.00 $0.00 $0.00 0% $12,800.00 $0.00 20100 Balcony High Level $23,900.00 $23,900.00 $0.00 $0.00 $23,900.00 100% $0.00 $0.00 20110 Attic 50 ft. Level $5,600.00 $0.00 $0.00 $0.00 $0.00 0% $5,600.00 $0.00 20120 Attic 66 ft Level $8,805.00 $0.00 $0.00 $0.00 $0.00 0% $8,805.00 $0.00 20130 Attic 80 ft Level $12,335.00 $0.00 $0.00 $0.00 $0.00 0% $12,335.00 $0.00 20140 Pre-action Detection $15,984.00 $0.00 $0.00 $0.00 $0.00 0% $15,984.00 $0.00 30000 INSTALLATION 30010 Underground $3,714.00 $3,714.00 $0.00 $0.00 $3,714.00 100% $0.00 $0.00 30020 Fire Pump $12,381.00 $1,238.00 $9,905.00 $0.00 $11,143.00 90% $1,238.00 $0.00 30030 Standpipe $17,024.00 $11,066.00 $0.00 $0.00 $11,066.00 65% $5,958.00 $0.00 30040 Basement $49,602.00 $49,602.00 $0.00 $0.00 $49,602.00 100% $0.00 $0.00 . t. Simplex Grinnell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 13 containing Contractor's signed Certification, is attached. CARMEL PERFORMING ARTS APPLICATION DATE: 11/16/2009 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 11/30/2009 Use Column I on Contracts where variable retainage for line items may apply. PROJECT NO.: 2695-4280 A B C D E F G_ H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE APPLICATION THIS STORED AND STORED % TO (IF VARIABLE) (D+E) PERIOD (NOT IN TO DATE (G+C) FINISH RATE D OR E) (D+E+F) (C-G) 30050 Plenum Level $17,179.00 $17,179.00 $0.00 $0.00 $17,179.00 100% $0.00 $0.00 30060 Orchestra Low Level $26,620.00 $26,620.00 $0.00 $0.00 $26,620.00 100% $0.00 $0.00 30070 Orchestra High Level $15,012.00 $9,011.00 $4,499.00 $0.00 $13,510.00 90% $1,502.00 $0.00 30080 Box Tier Level $31,572.00 $0.00 $9,471.00 $0.00 $9,471.00 30% $22,101.00 $0.00 30090 Balcony Low Level $16,328.00 $0.00 $0.00 $0.00 $0.00 0% $16,328.00 $0.00 30100 Balcony High Level $34,822.00 $13,930.00 $17,410.00 $0.00 $31,340.00 90% $3,482.00 $0.00 30110 Attic 50 ft Level $4,333.00 $0.00 $0.00 $0.00 $0.00 0% $4,333.00 $0.00 30120 Attic 66 ft.Level $9,673.00 $0.00 $0.00 $0.00 $0.00 0% $9,673.00 $0.00 30130 Attic 80 ft.level $15,554.00 $0.00 $0.00 $0.00 $0.00 0% $15,554.00 $0.00 ALLOWANCE $50,000.00 $0.00 $0.00 $0.00 0% $50,000.00 $0.00 CHANGE ORDERS $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 Change Order 1 RFQ 006 $4,601.00 $0.00 $0.00 $0.00 0% $4,601.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 TOTALS $619,960.00 $380,077.00 $41,285.00 $0.00 $421,362.00 68% $198,598.00 $0.00 SimplexGrinnell 11820 Pendleton Pike, Indianapolis, IN 46236 SL Subcontract Billing Report For Work Invoiced From 11/01/09 to 11/30/09 Subcontract: 2695-4280 4280 Fire Protection Job: 2695- Carmel-RPAC Construction Vendor: 6242 SIMPLEX GRINNELL LP 777 3rd Ave. SW Carmel,IN 46032 Contract To Date This Period .• Item Units UM Unit Cost Amount Units/°/a Amount Unitsl°/a Amount 1 4280 Fire Protection LS 615,359.00 68.47% 421,362.00 6.71% 41,285.00 Total Contract Items 615,359.00 421,362.00 41,285.00 ***Change Orders*** 2 CCR-1048 RCP-006&Suppl't LS 4,601.00 0.00% 0.00 0.00% 0.00 1 Box Tier catering space rev'ns Total Change Order Items 4,601.00 0.00 0.00 Subcontract Totals: 619,960.00 421,362.00 41,285.00 Total Billings: 421,362.00 41,285.00 Unpaid Retainage: 30,998.00 -7,009.70 Discounts: 0.00 0.00 Net Billings: 390,364.00 48,294.70 98 SSC-CMa Projects Page 1 11/19/09 12:02:07 PM Date Format-MM/DD/YY SLSubBillingReport.rpt 060 _ ®current 7021Ca TM ® 1992 ti � imalba ,. .�; Application and Certificate for Payment Construction Manager-Adviser Edition N.--:-,----\. ,`• �; r)�p� \'' \-f 3 TO OWNER:CARMEL REDEVELOPMENT PROJECT: PARCEL 7A REGIONAL APPLICATION NO: 1.2 `'• . -\Cc, r'' - `Distribution to: COMM. PERFORMING ARTS CENTER ONE CIVIC SQUARE PERIOD T010/31/2009. �ej\` /�✓ OWNER ❑ CARMEL, IN 46032 Y� , INSTRUCTION MANAGER X] FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: f ARCHITECT ❑ SIMPLEXGRINNELL LP SHIEL SEXTON CO. 6/20/2008 11820 PENDLETON P I'KE PROJECT NOS: 2695/ 4 2 8 0 / CONTRACTOR ❑ INDIANAPOLIS, IN VIA ARCHITECT: FIELD ❑ CONTRACT FOR: 4623.6 CSO ARCHITECTS AUTO FIREPROTECTION 4/XRo ❑ _ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payme•t were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $615, 359 . 00 payment shown herein s now due. 2.Net change by Change Orders $ 4 , 601 . 00 CONTRACT /: 3.CONTRACT SUM TO DATE(Line''1 ±2) $619 , 960 . 00 By: i� , Date: —' 2-0 cl 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $1 R 0, 077 _ 00 State of: I 'H'El., M M. MACDOIQALI) t.= 5.RETAINAGE: County of MARION PAULA K.LEWIS > MARION a. 0 %of Completed Work Subscribed and sworn to before Notary Public-Seal )State of Indiana (Column D+Eon G703) $ 38 , 007 . 70 me this 22TH:da of . CTOBE 2009 My Commission Expires'Aug 12,2017 b. %of Stored Material Notary Public: -a A- 4 ö - — .. — - -(Column F on G703) $ 0. 00 My Commissiorf expires: „a _l • Total Retainage(Lines 5a+5b or Total in Column I of G703). $ 38 , 007 . 70 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $142, 069 . 10 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT Q78, 994 . 60 accordance with the Contract Documents,and the Contractor is entitled to payment of.the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 70 8.CURRENT PAYMENT DUE $ 63 , 074 . 70 AMOUNT CERTIFIED $ (e Si 0-14 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial all fgures on this Application and on th• Continuation Sheet that• angecl to conform with the amount certified.) (Line 3 less Line 6) $ -2 7 7 , 8 9 0 .7 0 CONST-.CTION MA PA,—I / BY• iir. &i�7�.o/j=e/._ _i Date: /e15j0 e CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: r Total changes approved.in previous months by Owner $ 4, 601 . 03$ 0 . 0 0 By: Date: I` •Z- 09 Total approved this Month $ 0 . 03$ 0 .0 0 This Certi rcate is not.negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 4 , 6 01 . 0 0 .0 0 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 4 6 01 . 0 0 the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702ICMaTM-1992.Copyright ©1992 by The American Institute of Architects.,All rights reserved.WARNING:This AlA' Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA° Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. *AIA Document G7021CMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A Regional APPLICATION NO: 11 Distribution to: Comm Performing Arts Center PERIODTO; 9/30/2009 • OWNER ❑ One Civic Square CONSTRUCTION MANAGER r Carmel, IN 46032 FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6/20/2008 ARCHITECT ❑ SimplexGrinnell LP Shiel Sexton Co. PROJECT NOS: 2695 / 4280 / CONTRACTOR ❑ 11820 Pendleton Pike Indianapolis, IN VIA ARCHITECT: FIELD ❑ CONTRACT 46236 CSO Architects ❑ ONTRACT FOR: Auto Fire Protection CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered-by this Application for Payment has been completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates.for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615, 359 . 00 payment shown herein is now due. 2.Net change by Change Orders $ 4 ,601 . 0 0 CONTRACTOR:S i • x3ri. - 3.CONTRACT SUM TO DATE(Line I.±2) $ 619 , 9 6 0 .0 0 By: L.�, w Date: 1-IF-0 9 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 309, 9 9 4 .0 0 State of: -ti 4./ , 4 i 5.RETAINAGE: County of: - �,• a. 10 %of Completed Work Subscribed andwo o.before 9 GLORIA)GALLEN (Column D+Eon G703) $ 30,999 . 40 me this /-:� day of S 4;„,,,r- a 7 N(7I ARY PLORI STA LLE OF INDIANA b. %of Stored Material Notary Public: MARION COUNTY (Column F on G703) $ My Commissionntc ' es: MY COMMISSION EXP.'DEG 28,2009 Total Retainage(Lines 5a+5b or Total in Column I of G703). $ 30, 999 . 40 CERTIFICATE FOR P YMENT In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 278 , 994 .60 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge;information and belief the Work-has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 238., 839 . 30 accordance.with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6-from prior Certificate) CERTIFIED. (� 3 8.CURRENT PAYMENT DUE $ 40 , 155 . 30 AMOUNT CERTIFIED $ —/�1 155 ....... 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet '.t are changed to conform with th amount certified.) (Line 3 less Line 6) $ 340 , 965 .40 CON.TRUCTION LAG '. BY: '�.1. ..•'>i. SL/1i�! Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCH r ~ _ • III Total changes approved in previous months by Owner $ 4 , 601 $ By: •4/ ■ Date: IP•f• 01 Total approved this Month $ 0 $ This Certificate is not negotiable. The AMO CERTIFIED is payable only to the Contractor TOTALS $ 4, 6 01 $ named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order . .$ 4 , 601 . 00 the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702ICMaTM—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. � IA TM Document G702/CMa - 1.992: • W Application;and:Certificate for Payment ConstructionManager-Adviser Edition TO;OWNER:'CARMEL REDEVELOPMENT,PROJECT: PARCEL 7A .-REGIONAL APPLICATION NO: 10 Distribution to: COMM:..` PERFORMING ARTS CENTER ONE .CIS7IC SQUARE PERIOD TO: 6/30/2009 OWNER ❑ .CARMEL., IN 46-032 CONSTRUCTION MANAGER XI FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6/20/2008 ARCHITECT ❑ SIMPLEXGRINNELL LP SHIEL SEXTON CO. 11820 PENDLETON PIKE PROJECT NOS: 2695 I 4280 I CONTRACTOR ❑ INDIANAPOLIS, IN 4 6 2 34A ARCHITECT: FIELD ❑ CSO ARCHITECTS CONTRACT.FOR; AUTO.-F,I',RE -PROTECTION ❑ C.ONTRACTOR'S:APPLICATION=FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615 , 359 . 00 payment shown herein is now due. 2:-Net change by Change Orders . $ 4, 60:1 .00 CONTRACTOR: 4---71y 3.CONTRACT.SUM TO DATE(Line'.1 ±:2)' $ 619 , 9 6 0 . 0 0 By: ( /1. Date: JUNE 2 5 , 2 0 0 9 4.TOTAL COMPLETED&STORED ED TO'DATE(Column G on G703) $ 265, 377 . 00 State of: 7 '' V I al ►A 5.RETAINAGE: County of: RI 3 , NOTARY PUBLIC a. 10 %of Completed Work Subscribed and sworn to before PAULA K.LEWIS (Column D+E on G703) $2537 . 70 me this 25 T. +y ofJUNE 20■ 9 STATE OF INDIANA b. %of Stored Material Notary Public: /, �µ„o HAMILTON COUNTY COMMISSION EXPIRES F on G703) $ 0-0-0 My Commissi.n expires: ' _0 PIRES 9-27-09 Total Retainage(Lines 5a+5b or Total'in'Column I of G703). $ 26, 53 7 • 7.0 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and The data comprising 6.TOTAL EARNED LESS RETAINAGE $238 , 839 . 30 this application,the Construction Manager and Architect certify to the Owner that to the best of their - (Line 4-Less Line 5 Total): knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $196 , 153 . 20 accordance rwith the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6-from prior Certificate) CERTIFIED. /� 8.CURRENT PAYMENT DUE $ 42, 68.6 . 10 AMOUNT CERTIFIED $ 41 Z.1 6�(s .jO_. 9.BALANCE TO FINISH,INCLUDING RETAINAGE • (Attach.explanation if amount certified,differs from the amount applied. Initial all figures on this Application and on the Continuation eet that o changed to conform with the amount certified.) (Line 3 less Line 6) $-381 ;120 . 70 CONST' CTION A / BY: �i . w::I L4:_.*_, _! Date: 6/240/92 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHI CT: '. • . Total changes approved in previous months by Owner $4 , 601 $ g PP P Y By: �:ix'.} ::i<,? .. Date: G'�'°�/'en Total approved this Month $ $ This Certificate`'''-di.negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $4, 601 $ named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Chan e'Order $ the Owner or Contractor under this Contract. Y g 4 , 601. 00 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED. An original assures that changes will not be obscured. AIA Document G702/CMaTM—1992.Copyright:©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®' Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA5 Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. - , Document G702/CMaTM 19.92 Application and Certificate for Payment Construction'Manager Adviser Edition TO:OWNER: Carmel .Redevelopment PROJECT: Parcel 7A Regional APPLICATION NO: 9 `'' '';:.. Distribution to: Comm Performing Arts Center PERIOD TO:51311 2 0 0 9 OWNER ❑ On,e.: .Civic Square :;;:: Carmel, IN 46032 CONSTRUCTION MANAGER FROM CONTRACTOR: S imp lexGr inne 1 YIA CONSTRUCTION MANAGER: CONTRACT DATE: 6/2/20/20 as ARCHITECT ❑ 1.1820 Pendleton Pike Shie:l Sexton Co.' PROJECTNOS: 2695 /4:280 / CONTRACTOR ❑ Indianapolis , IN 1E235 VIA A I CT:CSO Architects FIELD ❑- •CONTRACT.-FOR:.Auto Fire Protection . ❑ CONTRACTOR'S.APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has.been completed in accordance with the Contract Documents,that all amounts have been paid by the.Contractor for Work for.which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments•received from the'Owner, and that current 1:ORIGINAL CONTRACT SUM $ 6.15,-3.59 . 00 payment shown herein i ' ow due. 2:Net chan e b Change Orders ._ $ 9 Y 9 4;60.1 . 0`0:CONTRACTOR: 5;; • o - Gririnel, ':' :...' / 3.CONTRACT SUM TO DATE(Line 1 ±:Z) $ 619 , 9 6 0 . 00 By 16- • `L` _ ,ii. Date: may .20 2009 4.TOTAL COMPLETED 4 STORED.TO DATE(Column G on G703) $ 217 , 9 4 8 . 0 0 State of:'Mac. ae M. .c.Dona; • .1 istrict Bus in _s s -Aanager County of:- /it/C�/Atitl' -... . 5.RETAINAGE: i"I ,erON a. 10 %of Completed Work Subscribed an'd sworn to:before- , •NOTARY PUBLIC (Column:D.+E on 0703) $ 21 , 794 . 8'0 me•this 2:0 day;of May 2009, PAULA K.:LEWIS. b. lid':,%of Stored Material Notary Public:./.. ublic:. Q xSTATE OF'INDiANA _ (Column F on G703) $ 0 . 01) My Commission expires:• 9--„2.7—(.1,7 'HAMILTOMCOUNTY "COMMaslo exriRE3,9 7z7 09- Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 21., 7.9'4 . 8 0 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data.comprising 6.TOTAL EARNED LESS RETAINAGE $ 196, 153 . 20 this application, the Construction Manager and Architect certify to the Owner that to the best of their (Line 4.Less Line 5 Total) knowledgeinforniation and:belief-the Work has progressed as indicated,the quality Of the Work is in • 7;LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 168 , 333 . 30 accordance with the Contract Documents,and the Contractor is entitled to payment of the'AMOUNT • (Line 6 from prior Certificate) CERTIFIED. S:CURRENT:PAYMENT DUE $.27 , 819:. 9 0 AMOUNT CERTIFIED $2:719)1 1 9."BALANCE TO FINISH,INCLUDING RETAINAGE. (Attach explanation if amount certified differs f•. .the-anioient:applied.Initial all figures-on this A li.cation and o e Continuation heet t pp .t a„e changed"to conform with the amount certified.) (Line 3 less Line 6) • $ 423 , 806 . 80 CONST' OTION. t A ' e / By. '/. �e -...4, . -• Date: c2 /09 , CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT CT: Total changes a roved:in revious months b Owner $ $ f. g PP ,. .. P Y — '__�°' Date: 0 . 0;.0 0 ..0 0 BY: i" Total approvedthis Month $4 $. 4 , 6 O 1 . 0 0 0`. OD. This ertificate i .■1 ot_:negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ na d herein. • trance,:payment and acceptance of payment are without prejudice to any rights of 4_, 601 . 00 `0'. 00 NET CHANGES by Change Order $ • th :Owner'o . ontractor.under this Contract. Y g 4 ,.6'0:1.. GO CAUTION: You should sign an original AIA Contract Document,on which.this text:appears iii-RED.An:original:assures that changes will not be obscured. AIA.Document.G702/CMaTM-1992.'Copyright ©1992 by The American Institute of.Architects.All rights reserved;WARNING:This AIAe Document is protected by U:S.'Copyright.Law and International Treaties. Unauthorized reproduction or distribution of this Ale Document,or any portion of it;may result in,severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyri,ght'violations of.AIA Contract Documents,e-mail The American Institute of Architects'legal counsel.coovriaht0aia.ora. Ilq) L' II" ir"' '1' 10 N [-) *4i[A. Document T N V,I 0 1 C 11d1a 1992 c'L�j I APR 2 0 2009 ij ,i II Application and Certificate for Payment Construction Manager-Adviser Edition I y4` _ TO OWNER: PROJECT: APPLICATION N0:,8 Distribution to: Carmel Redevelopment • Parcel 7A Performing One Civic Square Arts Center PERIOD TO:April 30,2009 OWNER ❑ Cannel,IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: June 20,2008 ARCHITECT ❑ SimplexGrinnell LP Shiel Sexton Co.,Inc. il 11820 Pendleton Pike PROJECT NOS:2695-4280 CONTRACTOR ❑ Indianapolis,IN 46236 VIA ARCHITECT: FIELD ❑ CSO Architects CONTRACT FOR: Auto Fire Prot ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,ALA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current i. 1.ORIGINAL CONTRACT SUM $ 615 , 359 . 0 Opayment shown herein is ow • . / 2.Net change by Change Orders $ 0 . 0 OCONTRACTOR: / r 3.CONTRACT SUM TO DATE(Line 1±2) $ 615 , 359 . 0 OBY: `7 Date: — "-0 cr 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 187 , 037 . 00Stateof:Michael . MacDonald District Buseidtagez 5.RETAINAGE: County of: Marion WOrARY PUBUC51'ATEOFINDL a. 10 %of Completed Work Subscribed and sworn to before 'MARION COUNTY (Column D+Eon G703) $ 18 ,7 0 2 . 7 0 me this 20 thday of Apri 20o.• pq�(COIuItulISSION EXP.DEC.28,: • b. 10 %of Stored Material Notary Public: 6- / (Column F on G703) $ n _ n n My Commission expires: = -1 1 / �4'. / Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 18 , 703 . 70 CERTIFICATE FOR PAYMEN" In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 168 , 333 . 30 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 105 , 768 . 90 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT • (Line 6 from prior Certificate) CERTIFIED. // (`( �r 8.CURRENT PAYMENT DUE $ 62 , 564 . 40 AMOUNT CERTIFIED $ (" 2.`SL . /j 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 447 , 075 _ 70 CONSTRUCTION MAN. ER: By: Date: ) 09 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: • Total changes approved in previous months by Owner $ 0 . 00 $ 0 . 00 By: - - — Date: 4 Total approved this Month $ 0 . 00 $ 0 . 00 This Certi ••to is no egotiable. The AMOUNT CERTIFIED is payable onl to the Contractor TOTALS $ 0 . 00 $ 0 . 00 named , ein. Iss • ce, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 0 . 00 the 0• er or : tractor under this Contract. AIA Document G702/CMaDA-1992.Copyright ®1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was created at 14:1 1:56 MST on 03/16/2009 under the terms of license number 26001 issued by the American Institute of Architects,and is not for resale.This document is licensed for one time use only and may not be W I'L; LI, '';,1: !! `∎:J ;'_' i t , , , , ., ,, ����� Document 6702/C�la 1992 I tat r �l I L Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO:7 Distribution to: Carmel Redevelopment Parcel 7A Performing One Civic Square Arts Center PERIOD TO:February 28,2009 OWNER ❑ Cannel,IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: June 20,2008 ARCHITECT ❑ Sim lexGrinnell Shiel Sexton Co.,Inc. 1180 Pendleton Pike PROJECT NOS:2695-4280 CONTRACTOR ❑ Indianapolis,IN 46236 VIA ARCHITECT: FIELD ❑ CSO Architects CONTRACT FOR: Auto Fire Prot CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and; Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the:, Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous: Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615, 359 . 0 Opayment shown herein is now . 2.Net change by Change Orders $ 0 . 0 OCONTRACTO 3.CONTRACT SUM TO DATE Line 1 f 2 $ 615 3 5 9. 0 OBy: .it' ''/ U Date: 9, C 4.TOTAL COMPLETED 8.STORED TO DATE(Column G on G703) $ 117 , 521 . 0 OState of Micheal MacDonald 5.RETAINAGE: County of:fnd sworn "i„„f_4_ Xv�•C�.-v B ITARY t UBLIC;a. 1 0%of Completed Work Subscribed and sworn to before PAULA K.LEWIS (Column D+Eon G703) $ 11 , 752 . 10 me this /71V day of ff--7740 STATE OF INDIANA b. 1 (1%of Stored Material Notary Public: i iAMILTON COUNTY (Column F on G703) $ 0 0 0 My Commission expires: l ;,2 7-d7 ;'r. ,_i i SSiON EXPIRES 9-27-q . Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 11, 752 . 10 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $1 0 5 ••768 . 90 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in T.LESS PREVIOUS CERTIFICATES FOR PAYMENT $101 , 256 . 30 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. f c 8.CURRENT PAYMENT DUE $ 4 , 512 .60 AMOUNT CERTIFIED $ 441S1 Ji 2 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $509 , 590 . 10 CONSTRUCTI 0, u� ,AGER: By: --�L_` Date: '2+Z5/Z i9 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner $ $ By: .:. wasiar Date: Z •2.1 * l Total approved this Month $ $ This Certificate is of nego...le. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ named herein. Is ance, f, ent and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or C,ntrac • under this Contract. AIA Document G7021CMaTM—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U,S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was created at 14:00:49 MST on 02/17/2009 under the terms of license number 26001 issued by the American Institute of Architects,and is not for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. __ 4,10 =.,:tf Document 6702/CMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO:6 Distribution to: Cannel Redevelopment PARCEL 7A PERFORMING One Civic Square ARTS CENTER PERIOD TO:January 31 ,2009 OWNER ❑ Carmel,IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: June 20,2008 ARCHITECT ❑ SimplexGrinnell LP SHIEL SEXTON CO.,INC® CONTRACTOR ❑ 11820 Pendleton Pike PROJECT NOS:2695-4280 Indianapolis,IN 4623 VIA ARCHITECT: FIELD ❑ CSO ARCHITECTS ❑ CONTRACT FOR: AUTO FIRE PROT CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Application is Sheet,ALA Document payment,as shown is below,in attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments ceived from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615,359.00 payment shown herein is no due. / 2.Net change by Change Orders $ 0.00 CONTRACTOR: _ 3.CONTRACT SUM TO DATE(Line 1 f 2) $ 615,359.00 By �7_, (��f Date: January 20, „2009 , 4.TOTAL COMPLETED&STORED TO DATE(Column G on 0703) $ 112,507.00 State of: Indiana \ M chae 1 McDonald 5.RETAINAGE: County of:Mar ion ,V CLO�JCALj a. 10 %of Completed Work Subscribed and sworn to before pima p 20th Janu.r 2009 �3 RI So ®Fl (Column D+E on G703) $ 11,250.70 me this day of ) v OM�p /€ b. 1 Q %of Stored Material Notary Public: 2 C 2g 200 (Column F on 0703) $ 0 00 My Commission expires: `1�7e . Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 11,250.70 CERTIFICATE FO• PAYMENT 101 25630 In accordance with the Contract Documents, based on on-site observations and the data comprising . 6.TOTAL EARNED LESS RETAINAGE $ this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 61,515.00 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 744 8.CURRENT PAYMENT DUE $ 39,741.30 AMOUNT CERTIFIED $ E 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this � Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $, 514,102.70 'i CONSTRU0O. 1. ;GER: By: __• ..;1 Date: I r it; CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Date: I� 'f ®'e® .� Total changes approved in previous months by Owner $ 0.00 $ 0.00 By: ` a Total approved this Month $ 0.00 $ 0.00 This Certific. :.;=:: not negotiable. The AMOUNT CERTIFIED is payable :illy to the Contractor TOTALS $ 0.00 $ 0.00 named herei,• 'ssuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 0.00 the Owner o"Contractor under this Contract. AIA Document G702/CMaTM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law:"This document was created at 12:55:17 MST on 01/20/2009 under the terms of license number 26001 issued by the American Institute of Architects,and Is not for resale.This document is licensed for one time use only and may nat'be reproduced prior to its completion. „....... . ____,:,.,..,...„.....,„,..„_,,,:.„:„,„, 1.4-AttAIA Document G702/CMa TM — 1992 DEC 1 3 2006 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO:5 Distribution to: Carmel Redevelopment PARCEL 7A REGIONAL One Civic Square PERFORMING ARTS CENTER PERIOD TO:December 31 ,2008 OWNER ❑ Carmel,IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: June 20,2008 ARCHITECT ❑ Sim lexGrinnell LP Shiel Sexton Co.,Inc. 11820 Pendleton Pike PROJECT NOS:2695-4280 CONTRACTOR ❑ Indianapolis,IN 4623 VIA ARCHITECT: FIELD ❑ CSO Architects CONTRACT FOR: FIREPROTECTION ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $615,359.00 payment shown herein is now due. 2.Net change by Change Orders $ 0.00 CONTRACTOR: G / LP 3.CONTRACT SUM TO DATE(Line 1±2) $615,359.00 By SLi/ (,t f, IFii Date: 12/19/2008 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 68=050.00 State of: err . I)o .1.. "1 • In. GLORIA I G►LLEtN 5.RETAINAGE: County of:1;r, on P1Ji3LiCSTATE®FIIiDL a. 10%of Completed Work Subscribed and .worn o before (Column D+E on G703) $ 6,835.00 me this 19th ,. of Dec mber 2008 ARAR101VC®UNTY b. %of Stored Material Notary Public: - wry EXP•Df 28 (Column F on G703) $ My Commission expires: Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 6,835.00 CERTIFICATE F R PAYME 6.TOTAL EARNED LESS RETAINAGE $ 61,515.00 In accordance with the Contract Documents, based on on-site observations and the data comprising this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 45,602. 10 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 410 8.CURRENT PAYMENT DUE $ 15,912.90 AMOUNT CERTIFIED $ %To mossio 9.BALANCE TO FINISH,INCLUDING RETAINAGE v (Attach explanation if amount certified differs from the amount applied. Initial all gures on this �o Application and on the Continuation Sheet that are changed to conform with the amount certified.) 3 less Line 6) $ 553,844.00,844.00 CONSTRUCT',, i A ,GER: ` CHANGE ORDER SUMMARY ARCHITECT: -Mill Date: j /2L/v� ADDITIONS DEDUCTIONS !! Total changes approved in previous months by Owner $ $ By: �/ `_' _ Date: 1 L4 *04k Total approved this Month $ $ This Certificate •;;,.'ot nego axle. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ named herei uance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or ontractor under this Contract. -- AFA..DocumentG702/CMaTM—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document Is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was created at 08:18:56 MST on 12/19/2008 under the terms of license number 26001 issued by the American Institute of Architects,and is not for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. ==' '=AIA Document G702/C aT" ® ' 992 Application and Certificate for Payment Construction Manager Adviser Edition TO OWNER: PROJECT: APPLICATION NO:4 Distribution to: Cannel Redevelopment PARCEL 7A REGIONAL One Civic Square PERFORMING ARTS CENTER PERIOD TO:November 30,2008 OWNER ❑ Carmel,IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: June 20,2008 ARCHITECT ❑ SimplexGrinnell LP Shiel Sexton Co.,Inc. II 11820 Pendleton Pike PROJECT NOS:, 2695-4280 CONTRACTOR ❑ Indianapolis,IN 46236 VIA ARCHITECT: FIELD ❑ CSO Architects ❑ CONTRACT FOR: FIRE PROTECT CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and • Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the • • Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615,359.00 payment shown here'n is •• due. • 2.Net change by Change Orders $ 0.00 CONTRACT•R: S i 1 • •xG in el LP/ • • 3.CONTRACT SUM TO DATE(Line 1±2) $ 615,359.00 By: - .AgeA. .∎ Date: November 13, 200E 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 50,669.00 State of. 1C 7 = I!C ion.' • , I •- Indiana 5.RETAINAGE: County of:Marion a. 10 %of Completed Work Subscribed and sworn to before GARAAI G LLEN (Column D+Eon G703) $ 5,066.90 me this 13th day of �,�, -mb 20 NOI'ARYFU8ITCSTA EOFI INDIA b. %of Stored Material Notary Public: �� 4 MARIONCOUNTI'Y (Column F on G703) $ My Commission expire• A - MY COMMISSION EXP.DEC.28,2C Total Retainage(Lines 5a+5b or Total in Column I of 0703).. $ 5,066.90 CERTIFICATE FOR PAY NT 6.TOTAL EARNED LESS RETAINAGE $ 45,602. 10 In accordance with the Contract Documents, based on on-site observations and the data comprising this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 3 6,18 2.7 0 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 9,419.40 AMOUNT CERTIFIED $ ginn. 9.BALANCE TO FINISH,INCLUDING RETAINAGE • (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 569,756.90 CONSTRUCTION MANAGER: By: 34.:1• Date: 1/2 et CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner $ $ By: 4/ Date: 12 1 • "b Total approved this Month $ $ This Certifica: s • t1 • ■ • - . -'•TIFIED is payable only to he Contractor TOTALS $ $ named herei•. ssuan payment and acceptance o payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner :r Cont . 'or under this Contract. AIA Document G702ICMaT"-1992.Copyright ®1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was created at 14:32:52 MST on 11/13/2008 under the terms of license number 26001 issued by the American institute of Architects,and Is not for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. 4 10 Document G7021C aT" ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: ',; APPLICATION NO:3 Distribution to: Cannel Redevelopment PERFORMING One Civic Square ARTS CENTER �, PERIOD TO:October 31,2008 OWNER ❑ Cannel,IN 46032 PAW-Gt. i „4, t ,,QOM CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MAN R: .\.4/W , CONTRACT DATE: June 20,2008 ARCHITECT ❑ Sim IexGrinnell LP SHIEL SEXTON CO.,IN ' ' 11820 Pendleton Pike '"' PROJECT NOS:688-6856 CONTRACTOR ❑ Indianapolis,IN 4623 VIA ARCHITECT: FIELD ❑ CSO ARCHITECTS �f/ ❑ CONTRACT FOR: FIRE PROTECT CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Pay',-nt were issued an' payments received from the Owner, and that current .1.ORIGINAL CONTRACT SUM $ 615,359.00 payment shown her:// is now dill/ 2.Net change by Change Orders $ 0.00 CONTRA 08: / Si1 p1e/trin, - 11 LP 3.CONTRACT SUM TO DATE(Line 1±2) $ 615,359.00 By L. -Air- , Date: ()c f. 2n, 2008 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 40,203.00 State,': n'1.. - '1.c - 'c I ona • 5.RETAINAGE: County of: Marion a. 10 %of Completed Work m Subscribed d wor to before 08 (Coital-in D+Eon G703) $ 4,020.30 me this " t" da t .of - b. %of Stored Material Notary Public: (Column F on G703) $ 0.00 My Commission expires;i'.d CP I@ r � LA Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 4,020.30 CERTIFICATE FOR PAYM T vet co oll Eat DECIONO In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 36,182.70 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 33,1 5 5. 10 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. �� 8.CURRENT PAYMENT DUE $ 3,027.60 /AMOUNT CERTIFIED $ 3,021 21 v 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 579,176.30 CONSTRUCTI•, u• .ER: Date: /p /p, By: "�: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: 1 Total changes approved in previous months by Owner $ $ By: ` . Date: (rg Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only o��the Contractor TOTALS $ $ named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or Contractor under this Contract. • A1A Document G702/CMaT"'—1992.Copyright ®1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was created at 13:12:18 MDTon 10/20/2008 under the terms of license number 26001 issued by the American Institute of Architects,and Is not for resale.This document is licensed for one time use only and may not be reproduced prior to Its completion. _ wy, - = Document 6702/C aT" - 1992• Application and Certificate for Payment Construction Manager-Adviser Edition • TO OWNER: PROJECT: APPLICATION NO:2 Distribution to: Carmel Redevelopment C PARCEL 7A PERFORMING One Civic Square ARTS CENTER PERIOD TO:September 30,2008 Cannel,IN 46032 P OWNER ❑ CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: June 20,2008 ARCHITECT ❑ Sim lexGrinnell LP SHIEL SEXTON CO.,INC 11820 Pendleton Pike PROJECT NOS:2695-4280 CONTRACTOR ❑ Indianapolis,IN 4623 VIA ARCHITECT: FIELD ❑ CSO ARCHITECTS CONTRACT FOR: AUTO FIRE PROT ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,A]A Document G703,is attached. Contract Documents,that al amounts have been paid by the Contractor for Work for which previous Certificates for er- sued and payments receive, from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615.359.00 payment shown herein isiw d •. 2.Net change by Change Orders $ 0.00 CONTRACTO•: 3.CONTRACT SUM TO DATE(Line 1±2) $ 615,359.00 By: " �`�f" / / / Date:September 19, 2008 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 36,839.00 State of:. Indiana MICHAEL MACDO 5.RETAINAGE: Marion GLORIA.J CALLEN County of: NOTARY PUi3L.tC STATE OF INDIANA a. %of Completed Work Subscribed and sworn to before MARION COUNTY (Column D+Eon G703) $ 3,683.90 me this 19th day of embe4, 08.� OMMI ION EXP.DEC.28,2::19•b. %of Stored Material Notary Public: //� (Column F on G703) $ 0.00 My Commission expires: -.. i' Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 3,683.90 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ In accordance with the Contract Documents, based on on-site observations and the data comprising 33,155. 10 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 16,374.60 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 16.780.5d AMOUNT CERTIFIED $ 1U ISO 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 582,293.90 CONSTRUCTION AGER: By: Date: Z' CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: (� Total changes approved in previous months by Owner $ 0.00 $ 0.00 By: �/� Date: w I Total approved this Month $ 0.00 $ 0.00 This Certificate ': not egotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00 $ 0.00 named herein ssu.• e, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner• Co• actor under this Contract. MA Document G7021CMaTM-1992,Copyright m 1992 by The American Institute of Architects.AU rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was created at 11:05:31 MDTon 09/18/2008 under the terms of license number 26001 issued by the American Institute of Architects,and is not for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. et, ..VAL; Document 6702/ a - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: 1 Distribution to Cannel Redevelopment C PARACEL 7A PERFORMINHG One Civic Square ARTS CENTER • PERIOD TO:August 31,2008 OWNER ❑ Carmel,IN 46032 CONSTRUCTION MANAGER a FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: June 20,2008 ARCHITECT ❑ Pendleton Pike Sim lexGrinnell LP SHIEL SEXTON CO.,INC 1180 PROJECT NOS:2695.4280 CONTRACTOR ❑ Indianapolis,IN 46236 VIA ARCHITECT: FIELD ❑ CONTRACT FOR: AUTO FIRE PROT CSO ARCHITECTS ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Application is Sheet,made AIA payment, shown is below, Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $615,359.00 payment shown herein is now due, 2.Net change by Change Orders $ 0.00 CONTRACTOR' - p1 ac9 n e A P .. 3.CONTRACT SUM TO DATE(Line l*2) $61.5,359.00 By: t«.e= t//� "Gt_.- Date: 8/20/2008 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 18,19 4.00 State of: d i : O 5.RETAINAGE: Cou of: Ma On GLORIA J CALL EN a. 10 %of Completed Work Subscribed and sworn to before 0TAP.Y f�UI3LtC STATE OF INDIANA yv MP.RIQN COUNTY (Column D+Eon 0703) $ 1.819.40 me this A6Y1)day of �U�U-- / ' ° C OMMISSION EXP.DEC.23,20;7 b. 1.(:):),%of Stored Material Notary Public: - (Column F on G703) $ 0.00 My Commission expires: _� Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 1 .819.40 CERTIFICATE FO PAYMENT 8.TOTAL EARNED LESS RETAINAGE $ 16,374.60 In accordance with the Contract Documents, based on on-site observations and the data comprising this application,the Construction Manager and.Architect certify to the Owner that to the bast of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated;the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 0.00 accordance with the Contract Documents,and t Contractor is entire payment of the AMOUNT (Line 6 from prior Certificate) 16,3 7 y, 1p d CERTIFIED. C o r t'e c..ka. IVA-1 •)•8.CURRENT PAYMENT DUE I $ )...§..,-4-711:6-0. AMOUNT CERTIFIED QmO1c1`+ $ V�Sr� 9.BALANCE TO FINISH,INCLUDING RETAINAGE" _ t / (Attach explanation((amount 0ert(/led differs from the amount applied.Initial a figures on this tlif., Ilpplicatlon and on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 598,984 98 :40 0`—CONSTRU •, A AGER: BY �.2� _ Date: 8// 29/0i CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT:Total changes approved in previous months by Owner $ 0.00 $ 0.00 By: el- Qt I Date: p 1'b e Total approved this Month $ 0.00 $ 0'.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00 $ 0.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 0.00 "'' °°the.,Owne>.or•Contractor under this Contract, 0 AIA Document 0702/CMST"-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and international Treaties. Unauthorized reproduction or distribution of this AIA' Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This ocument was created at 08:26:43 MDTon 08/25/2008 under the terms of license number 28001 Issued by the American institute of Architects,and Is not for resale.This document Is licensed for one time use only and may not be reproduced prior to Its completion, =1171AIA Document G702/C a 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Cannel PROJECT: Cannel Performing Arts Center APPLICATION NO:015 Distribution to: OWNER:❑ PERIOD TO:December 31,2009 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:0 Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM .. $ 4,136,000.00 Payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS $ 172,713.00 CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1 t 2) $ 4,308,713.00 By: Date: /2//S01 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 3,290,133.00 State of:In i 5.RETAINAGE: County of:Hendricks a. 100 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 216,312.30 me this /,S day of bee. ZO:3`t b. 0 %of Stored Material Notary Public:Luke Roseboom /✓(/�-- (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of 0703) $ 216,312.30 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 3,073,820.70 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,937,656.65 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE 1$ 136,164.05 AMOUNT CERTIFIED $ 136,164.05 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs• • the amount applied.Initial all figures on this Application and on the Continuation a et t. • changed to conform with the amount certified.) (Line 3 less Line 6) $ 1,234,892.30 CONS RUCTION tla AG i Date: /7- 2.— 0 9 BY: ��•. �4.. ll CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC : J / Total changes approved in previous months by Owner$ 196,803.00 S 24,090.00 By: __el / I- —- Date: 01 ter Total approved this Month $ 0.00$ 0.00 This .cate is not negotiable. The AMOUNT CERTIFIED is payable only to the ontractor TOTALS $ 196,803.00$ 24,090.00 named herein.Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 172,713.00 AIA Document 0702/Ct#sn,—1992.Copyright O 1992 by The American Institute of Architects.As rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 09:59:11 on 12/15/2009 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (2883765075) CONTINUATION PAGE Page 3 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts \PPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column 1 when variable retainage for line items may apply. PROJECT#s: A B C D E F G H 1 COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 015 AW#16-CAD(BP 4290) $10,000.00 $0.00 $0.00 $0.00 $0.00 0% $10,000.00 $0.00 016 Allowance#16-CAD(BP 4300) $10,000.00 $0.00 $0.00 $0.00 $0.00 0% $10,000.00 $0.00 Mechanical ID 018 Labor $5,100.00 $0.00 $765.00 $0.00 $765.00 15% $4,335.00 $0.00 019 Material $5,100.00 $1,020.00 $2,295.00 $0.00 $3,315.00 65% $1,785.00 $0.00 Firestopping 021 Labor $5,350.00 $3,210.00 $107.00 $0.00 $3,317.00 62% $2,033.00 $160.50 022 Material $5,939.00 $3,563.42 $118.78 $0.00 $3,682.20 62% $2,256.80 $178.18 Housekeeping Pads 024 Labor $1,411.00 $1,411.00 $0.00 $0.00 $1,411.00 100% $0.00 $141.10 025 Material $2,676.00 $2,676.00 $0.00 $0.00 $2,676.00 100% $0.00 $267.61 026 Painting $3,000.00 $2,610.00 $240.00 $0.00 $2,850.00 95% $150.00 $135.00 Sleeves/Core Drill Holes 028 Labor $19,200.00 $17,088.00 $1,152.00 $0.00 $18,240.00 95% $960.00 $1,536.00 I I TOTALS I $761,544.051 $410,788.601 $7,516.481 $0.00 I $418,305.08 ' 55%1 $343,238.971 $32,834.55 I CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 5 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts kPPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C 0 E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 043 Aboveground Waste and Vents(Bulk M $165,426.00 $163,771.74 $0.00 $0.00 $163,771.74 99% $1,654.26 $14,888.34 Aboveground Waste and Vents(Labor) 045 Basement $33,050.00 $26,440.00 $1,652.50 $0.00 $28,092.50 85% $4,957.50 $2,247.40 046 Plenum $17,879.00 $17,879.00 $0.00 $0.00 $17,879.00 100% $0.00 $446.98 047 Orchestra $22,368.00 $16,776.00 $671.04 $0.00 $17,447.04 78% $4,920.96 $559.21 048 Box Tier $18,144.00 $7,257.60 $1,814.40 $0.00 $9,072.00 50% $9,072.00 $453.60 049 Balcony $18,409.00 $1,840.92 $0.00 $0.00 $1,840.92 10% $16,568.08 $92.05 050 Attic $7,121.00 $712.12 $1,068.16 $0.00 $1,780.28 25% $5,340.72 $35.61 051 Aboveground Storm(Bulk Material) $67,165.00 $66,493.36 $0.00 $0.00 $66,493.36 99% $671.64 $6,044.86 Aboveground Storm(Labor) 053 Basement $6,120.00 $6,120.00 $0.00 $0.00 $6,120.00 100% $0.00 $459.00 054 Plenum $365.00 $365.00 $0.00 $0.00 $365.00 100% $0.00 $0.00 055 Orchestra $7,856.00 $5,892.01 $785.60 $0.00 $6,677.61 85% $1,178.39 $314.24 056 Box Tier $3,665.00 $2,748.76 $549.76 $0.00 $3,298.52 90% $366.48 $18.33 I I TOTALS j $1,296,562.051 $865,567.11 I $16,445.941 $0.00 ' $882,013.05 I 68%1 $414,549.001 $71,524.171 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 7 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F _ G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) _ (C-G) RATE) 071 Plenum $19,393.00 $11,635.82 $2,908.96 $0.00 $14,544.78 75% $4,848.22 $232.72 072 Orchestra $26,728.00 $16,036.80 $5,345.60 $0.00 $21,382.40 80% $5,345.60 $320.741 073 Box Tier $18,955.00 $5,686.50 $568.66 $0.00 $6,255.16 33% $12,699.84 $227.46 074 Balcony $17,692.00 $1,769.20 $0.00 $0.00 $1,769.20 10% $15,922.80 $123.84 075 Attic $823.00 $82.32 $0.00 $0.00 $82.32 10% $740.68 $5.76 Incoming Dom.Water Service and Unde 077 Labor $6,864.00 $2,745.60 $0.00 $0.00 $2,745.60 40% $4,118.40 $274.56 078 Material $7,163.00 $7,163.00 $0.00 $0.00 $7,163.00 100% $0.00 $716.30 079 Drains and Cleanouts(Bulk Material) $25,175.00 $25,175.00 $0.00 $0.00 $25,175.00 100% $0.00 $2,517.50 Drains and Cleanouts(Labor) 081 Basement $21,076.00 $21,076.00 $0.00 $0.00 $21,076.00 100% $0.00 $2,107.60 082 Plenum $1,920.00 $1,920.00 $0.00 $0.00 $1,920.00 100% $0.00 $153.60 083 Orchestra $1,320.00 $1,320.00 $0.00 $0.00 $1,320.00 100% $0.00 $118.80 084 Box Tier $3,120.00 $3,120.00 $0.00 $0.00 $3,120.00 100% $0.00 $249.60 I TOTALS I $2,003,203.05 I $1,470,421.01 I $31,121.32 I $0.00 ` $1,501,542.33 I 75%I $501,660.72 I $121,397.52 I CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 9 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 099 Labor $2,858.00 $0.00 $0.00 $0.00 $0.00 0% $2,858.00 $0.00 100 Material $1,220.00 $1,098.00 $0.00 $0.00 $1,098.00 90% $122.00 $109.80 101 Kitchen Connections $6,000.00 $0.00 $0.00 $0.00 $0.00 0% $6,000.00 $0.00 Plumbing Fixtures 103 Labor $54,840.00 $5,484.00 $0.00 $0.00 $5,484.00 10% $49,356.00 $274.20 104 Material $111,082.00 $111,082.00 $0.00 $0.00 $111,082.00 100% $0.00 $11,108.20 Water Heater 106 Labor $4,080.00 $408.00 $0.00 $0.00 $408.00 10% $3,672.00 $20.40 107 Material $62,669.00 $62,669.00 $0.00 $0.00 $62,669.00 100% $0.00 $6,266.90 Water Softener 109 Labor $2,400.00 $0.00 $0.00 $0.00 $0.00 0% $2,400.00 $0.00 110 Material $1,453.00 $0.00 $0.00 $0.00 $0.00 0% $1,453.00 $0.00 Thermostatic Mixing Valves 112 Labor $840.00 $0.00 $0.00 $0.00 $0.00 0% $840.00 $0.00 I I TOTALS I $2,287,719.05_1 $1,686,196.51 1 $31,121.32 I $0.00 1 $1,717,317.83 I 75%1 $570,401.22 1 $142,189.63 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 11 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts \PPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: ' A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 127 Orchestra $26,716.00 $6,679.00 $2,671.60 $0.00 $9,350.60 35% $17,365.40 $0.00 128 Box Tier $25,375.00 $2,537.52 $11,418.76 $0.00 $13,956.28 55% $11,418.72 $0.00 129 Balcony $43,190.00 $4,319.00 $19,435.50 $0.00 $23,754.50 55% $19,435.50 $0.00 130 Attic $13,309.00 $0.00 $665.46 $0.00 $665.46 5% $12,643.54 $0.00 Anchors and Guides 132 Labor $2,880.00 $2,448.00 $0.00 $0.00 $2,448.00 85% $432.00 $172.80 133 Material $1,834.00 $1,834.00 $0.00 $0.00 $1,834.00 100% $0.00 $183.40 134 Miscellaneous Supports $79,294.00 $71,364.60 $1,585.88 $0.00 $72,950.48 92% $6,343.52 $4,757.65 135 Hydronic Specialties $77,660.00 $73,777.00 $0.00 $0.00 $73,777.00 95% $3,883.00 $0.00 HVAC Pumps 137 Labor $6,120.00 $5,936.40 $0.00 $0.00 $5,936.40 97% $183.60 $0.00 138 Material $28,061.00 $28,061.00 $0.00 $0.00 $28,061.00 100% $0.00 $2,806.10 Water Treatment 140 Labor $600.00 $480.00 $30.00 $0.00 $510.00 85% $90.00 $0.00 I I TOTALS I $2,942,975.05 { $2,192,436.73 I $75,747.04 I $0.00 I $2,268,183.77 I 77% $674,791.28 I $168,927.35 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 13 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H 1 COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 156 Fan Coil Connections-Basement $2,057.00 $0.00 $102.86 $0.00 $102.86 5% $1,954.14 $0.00 157 Fan Coil Connections-Orchestra $1,028.00 $0.00 $51.40 $0.00 $51.40 5% $976.60 I $0.00 158 Fan Coil Connections-Box Tier $515.00 $0.00 $25.76 $0.00 $25.76 5% $489.24 $0.00 Radiant Floor Systems 160 Labor $20,483.00 $20,483.00 $0.00 $0.00 $20,483.00 100% $0.00 $1,904.92 161 Material $11,816.00 $11,816.00 $0.00 $0.00 $11,816.00 100% $0.00 $1,181.60 162 Humidifier Connections 515,360.00 $2,304.00 $0.00 $0.00 $2,304.00 15% $13,056.00 $0.00 163 Fin Tube Connections-Basement $664.00 $66.41 $0.00 $0.00 $66.41 10% $597.59 $0.00 164 Fin Tube Connections-Plenum $2,656.00 $265.61 $531.19 $0.00 $796.80 30% $1,859.20 $0.00 165 Fin Tube Connections-Orchestra $14,605.00 $0.00 $4,381.50 $0.00 $4,381.50 30% $10,223.50 $0.00 166 Fin Tube Connections-Box Tier $6,307.00 $0.00 $1,892.10 $0.00 51,892.10 30% $4,414.90 $0.00 167 Fin Tube Connections-Balcony $9,958.00 $0.00 $2,987.40 $0.00 $2,987.40 30% $6,970.60 $0.00 168 Fin Tube Connections-Attic $1,992.00 $0.00 $0.00 $0.00 $0.00 0% $1,992.00 50.00 Insulation-Basement I TOTALS I $3,237,108.05 I $2,391,761.15 1 $93,140.99 I $0.00 I $2,484,902.14 I 77%' $752,205.91 I $181,053.77 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 15 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts 5,PPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A 13 C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) Insulation-Attic I 185 Labor $13,835.00 $0.00 $0.00 $0.00 $0.00 0% $13,835.00 $0.00 186 Material $11,786.00 $0.00 $0.00 $0.00 $0.00 0% $11,786.00 $0.00 187 Temperature Controls-Engineering $64,446.00 $64,446.00 $0.00 $0.00 $64,446.00 100% $0.00 $6,444.60 Temperature Controls-Basement 189 Labor $83,003.00 $49,801.81 $12,450.46 $0.00 $62,252.27 75% $20,750.73 $0.00 190 Material $151,376.00 $151,376.00 $0.00 $0.00 $151,376.00 100% $0.00 $12,110.09 Temperature Controls-Plenum 192 Labor $51,877.00 $14,006.80 $5,706.48 $0.00 $19,713.28 38% $32,163.72 $0.00 193 Material $78,178.00 $78,178.00 $0.00 $0.00 $78,178.00 100% $0.00 $5,472.46 Temperature Controls-Orchestra 195 Labor $15,563.00 $2,801.36 $1,556.30 $0.00 $4,357.66 28% $11,205.34 $0.00 196 Material $25,508.00 $25,508.001 $0.00 $0.00 $25,508.00 100% $0.00 $0.00 Temperature Controls-Box Tier I TOTALS I $3,904,213.05 I $2,869,375.91 I $118,689.31 I $0.00 I $2,988,065.22 I 77%I $916,147.83 I $207,896.30 I CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 17 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:15 containing Contractor's signed Certification is attached Cannel Performing Arts kPPLICATION DATE:12/04/2009 PERIOD TO:12/31/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 212 GPI#23B-Strm Water Control Panel $30,693.00 $30,693.00 $0.00 $0.00 $30,693.00 100% $0.00 $3,069.30 213 AW 4300A-F#15-Oculus Cntrls $7,277.00 $7,277.00 $0.00 $0.00 $7,277.00 100% $0.00 $72.78 214 AW 4300A-F#18-OA Damper $8,605.00 $8,605.00 $0.00 $0.00 $8,605.00 100% $0.00 $86.06 215 AW 4290A-F#5-W.Mech.Drain $1,392.00 $1,392.00 $0.00 $0.00 $1,392.00 100% $0.00 $139.21 216 AW 4290A-F#8-N.Wall Storm $1,372.00 $1,372.00 $0.00 $0.00 $1,372.00 100% $0.00 $137.21 217 AW 4290A-F#9-E.Mech FD $1,845.00 $1,845.00 $0.00 $0.00 $1,845.00 100% $0.00 $184.50 218 AW 4290B-F#19-Fiberoptic Line $8,044.00 $8,044.00 $0.00 $0.00 $8,044.00 100% $0.00 $80.44 219 AW 4290A-F#23A-Stone $5,361.00 $5,361.00 $0.00 $0.00 $5,361.00 100% $0.00 $536.10 220 AW 4290B-Water/Sewer Bills $6,020.95 $4,819.84 $1,201.12 $0.00 $6,020.96 100% ($0.01) $317.94 221 AW 4300A-005-F#27 $21,740.00 $9,783.00 $0.00 $0.00 $9,783.00 45% $11,957.00 $0.00 222 AW 4300A-003-F#24 $5,023.00 $5,023.00 $0.00 $0.00 $5,023.00 100% $0.00 $0.00 223 AW 4290A-005-F#28 $6,928.00 $1,039.20 $0.00 $0.00 $1,039.20 15% $5,888.80 $0.00 224 AW 4300A-006-F#25 $10,104.00 $10,104.00 $0.00 $0.00 $10,104.00 100% $0.00 $0.00 225 GPI#22-CROSSOVER BRIDGE $17,533.00 $17,533.00 $0.00 $0.00 $17,533.00 100% $0.00 $876.65 I TOTALS I $4,308,713.00 I $3,153,968.95 I $136,164.05 I $0.00 I $3,290,133.00 I 76%I $1,018,580.00 I $216,312.30 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT 5 o 26I� �'b Document G702/C a — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Cc;rmet PROJECT: Cannel Performing Arts Center APPLICATION NO:014 DIstribtttion to to: OWNER:0 PERIOD TO:November 30,2009 CONSTRUCTION MANAGER:0 FROM General Piping.Inc. VIA CONSTRUCTION Shie1 Sexton CONTRACT DATE:June 11,2008 ARCHITECT:0 CONTRACTOR: P.O.Sax 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:0 Indianapolis,IN 46234 FIELD: CONTRACT FOR: Bid Package No,4300 VIA ARCHITECT: CSO Architects CSR:0 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge.information and belief the Work covered by this Application for Payment has been completed in accordance with the Application i$made for payment,as shown below,in connection with the Contract. Contract Do uments.that all amounts have been paid by the Contractor for Work for which prcviowi Continuation Sheet,AIA Document 0703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1,ORIGINAL CONTRACT SUM............... .........„,»„,.,,..,...........„......... . ....5 4.136,000.00 payment shown herein is now due. Z NET CHANGE BY CHANGE ORDERS ,..,.„........................... ........„..»„.,....,..$ 172.713.00 CONTRACTOR:' / 3.CONTRACT SUM TO DATE(Line I*2)........». .„. $ 4.308.713.00 By �Y�I C r,/�4� Date: II/2 r'/0 1 4.TOTAL COMPLETED&STORED TO DATE(Column G on 0703) $ 3353,968.95 State of:Indian}►..-. 5.RETAINAGE: County of:Hendricks a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon G103) $ 216,312.30 me this 26 day of .00,./. Zeo^'t b. 0 4b of Stored Material Notary Public:Luke Roseboam (Column F on 0703) S 0.00 My Commission expires:July 07.2012 Total Retainage(Lines Sa+Sb orTot,d in Column I of 0703).—..— 5 216.31130 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE.....»..,....., .................,,.......$ _'..937.656.65 In accordance with the Contract Documents.based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Arehitoct certify to the Owner that to the best of their 7.LESS PREVIOUS tERTIFiCATES FOR PAYMENT „ .„ $ +820.007.9) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 6.CURRENT PAYMENT DUE...........................................W.....„,.,,.„.....................,$ 117.648.741 AMOUNT CERTIFIED .....,...... S 11764$.74 9.BALANCE TO FINISH,INCLUDING RE TAINAGE (Attach explanation Ifamotalt certified differs from the amount applied.Initial alt figures on this Application and on the Continuation Sheet that are changed to conform with the amount certed.) (Line 3 less Line 6) $ 1.371,056.35 CONSTRUCTION MANAGER: By: Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner$ 196.80300$ 24,090.00 By: Date: Total approved this Month $ 0,00 S 0,00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 196,803.00$ 24,090.00 named herein.issuance,payment and acceptance of payment arc without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order S 172.713.00 AIA Deoumint Q702!CMa' —1022 Copyright Ct 1882 by The American Institute at ArellitK'ta.AU sights reserved.WAtiNINQ:This Ale Docunnent In protected by U.S.Copyright Law and international Treaties.Unauthorized reproduction ordintribution of this Ale Document,or any portion of it,may result in savers civil and criminal penaitloe,and will be prosecuted to!ha maximum extent possible 1 under the law.This document was produced by AIA no twue at 011:08:t0 on 11/2512009 under Order No.1000380341,�1 which*Rosa on 5/13/2010,and is net for ale. User New: res (?eeea2043) CONTINUATION PAGE Patio 18. APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Perfurming Arts kPPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable rotalnage for line Items may apply. PROJECT its: A B C 0 E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE U WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS 'COMPLETED AND % TO RETAINAGEE APPLICATION (NOT IN 0 OR E) STORED (G I C) COMPLETION (IF VARIABLE (0+E) (D+E+F) (C-G) RATE) 001 I Band 527,350.00 527,350.00 $0.00 $0.00 527,350.00 100% 50.00 52,735.00 Stipervision/Proj t Mgmt/Gen.Cnnditi I I ( I I { 003 Labor $181,855.00 $154,576.76 $3,637,10 50.00 $158,213.86 87% $23,(,41.14 $111,911.30 004 Material $72,013,00 $61,11.06 $1,440.26 $11.00 562,651.32 117% 59,361.68 54,320.78 005 Submittals 521,869.00 $21,431.62 $437.38 $0.00 521,869.00 100% S0.00 $2.077.56 006 Panelist $12,000.00 $0.00 $0.00 $0.00 f $0,00 0% $12,000,00 $0.00 007 Closeout $6,000.00 ( $0.00 50.00 50.00 50.00 0% 56.000.00 50.0(1 If 3D CAUICnnrdin,itiun If 009 Luber $34,726.00 $34,378.74 5347.26 50.00 $34,726.00 100% $0.00 51279.58 010 Material $64.200.00 $64,200.00 $0.(10 $(1.011 564,200,00 100% $1,911 S6,099.(10 011 I Daily Clam-up $15,000.00 $9,750.00 ( 5450,00 S0.00 510,200.00 I 08%1 $4,800.00 5675,00 012 AW 118•Plumbing(4290A) $83,102.00 50.00 50.00 $0.00 50.00 0% $83,102.00 90,00 013 AW 1t9-Project WaterIGann{429001 I $147,136.17 50.00 5(1,00 $0.00 $0.00 11% 5147,136.17 S317.94 014 AW 1)10-Hydmnie(43110A) j 522 9,718.00 $0.00 I $0.00 I $0.00 501.00 0%1 529.718.110 ! 50.0(1 TOTALS $694,969.17 $372,898.18 1 56.3 12.00 $0.00 ( $379,210,I8 5.5%1 5315.751.vv I $30,416.16 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Eaaa 2 APPLICATION FOR PAYMENT PROJECT:111)21429 APPLICATION NO.:14 containing Contractor's signed Certification Is altaahed Carmel Performing Arta 4PPLICAT1ON DATE:t 1/25/2009 PERIOD TO:11/30/2009 Use Column 1 when variable relainage for line!toms may apply. PROJECT 4ia: --^ A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND '41, TO RETAINAGE APPLICATION (NOT IN 0 OR E) STORED (G1 C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 015 Awril6•CAD(BP 429(0 $10,000.00 w $0.00 $0.110 $0.00 $0.00 o%j $10,000,110 $0.091 (HP t 00.00 $0.00 $11,00 50.1111 50.00 0% $11/,000,00 $0.00 016 Allnwance}t[6-CAD(HI 4300) il},U Mechanical ID 1 I I I I 018 Labor $5,100.00 $0.00 $0.00 $0110 $0.00 0%I 55,100,00 $11,00 0199 Material $5,100.00 $0.00 $1,020.00 $0.00 $1,020.00 2041 S4,080.00 $0.00 19restopping I I I I 021 Labor $5,350.00 $29.42.50 $267.50 $0.00 53,210,00 60% 52,14000 I $160.50 022 Material $5,939.00 $3266,46 $296.96 $0.00 $3,563.42 Ell% 52,375.58 $178.18 Housekeeping Parts I I I I I 024 Libor $1,411,(10 $1,411.00 I $0.00 $0.00 $1,411.00 1 un% 50.00 5141.10 1025 Material 52,676.00 $2,676.00 50.00 $0.00 $2,676,00 1181% $0.00 $267.61 1 026 Painting $3,0(11},O0 $2 550,091 $60.00 $0.091 $2,610.00 87% $341,00 5135.011 ISlecvcdCore Drill Holes I I I I028 I Libor 519,200.00 $16,704.001 $384.00I 50.00 517,088.00 / 114% $2,112.00 / $1,536.00 MIMI TOTALS $762,745.17 5402,4411.14 58,340.46 50.011 $410,788_60 54% $351,156.57 532,834.55 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE APPLICATION FOR PAYMENT PROJECT:0112829 APPLICATION NO,:14 containing CantractOr's signed CortIflC.ation Is attached Cannel Prrlurming Arts \PPLICATION DATE:1 1/252009 PERIOD TO:1113112009 Use Column I when variable retalnago for Tine items may apply, PROJECT its: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS ;COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN 0 OR E) STORED (G!C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 029 Material $31,800.00 527,666.001 5636.00 $0.110 528,302.00 89% $3,498.00 52,544.00 Greene Interceptor 031 tahnr $3,360,00 $0.00 I 50.00 f $0.00 $0.00 0%I $3,360.110 J S0.O0 032 Material $16,830,00 $0.00 50.00 50.00 50.00 01 .$16,1130,00 ( $0.00 033 Cranes and Li1la 524,000.00 $1 8,000,00 5720.00 $0,00 $18,720,110 781 55 280,00 $1,440,00 Underground Warne and Vents I I I 035 Labor 528.186.00 $28,1 x6.00 $0.00 $0.00 $28,186.00 10041 50.00 52,818.60 038 Material $35,120,00 535.1211.00 $0.00 50.00 535,120,00 1001 50,00 $3,512.00 Underground Stonn 1 1 I 038 Labor 56,303.00 56,303.00 50,00 50.00 56,303.00 1110% 50.00 5630.30 039 Material $10,637,110 510,637.00 $0.00 50.00 5111,637.00 100%1 50.00 51,063.70 UudenLInh Drainage I 041 1 tabor I 59,500.00 ( $9,500,00 I $0.00 50.00 59,500.00 I 100% 50.00 $950-00 042 I Material I $1,714.00 I $1,714.00 1 50.00 50.00 51,714,00 I 100% 50.00 5171.40 TOTALS 111.23=1111.113MERIMENEEZIIIIIMEEMINECTESEI 59% 53811,924.57 $45.964.55 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE _ - • ..• APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.;14 containing Contractors signed Certification is attached Carmel Performing Arts WPLEGATIi)N DATE:1 1/25/2009 PERIOD TO:I 1 130/20[19 Use Column I when variable retainage for line Items may apply. PROJECT Us: A B C 0 E F G _.. H I ^- COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE ## WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G 1 C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 043 Abevegruund Waste Vcntu(Bulk M $165,426.00 $160,463 22 $3,308,52 50.01 $163,771.74 99% $1,(.54.26 514,808,34 IAboveground Waste and Vents(labor) i I 045 1 t3asetiumt $33,050,00 524,787.50 51,652.50 50,00 522 6,440.011 80% 56,610.00 $2,247.40 046 Plenum $17,879.00 $16,985,06 $803.94 $0.00 $17,879.00 11141% 50.00 S446.98 047 Ot,:Leuuu $22,368,00 $16,776.00 $11.00 50.111) 516,776.00 75% $5,592,011 $559.2 1 048 Box Tier $18,144.00 56,350.40 i 5907.20 $0,00 57,257.01) 40% $10,880.40 ( $453,00 049 ` Balcony S18,409.0(1 $1,840.92 I 50.00 $0,00 51,841192 10% 516,568,08 $92.05 050 Attic 57,121.00 $712.12 I 50.00 $11,00 ( $712.12 10% 50,4118,88 ( $35.h1 051 , Abovegtuund'Storm(Bulk Material) $67,165.00 $05,150.06 $1,343.30 $0.00 566,493.36 99% 5671,04 56,044.86 Abovegzuund Stnnn(1 abort 053 Basement 56,12.0.00 55,5011.00 5612.00 50.00 f 50,120.00 100% 50.00 5159.00 054 Plenum $305,00 $305.00 50,1111 50.00 5365.00 100% 50.11(1 50.00 055 clmhcstrt 57,856.00 $4,713.60 $1,178.41 1 50.110 55,892.01 751 St 903.40 531.4..24 1 056 Box Tier 53,665.011 5549.70 1 $2,199.00 1 50.00 52,748.76 1 75%1 $010.24 518.33 TOTALS 51297,763,17 5843,775.78 I 521,791.33 $0.00 j 5865,567.11 1719 ,$432,19o.06 $71,524.17 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Paae 6 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM ' SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 057 Balcony $15,976.00 $11,982.00 $798.80 $0.00 $12,780.80 80% $3,195.20 $127.81 058 Attic $9,667.00 $5,800.20 $0.00 $0.00 $5,800.20 60% $3,866.80 $77.34 Force Main 060 Labor $7,546.00 $6,036.80 $0.00 $0.00 $6,036.80 80% $1,509.20 $528.22 061 Material $27,882.00 $27,045.54 $0.00 $0.00 $27,045.54 97% $836.46 $2,369.98 Sewage Ejector/Triplex Pumps 063 Labor $26,640.00 $25,308.00 $0.00 $0.00 $25,308.00 95% $1,332.00 $2,530.81 064 Material $167,273.00 $167,273.00 $0.00 $0.00 $167,273.00 100% $0.00 $16,727.30 Domestic Pumps 066 Labor $4,440.00 $1,776.00 $0.00 $0.00 $1,776.00 40% $2,664.00 $0.00 067 Material $27,066.00 $27,066.00 $0.00 $0.00 $27,066.00 100% $0.00 $2,706.60 068 Domestic Water Above Slab(Bulk Mate $184,831.00 $177,437.76 $5,544.94 $0.00 $182,982.70 99% $1,848.30 $15,710.64 Domestic Water Above Slab(Labor) 070 Basement $85,091.00 $46,800.06 $4,254.56 $0.00 $51,054.62 60% $34,036.38 $2,046.17 I TOTALS I $1,854,175.171 $1,340,301.141 $32,389.631 $0.00I $1,372,690.77 I 74%I $481,484.401 $114,349.04 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Pale 5 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 043 Aboveground Waste and Vents(Bulk M $165,426.00 $160,463.22 $3,308.52 $0.00 $163,771.74 99% $1,654.26 $14,888.34 Aboveground Waste and Vents(Labor) 045 Basement $33,050.00 $24,787.50 $1,652.50 $0.00 $26,440.00 80% $6,610.00 $2,247.40 046 Plenum $17,879.00 $16,985.06 $893.94 $0.00 $17,879.00 100% $0.00 $446.98 047 Orchestra $22,368.00 $16,776.00 $0.00 $0.00 $16,776.00 75% $5,592.00 $559.21 048 Box Tier $18,144.00 $6,350.40 $907.20 $0.00 $7,257.60 40% $10,886.40 $453.60 049 Balcony $18,409.00 $1,840.92 $0.00 $0.00 $1,840.92 10% $16,568.08 $92.05 050 Attic $7,121.00 $712.12 $0.00 $0.00 $712.12 10% $6,408.88 $35.61 051 Aboveground Storm(Bulk Material) $67,165.00 $65,150.06 $1,343.30 $0.00 $66,493.36 99% $671.64 . $6,044.86 Aboveground Storm(Labor) 053 Basement $6,120.00 $5,508.00 $612.00 $0.00 $6,120.00 100% $0.00 $459.00 054 Plenum $365.00 $365.00 $0.00 $0.00 $365.00 100% $0.00 $0.00 055 Orchestra $7,856.00 $4,713.60 $1,178.41 $0.00 $5,892.01 75% $1,963.99 $314.24 056 Box Tier $3,665.00 $549.76 $2,199.00 $0.00 $2,748.76 75% $916.24 $18.33 I TOTALS 1 $1,297,763.171 $843,775.781 $21,791.33 I $0.00 I $865,567.11 I 67%I $432,196.061 $71,524.171 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 7 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 071 Plenum $19,393.00 $8,726.86 $2,908.96 $0.00 $11,635.82 60% $7,757.18 $232.72 072 Orchestra $26,728.00 $14,700.40 $1,336.40 $0.00 $16,036.80 60% $10,691.20 $320.74 073 Box Tier $18,955.00 $3,032.80 $2,653.70 $0.00 $5,686.50 30% $13,268.50 $227.46 074 Balcony $17,692.00 $1,238.44 $530.76 $0.00 $1,769.20 10% $15,922.80 $123.84 075 Attic $823.00 $57.62 $24.70 $0.00 $82.32 10% $740.68 $5.76 Incoming Dom.Water Service and Unde 077 Labor $6,864.00 $2,745.60 $0.00 $0.00 $2,745.60 40% $4,118.40 $274.56 078 Material $7,163.00 $7,163.00 $0.00 $0.00 $7,163.00 100% $0.00 $716.30 079 Drains and Cleanouts(Bulk Material) $25,175.00 $25,175.00 $0.00 $0.00 $25,175.00 100% $0.00 $2,517.50 Drains and Cleanouts(Labor) 081 Basement $21,076.00 $21,076.00 $0.00 $0.00 $21,076.00 100% $0.00 $2,107.60 082 Plenum $1,920.00 $1,920.00 $0.00 $0.00 $1,920.00 100% $0.00 $153.60 083 Orchestra $1,320.00 $1,320.00 $0.00 $0.00 $1,320.00 100% $0.00 $118.80 084 Box Tier $3,120.00 $3,120.00 $0.00 $0.00 $3,120.00 100% $0.00 $249.60 I TOTALS I $2,004,404.171 $1,430,576.861 $39,844.15 I $0.00 I $1,470,421.01 I 73%1 $533,983.161 $121,397.52 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 8 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 085 Balcony $2,400.00 $2,400.00 $0.00 $0.00 $2,400.00 100% $0.00 $120.00 086 Attic $3,720.00 $3,720.00 $0.00 $0.00 $3,720.00 100% $0.00 $186.00 087 Carriers(Bulk Material) $12,347.00 $12,347.00 $0.00 $0.00 $12,347.00 100% $0.00 $1,222.35 Carriers(Labor) 089 Basement $1,200.00 $1,140.00 $0.00 $0.00 $1,140.00 95% $60.00 $102.00 090 Plenum $6,750.00 $6,412.50 $0.00 $0.00 $6,412.50 95% $337.50 $573.76 091 Orchestra $2,100.00 $1,995.00 $0.00 $0.00 $1,995.00 95% $105.00 $178.50 092 Box Tier $4,500.00 $4,050.00 $0.00 $0.00 $4,050.00 90% $450.00 $382.50 093 Balcony $3,000.00 $2,700.00 $0.00 $0.00 $2,700.00 90% $300.00 $225.00 094 Attic $300.00 $270.00 $0.00 $0.00 $270.00 90% $30.00 $22.50 Gas Pressure Regulator 096 Labor $480.00 $0.00 $0.00 $0.00 $0.00 0% $480.00 $0.00 097 Material $277.00 $0.00 $0.00 $0.00 $0.00 0% $277.00 $0.00 Gas Piping I TOTALS I $2,041,478.171 $1,465,611.361 $39,844.151 $0.00 I $1,505,455.51 I 74%1 $536,022.661 $124,410.13 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Pageg 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:1 1/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A f B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 099 Labor $2,858.00 $0.00 $0.00 $0.00 $0.00 0% $2,858.00 $0.00 100 Material $1,220.00 $1,098.00 $0.00 $0.00 $1,098.00 90% $122.00 $109.80 101 Kitchen Connections $6,000.00 $0.00 $0.00 $0.00 $0.00 0% $6,000.00 $0.00 Plumbing Fixtures 103 Labor $54,840.00 $5,484.00 $0.00 $0.00 $5,484.00 10% $49,356.00 $274.20 104 Material $111,082.00 $111,082.00 $0.00 $0.00 $111,082.00 100% $0.00 $11,108.20 Water Heater 106 Labor $4,080.00 $408.00 $0.00 $0.00 $408.00 10% $3,672.00 $20.40 107 Material $62,669.00 $62,669.00 $0.00 $0.00 $62,669.00 100% $0.00 $6,266.90 Water Softener 109 Labor $2,400.00 $0.00 $0.00 $0.00 $0.00 0% $2,400.00 $0.00 110 Material $1,453.00 $0.00 $0.00 $0.00 $0.00 0% $1,453.00 $0.00 Thermostatic Mixing Valves 112 Labor $840.00 $0.00 $0.00 $0.00 $0.00 0% $840.00 $0.00 TOTALS I $2,288,920.17 1 $1,646,352.361 $39,844.15 I $0.001 $1,686,196.51 I 74%1 $602,723.661 $142,189.63 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 10 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK 1 ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) j 113 Material $1,159.00 $1,159.00 $0.00 $0.00 $1,159.00 100% $0.00 $115.90 Backflow Preventers 115 Labor $1,920.00 $0.00 $0.00 $0.00 $0.00 0% $1,920.00 $0.00 116 Material $4,337.00 $4,337.00 $0.00 $0.00 $4,337.00 100% $0.00 $433.70 117 Vibration Isolation $29,532.00 $28,055.41 $0.00 $0.00 $28,055.41 95% $1,476.59 $1,033.63 118 Condensate Piping(Bulk Material) $1,608.00 $1,447.20 $0.00 $0.00 $1,447.20 90% $160.80 $112.56 Condensate Piping(Labor) 120 Basement $8,592.00 $1,288.80 $859.20 $0.00 $2,148.00 25% $6,444.00 $0.00 121 Orchestra $928.00 $0.00 $0.00 $0.00 $0.00 0% $928.00 $0.00 122 Box Tier $353.00 $0.00 $0.00 $0.00 $0.00 0% $353.00 $0.00 123 Hydronic Piping(Bulk Material) $197,044.00 $191,132.68 $0.00 $0.00 $191,132.68 97% $5,911.32 $15,763.52 Hydronic Piping(Labor) 125 Basement $90,564.00 $67,923.00 $9,056.41 $0.00 $76,979.41 85% $13,584.59 $1,358.46 126 Plenum $14,180.00 $2,127.00 $1,418.00 $0.00 $3,545.00 25% $10,635.00 $0.00 I TOTALS I $2,639,137.171 $1,943,822.451 $51,177.761 $0.00I $1,995,000.21 I 76%I $644,136.961 $161,007.401 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 11 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 127 Orchestra $26,716.00 $4,007.40 $2,671.60 $0.00 $6,679.00 25% $20,037.00 $0.00 128 Box Tier $25,375.00 $1,268.76 $1,268.76 $0.00 $2,537.52 10% $22,837.48 $0.00 129 Balcony $43,190.00 $2,159.50 $2,159.50 $0.00 $4,319.00 10% $38,871.00 $0.00 130 Attic $13,309.00 $0.00 $0.00 $0.00 $0.00 0% $13,309.00 $0.00 Anchors and Guides 132 Labor $2,880.00 $2,304.00 $144.00 $0.00 $2,448.00 85% $432.00 $172.80 133 Material $1,834.00 $1,834.00 $0.00 $0.00 $1,834.00 100% $0.00 $183.40 134 Miscellaneous Supports $79,294.00 $71,364.60 $0.00 $0.00 $71,364.60 90% $7,929.40 $4,757.65 135 Hydronic Specialties $77,660.00 $73,777.00 $0.00 $0.00 $73,777.00 95% $3,883.00 $0.00 HVAC Pumps 137 Labor $6,120.00 $5,814.00 $122.40 $0.00 $5,936.40 97% $183.60 $0.00 138 Material $28,061.00 $28,061.00 $0.00 $0.00 $28,061.00 100% $0.00 $2,806.10 Water Treatment 140 Labor $600.00 $450.00 $30.00 $0.00 $480.00 80% $120.00 $0.001 I TOTALS I $2,944,176.171 $2,134,862.71 I $57,574.021 $0.001 $2,192,436.73 I 74%I $751,739.441 $168,927.35 I CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 12 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 141 Material $3,132.00 $3,132.00 $0.00 $0.00 $3,132.00 100% $0.00 $0.00 142 HVAC Equipment $120,532.00 $114,505.40 $0.00 $0.00 $114,505.40 95% $6,026.60 $9,039.90 143 Rigging and Offloading HVAC Equipm $3,840.00 $2,496.00 $0.00 $0.00 $2,496.00 65% $1,344.00 $0.00 144 AHU Connections $55,320.00 $38,724.00 $5,532.00 $0.00 $44,256.00 80% $11,064.00 $0.00 145 Duct Heating Coil Connections $1,260.00 $0.00 $0.00 $0.00 $0.00 0% $1,260.00 $0.00 146 VAV Box Connections-Basement $8,285.00 $0.00 $0.00 $0.00 $0.00 0% $8,285.00 $0.00 147 VAV Box Connections-Plenum $1,763.00 $0.00 $0.00 $0.00 $0.00 0% $1,763.00 $0.00 148 VAV Box Connections-Orchestra $1,586.00 $0.00 $0.00 $0.00 $0.00 0% $1,586.00 $0.00 149 VAV Box Connections-Box Tier $4,231.00 $0.00 $0.00 $0.00 $0.00 0% $4,231.00 $0.00 150 VAV Box Connections-Balcony $3,173.00 $0.00 $0.00 $0.00 $0.00 0% $3,173.00 $0.00 151 VAV Box Connections-Attic $2,820.00 $0.00 $0.00 $0.00 $0.00 0% $2,820.00 $0.00 152 Unit Heater Connections-Basement $428.00 $0.00 $0.00 $0.00 $0.00 0% $428.00 $0.00 154 Unit Heater Connections-Orchestra $215.00 $0.00 $0.00 $0.00 $0.00 0% $215.00 $0.00 155 Unit Heater Connections-Box Tier $107.00 $0.00 $0.00 $0.00 $0.00 0% $107.00 $0.00 I I TOTALS I $3,150,868.171 $2,293,720.11 I $63,106.021 $0.001 $2,356,826.13 I 75%1 $794,042.041 $177,967.25 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT • CONTINUATION PAGE Page 13 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.: 14 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 156 Fan Coil Connections-Basement $2,057.00 $0.00 $0.00 $0.00 $0.00 0% $2,057.00 $0.00 157 Fan Coil Connections-Orchestra $1,028.00 $0.00 $0.00 $0.00 $0.00 0% $1,028.00 $0.00 158 Fan Coil Connections-Box Tier $515.00 $0.00 $0.00 $0.00 $0.00 0% $515.00 $0.00 Radiant Floor Systems 160 Labor $20,483.00 $20,483.00 $0.00 $0.00 $20,483.00 100% $0.00 $1,904.92 161 Material $11,816.00 $11,816.00 $0.00 $0.00 $11,816.00 100% $0.00 $1,181.60 162 Humidifier Connections $15,360.00 $0.00 $2,304.00 $0.00 $2,304.00 15% $13,056.00 $0.00 163 Fin Tube Connections-Basement $664.00 $0.00 $66.41 $0.00 $66.41 10% $597.59 $0.00 164 Fin Tube Connections-Plenum $2,656.00 $0.00 $265.61 $0.00 $265.61 10% $2,390.39 $0.00 165 Fin Tube Connections-Orchestra $14,605.00 $0.00 $0.00 $0.00 $0.00 0% $14,605.00 $0.00 166 Fin Tube Connections-Box Tier $6,307.00 $0.00 $0.00 $0.00 $0.00 0% $6,307.00 $0.00 167 Fin Tube Connections-Balcony $9,958.00 $0.00 $0.00 $0.00 $0.00 0% $9,958.00 $0.00 168 Fin Tube Connections-Attic $1,992.00 $0.00 $0.00 $0.00 $0.00 0% $1,992.00 $0.00 Insulation-Basement I I TOTALS I $3,238,309.171 $2,326,019.11 I $65,742.041 $0.00 I $2,391,761.15 I 74%I $846,548.02 I $181,053.77 I CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 14 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 170 Labor $31,937.00 $21,397.80 $0.00 $0.00 $21,397.80 67% $10,539.20 $638.74 171 Material $27,208.00 $27,208.00 $0.00 $0.00 $27,208.00 100% $0.00 $2,176.64 Insulation-Plenum 173 Labor $18,103.00 $2,896.48 $4,706.78 $0.00 $7,603.26 42% $10,499.74 $0.00 174 Material $15,423.00 $15,423.00 $0.00 $0.00 $15,423.00 100% $0.00 $0.00 Insulation-Orchestra 176 Labor $14,914.00 $1,640.55 $5,518.18 $0.00 $7,158.73 48% $7,755.27 $0.00 177 Material $12,706.00 $12,706.00 $0.00 $0.00 $12,706.00 100% $0.00 $0.00 Insulation-Box Tier 179 Labor $13,835.00 $0.00 $0.00 $0.00 $0.00 0% $13,835.00 $0.00 180 Material $11,786.00 $0.00 $0.00 $0.00 $0.00 0% $11,786.00 $0.00 Insulation-Balcony 182 Labor $13,835.00 $0.00 $0.00 $0.00 $0.00 0% $13,835.00 $0.00 183 Material $11,786.00 $0.00 $0.00 $0.00 $0.00 0% $11,786.00 $0.00 I TOTALS I $3,409,842.17 I $2,407,290.94 I $75,967.00 I $0.00 I $2,483,257.94 I 73%1 $926,584.23 I $183,869.15 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Paae 15 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) Insulation-Attic 185 Labor $13,835.00 $0.00 $0.00 $0.00 $0.00 0% $13,835.00 $0.00 186 Material $11,786.00 $0.00 $0.00 $0.00 $0.00 0% $11,786.00 $0.00 187 Temperature Controls-Engineering $64,446.00 $64,446.00 $0.00 $0.00 $64,446.00 100% $0.00 $6,444.60 Temperature Controls-Basement 189 Labor $83,003.00 $49,801.81 $0.00 $0.00 $49,801.81 60% $33,201.19 $0.00 190 Material $151,376.00 $151,376.00 $0.00 $0.00 $151,376.00 100% $0.00 $12,110.09 Temperature Controls-Plenum 192 Labor $51,877.00 $14,006.80 $0.00 $0.00 $14,006.80 27% $37,870.20 $0.00 193 Material $78,178.00 $78,178.00 $0.00 $0.00 $78,178.00 100% $0.00 $5,472.46 Temperature Controls-Orchestra 195 Labor $15,563.00 $2,801.36 $0.00 $0.00 $2,801.36 18% $12,761.64 $0.00 196 Material $25,508.00 $25,508.00 $0.00 $0.00 $25,508.00 100% $0.00 $0.00 Temperature Controls-Box Tier I TOTALS I $3,905,414.171 $2,793,408.91 I $75,967.00 1 $0.001 $2,869,375.91 I 73%1 $1,036,038.26I $207,896.30 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 16 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 198 Labor $15,563.00 $3,423.86 $0.00 $0.00 $3,423.86 22% $12,139.14 $0.00 199 Material $25,508.00 $25,508.00 $0.00 $0.00 $25,508.00 100% $0.00 $0.00 Temperature Controls-Balcony 201 Labor $15,563.00 $1,867.56 $0.00 $0.00 $1,867.56 12% $13,695.44 $0.00 202 Material $22,701.00 $22,701.00 $0.00 $0.00 $22,701.00 100% $0.00 $0.00 Temperature Controls-Attic 204 Labor $15,563.00 $1,867.56 $0.00 $0.00 $1,867.56 12% $13,695.44 $0.00 205 Material $16,170.00 $16,170.00 $0.00 $0.00 $16,170.00 100% $0.00 $0.00 206 Test and Balance $19,474.00 $0.00 $0.00 $0.00 $0.00 0% $19,474.00 $0.00 207 CO#1 -GPI#2-LEACH&RUSSEL ($24,090.00) ($24,090.00) $0.00 $0.00 ($24,090.00) 100% $0.00 ($2,409.00) 208 CO#2-GPI#3-ASI#18 $1,776.00 $1,776.00 $0.00 $0.00 $1,776.00 100% $0.00 $177.60 209 GPI#6-Triplex Sump Basin $61,694.00 $61,694.00 $0.00 $0.00 $61,694.00 100% $0.00 $3,084.70 210 GPI#7A-Basement Kitchen Rev. $17,328.00 $12,996.00 $866.40 $0.00 $13,862.40 80% $3,465.60 $356.26 211 GPI#10-Box Tier Catering Kitch. $85,312.00 $29,859.21 $17,062.41 $0.00 $46,921.62 55% $38,390.38 $1,706.25 TOTALS I $4,177,976.171 $2,947,182.101 $93,895.81 I $0.00 I $3,041,077.91 I 73%1 $1,136,898.261 $210,812.11 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 17 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.:14 containing Contractor's signed Certification is attached Carmel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) 212 GPI#23B-Strm Water Control Panel $30,693.00 $30,693.00 $0.00 $0.00 $30,693.00 100% $0.00 $3,069.30 213 AW 4300A-F#15-Oculus Cntrls $7,277.00 $7,277.00 $0.00 $0.00 $7,277.00 100% $0.00 $72.78 214 AW 4300A-F#18-OA Damper $8,605.00 $6,453.76 $2,151.24 $0.00 $8,605.00 100% $0.00 $86.06 215 AW 4290A-F#5-W.Mech.Drain $1,392.00 $1,392.00 $0.00 $0.00 $1,392.00 100% $0.00 $139.21 216 AW 4290A-F#8-N.Wall Storm $1,372.00 $1,372.00 $0.00 $0.00 $1,372.00 100% $0.00 $137.21 217 AW 4290A-F#9-E.Mech FD $1,845.00 $1,845.00 $0.00 $0.00 $1,845.00 100% $0.00 $184.50 218 AW 4290B-F#19-Fiberoptic Line $8,044.00 $8,044.00 $0.00 $0.00 $8,044.00 100% 50.00 $80.44 219 AW 4290A-F#23A-Stone $5,361.00 $5,361.00 $0.00 $0.00 $5,361.00 100% $0.00 $536.10 220 AW 4290B-Water/Sewer Bills $4,819.83 $4,819.84 $0.00 $0.00 $4,819.84 100% ($0.01) $317.94 221 AW 4300A-005-F#27 $21,740.00 $7,609.00 $2,174.00 $0.00 $9,783.00 45% $11,957.00 $0.00 222 AW 4300A-003-F#24 $5,023.00 $3,767.26 $1,255.74 $0.00 $5,023.00 100% $0.00 $0.00 223 AW 4290A-005-F#28 $6,928.00 $1,039.20 $0.00 $0.00 $1,039.20 15% $5,888.80 $0.00 224 AW 4300A-006-F#25 $10,104.00 $8,588.40 $1,515.60 $0.00 $10,104.00 100% $0.00 $0.00 225 GPI#22-CROSSOVER BRIDGE $17,533.00 $0.00 $17,533.00 $0.00 $17,533.00 100% $0.00 $876.65 I TOTALS I $4,308,713.001 $3,035,443.56I $118,525.391 $0.00 1 $3,153,968.95 I 73%1 $1,154,744.05 I $216,312.301 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT CONTINUATION PAGE Page 18 18 APPLICATION FOR PAYMENT PROJECT:002829 APPLICATION NO.: 14 containing Contractor's signed Certification is attached Cannel Performing Arts APPLICATION DATE:11/25/2009 PERIOD TO:11/30/2009 Use Column I when variable retainage for line items may apply. PROJECT#s: A B C D E F G H I COMPLETED WORK ITEM SCHEDULED FROM STORED TOTAL BALANCE # WORK DESCRIPTION VALUE PREVIOUS THIS PERIOD MATERIALS COMPLETED AND % TO RETAINAGE APPLICATION (NOT IN D OR E) STORED (G/C) COMPLETION (IF VARIABLE (D+E) (D+E+F) (C-G) RATE) I I TOTALS I $4,308,713.00 I $3,035,443.56 I $118,525.39 $0.00 $3,153,968.95 I 73%1 $1,154,744.05 $216,312.30 CONTINUATION PAGE FOR APPLICATION FOR PAYMENT SL Subcontract Billing Report For Work Invoiced From 11101109 to 11/30109 r ubcontract::2695_4300-4300-HVAG Pi ing :: Job; 2695- Cannel-RPAC Construction Vendor: 9501 GENERAL PIPING.INC. 777 3rd Ave.SW Carmel,IN 46032 Co tea>::=.';::: :;:;: ::>:.:<::`: Tts!?ate:"-> T is Period.::: 1 Item Units UM Unit Cost Amount Units!'/a Amount Units[% Amount 1 4300-HVAC Piping L5 3,846501.01 78 52% 3,020.338.18, 3.08% 118,525.39 2 Settlanent with honing LS 291,276.00 0.61% 1,776.00 0.00% 0.00 company to take over F.E. Irish'Work Total Cce'ra._t l:E-rns 4,137,776.1 3.022,114.16 118,525.39, "'Change Orders"` 3 Leath 8 Russel T8t,1 Cre it !S -24,090. 100.00% -24,09310 0.03% 0.00 5 SSC-1079 AS[-037&Supp;:t LS 17,328. °r 50.00% 8,6'64 CO O.CO% 0.00 1 Bsnat Waring K!tchen 024 rzrn s 8 CCR-1048 RCP-006 8 Suppit LS 65,312. • 64.34% 54,893.71 0.03% 0.00 1 Box Tier catering spa:e reins 7 SSC-1080 AS1-038&Supot 1 LS 2+7.693 0. 1(0.00% 30,693.03 0.00% 000 Triplex re'/r s-aid control panel 8 SSC 1138 ASI.070 Triplex LS 81,694.0. 103 CO% 61,694.01 . 010% 0.03 structure loins Total Change Order[terns 170,937.0C 131,854.77 0.00 Subcontract Totals: 4,308,713.00 3,153,968.95 118,525.39 Total BIllinfts: 3,153,968.95 118,525.39 Unpaid Retatnage: 216,31231 876.65 Discounts: 0.00 0.40 Net Billings: 2,937,655.64 117,648.74 9B SSC-CMa Projects Page 1 11/19/D9 12:06:43 P1.1 Date Format-M MID D/YY S LS u bam ng Report.rpt kwo -:: :o- Document G7O2/CMa' — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition sv Ny TO OWNER: City of Carmel PROJECT: Cannel Performing Arts Center APPLICATION NO:013 Distribution to: OWNER:❑ PERIOD TO:October 20,2009 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD: ❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects Li%90 OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,ALA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown here is now due. 2.NET CHANGE BY CHANGE ORDERS $ 172,713.00 CONTRACT �?. 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,308,713.00 By: .../ Date: /6/2d/°i 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 3,035,443.56 State f:Indiana 5.RETAINAGE: County of:Hendricks a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 215,435.65 me this ,Z 6 day of dC-eberi 2609 .14VL___ b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 215,435.65 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,820,007.91 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,662,328.14 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 157,679.771 AMOUNT CERTIFIED $ 157,679.77 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fr• •amount applied.Initial all figures on this Application and on the Continuation Sheet t st are changed to conform with the amount certified.) (Line 3 less Line 6) $ 1,488,705.09 CONS RUCTION M 47,i GE' / "I.'. ' � LA BY . � � _�iI� L ■ . Date: /O 30/e2 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC ': Total changes approved in previous months by Owner$ 196,803.00$ 24,090.00 By: IN _ - Date: I I "Z..•01 Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CER'T'IFIED is payable only to the Contractor TOTALS $ 196,803.00$ 24,090.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 172,713.00 AIA Document G702/CMaTM-1992.Copyright®1992 by The American Institute of Architects.AU rights reserved.WARNING:This AIA® Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 09:13:01 on 10/20/2009 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (928230584) ! AIA 1. a Document 6702/CMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Cannel Performing Arts Center APPLICATION NO:012 Distribution to: OWNER:❑ PERIOD TO:September 30,2009 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS $ 172,713.00 CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,308,713.00 By: G%`tW�rte- Date: /.2/•0 7 4.TOTAL COMPLETED 8 STORED TO DATE(Column G on G703) $ 2,877,763.79 State of:Indi 5.RETAINAGE: County of:Hendricks a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 215,435.65 me this 2 1 day of Sep 1.,2.009 b. 0 %of Stored Material Notary Public:Luke Roseboom /2-4---"-------___— (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 215,435.65 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,662,328.14 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,550,218.90 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE 1$ 112,109.241 AMOUNT CERTIFIED $ 112,109.24 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fro --amount applied.Initial all figures on this Application and on t. Continuation She that, , ged to conform with the amount certified.) (Line 3 less Line 6) $ 1,646,384.86 CON .\RUCTION M GER: BY: *.■F' •ie/■■ ! 4". _ ' Date: 2.2//90 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AR ' CT: 'dPI Total changes approved in previous months by Owner$ 196,803.00$ 24,090.00 10. I.By: l�_ Date: t Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 196,803.00$ 24,090.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 172,713.00 AIA Document G702/CMa*r—1992.Copyright 01992 by The American Institute of Architects.Al)rights reserved.WARNING:This AlA® Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 10:09:23 on 09/21/2009 under Order No.1000389341 1 which expires on 5/13/2010,and is not for resale. User Notes: (366781231) * AIA Document 6702/CMa TM - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Cannel Performing Arts Center APPLICATION NO:011 Distribution to: OWNER:❑ PERIOD TO:August 31,2009 CONSTRUCTION MANAGER: ❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,ALA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. . 2.NET CHANGE BY CHANGE ORDERS $ 172,713.00 CONTRACTOR: tr`,, 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,308,713.00 By: jf i/9/12-.-� Date: Au st'20;• Odd' 4,TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,765,654.55 State of Indi �`..;' 5.RETAINAGE: County of Hendricks . =- a. 100 %of Completed Work Subscribed and sworn to before \.: ;''' :fir':, (Column D+Eon G703) $ 215,435.65 me this aQ day of Am v51-1 200q / C '1 _:;/'.i_: .' b. 0 %of Stored Material Notary Public:Luke Rosebooni s.�y,.a ' _ (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Y., -,:il_• . ', j.,. Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 215,435.65 CERTIFICATE FOR PAYMENT ,..,:,;:.;, ::, , ;<. 6.TOTAL EARNED LESS RETAINAGE $ 2,550,218.90 In accordance with the Contract Documents,based on on-site observations and•.the data' omprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the`best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,508,728.31 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 41,490.59 AMOUNT CERTIFIED $41,490.59 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from •• amount applied.Initial all figures on this Application and one Continuation Sheet that a • •nged to conform with the amount certified.) (Line 3 less Line 6) $ 1,758,494.10 CONS -UCTION ,itt GE" �— / —/ ' By: 11_.:i /�._•_ii✓u �� '— Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE / Date:A Total changes approved in previous months by Owner$ 196,803.00$ 24,090.00 By: 1 /4 /2ftet Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 196,803.00$ 24,090.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 172,713.00 AIA Document G702/CMani—1992.Copyright®1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AtA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 15:22:50 on 08/20/2009 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (238628143) stA --4 IA Document G702/CMaTH - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Cannel Performing Arts Center APPLICATION NO:010 Distribution to: OWNER:❑ PERIOD TO:July 31,2009 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:0 CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CS?/Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the hest of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS $ 172,713.00 CONTRACTO : 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,308,713.00 By: Alo-L2_,— Date: 7/2° a� 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,724,163.96 State of: i a>�>'. 5.RETAINAGE: County of: .1.4wA.o rt-cks a. 5 %of Completed Work Subscribed and sworn to before / / / (Column D+Eon G703) $ 215,435.65 me this 2d day of N�,`, �o 4 b. 0 %of Stored Material Notary Public: LQ1<< Rd,��7cp Z (Column F on G703) $ 0.00 My Commission expires: �/�l if Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 215,435.65 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,508,728.31 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,365,146.84 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 143,581.471 AMOUNT CERTIFIED $ 143,581.47 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fro e amount applied.Initial all figures on this Application and on the Continuation Sheet that. hanged to conform with the amount certified.) (Line 3 less Line 6) $ 1,799,984.69 CONSTRUCTION :; AG r: BY \►is r.��10 A f- Date: 7 /�� CHANGE ORDER SUMMARY. ADDITIONS DEDUCTIONS ARCHITECT: -:: Total changes approved in previous months by Owner$ 135,109.00$ 24,090.00 By: Date: `40‘ Total approved this Month $ 61,694.00$ 0.00 This C-Allir.is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 196,803.00$ 24,090.00 named •rein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 172,713.00 AIA Document G702JCMaTm—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 10:19:36 on 07/20/2009 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (1424566495) WIV ,ti":21-AIA Document G702/CMa — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Cannel PROJECT: Cannel Performing Arts Center APPLICATION NO:009 Distribution to: OWNER:E PERIOD TO:June 30,2009 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 - FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS $ 111,019.00 CONTRACTOR' 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,247,019.00 By: ,a' 1111 f h/.L. /_ Date: 1p�/09 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,577,497.79 State of:India/11V 5.RETAINAGE: County of:Hendricks a. 100 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 212,350.95 me this /' day of jot(/poi O b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 212,350.95 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,365,146.84 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,303,786.88 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CER ITFIED. 8.CURRENT PAYMENT DUE a$ 61,359.96 AMOUNT CERTIFIED $61,359.96 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this r\i)(,/ Application and on the Continuation Sheet that ar- hanged to conform with the amount certified.) (Line 3 less Line 6) $ 1,881,872.16 CONSTRUCTION di. AAGGEERR• / By ‘,• -::41 `��. _/ IV— V Date: f0 2,4, 0, CHANGE ORDER SUMMARY ADDPTIONS DEDUCTIONS ARCH CT: .: 4r Total changes approved in previous months by Owner$ 135,109.00$ 24,090.00 By: ;r _ C � � h `;, � Date: o • Jail Total approved this Month $ 0.00$ 0.00 This Certificate i ot negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 135,109.00$ 24,090.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 111,019.00 AIA Document G702/CMSTM—1992.Copyright®1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 14:17:01 on 06/19/2009 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (1297164753) j Document 6702/CMa rM — 19.92 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Cannel PROJECT: Cannel Performing Arts Center APPLICATION NO:008 Distribution to: OWNER:❑ PERIOD TO:May 31,2009 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD: ❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,ALA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS $ 111,019.00 CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,247,019.00 By: ?j 7/4.rv_ Date: May 28,2009 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,516,137.83 State of:Indiana 5.RETAINAGE: County of:Hendricks a. 5 %of Completed Work Subscribed and sworn to before / / (Column D+Eon G703) $ 212,350.95 me this 2 Pk day of , Z 00 9 b. 0 %of Stored Material Notary Public:Luke Roseboom 7 (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 212,350.95 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,303,786.88 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,995,633.35 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE ,$ 308,153.53 1/AMOUNT CERTIFIED $308,153.53 ' S-j.— 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet th, r hanged to conform with the amount certified.) (Line 3 less Line 6) $ 1,943,232.12 CONST- CTION M.11 G . By: �j..%,�%_4.i, ■ . ■ Date: 512-S/0, CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: r �W �h • Total changes approved in previous months by Owner$ 1,776.00$ 24,090.00 By: _ - -�. Date: w 7 Total approved this Month $ 133,333.00$ 0.00 This Certi Cate is pat negotiable. The AMOUNT CERT'IFIED is payable only to the Contractor TOTALS $ 135,109.00$ 24,090.00 named h rein. Issrfance,payment and acceptance of payment are without prejudice to any rights of the Own r or—Clint—actor under this Contract. NET CHANGES by Change Order $ 111,019.00 AIA Document G702/CMar*'—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of It,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AlA software at 12:47:14 on 05/28/2009 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (1157248932) _cub Document G702/C.Ma TM - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Cannel Performing Arts Center APPLICATION NO:007 Distribution ti OWNER:[ PERIOD TO:April 30,2009 CONSTRUCTION MANAGER:[ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:[ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:[ Indianapolis,IN 46234 FIELD:[ CONTRACT FOR: Bid Package 41 No( O VIA ARCHITECT: CSO Architects l � OTHER:[ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information ai belief the Work covered by this Application for Payment has been completed in accordance with t Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previo Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that curre 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 Payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS $ -22,314.00 CONTRACTOR: / 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,113,686.00 By: Lill COI ag ( y: Y Date: 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,201,317.65 State of:Ind'ana..7 5.RETAINAGE: County of:Hendricks a. 100 %of Completed Work Subscribed and sworn to befo e (Column D+E on G703) $ 205,684.30 me this /(o day of (I 't 2eO b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 205,684.30 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,995,633.35 In accordance with the Contract Documents,based on on-site observations and the data comprisi (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of th 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,779,403.89 knowledge,information and belief the Work has progressed as indicated, the quality of the Work in accordance with the Contract Documents, and the Contractor is entitled to payment of I (Line 6 from prior Certificate) J AMOUNT CERT11-1hD. 8.CURRENT PAYMENT DUE $ 216,229.46 AMOUNT CERTIFIED $216,229.46 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 2,118,052.65 CONSTRUCTION MANAGER: By: 7 7 L,-e. Date: 1.1 13O /1:39 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner $ 1,776.00$ 24,090.00 �, _ _ r� �J ec By: j Date: l Total approved this Month $ 0.00$ 0.00 This 'fic. - is not negotiable. The AMOUNT CER'IINIbD is payable onl to the ontrac TOTALS $ 1,776.00$ 24,090.00 n.1 ,• by in. Issuance,payment and acceptance of payment are without prejudice to any rights the •. •ler or Contractor under this Contract. NET CHANGES by Change Order $ -22,314.00 AIA Document G702/CMaTM-1992.Copyright®1992 by The American institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the taw.This document was produced by AIA software at 14:37:51 on 04/16/2009 under Order.No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (3685834802) *AIA Document G702/CMaTh - 1992 lz-c� � f�E ",�, Application and Certificate for Payment Construction Manager-Adviser Edition / �f f : J TO OWNER: City of Carmel PROJECT: Carmel Performing Arts Center APPLICATION NO:006 ,. <.� , ; ,; `"`_) �ir Distribution to: f` `;,, / OWNER:❑ PERIOD TO:March 31,2W:,1-,1,_, '''', C STRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Stile'Sexton CONTRACT DATE:June 11, ARCHITECT:❑ $ \- ! CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A'0\/ 7/ CONTRACTOR:❑ Indianapolis,IN 46234 `', FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates.for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS $ -22,314.00 CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1±2) $/ 4,113,686.00 By: /, Date: -5 fil 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,977,115.43 State of:Indiana 5.RETAINAGE: County of:Hendricks a. 10 %of Completed Work Subscribed and sworn to before (Column D+E on G703) $ 197,711.54 me this 19 day of �a f4 L r ZOO 9 / / b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 197,711.54 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,779,403.89 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,452,100.59 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 327,303.30 AMOUNT CERTIFIED $327,303.30 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fro e amount applied.Initial all figures on this 1/ti Application and on the Continuation Sheet tha . hanged to conform with the amount certified.) (Line 3 less Line 6) $ 2,334,282.11 CON TRUCTIO L ANA R: BY: r..tii-qr 74 .. A. 1- _ Date: b CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: r Total changes approved in previous months by Owner$ 1,776.00$ 24,090.00 By: Date: 1 3\ )Calk Total approved this Month $ 0.00$ 0.00 This Certi y-I of negotiable. The AMOUNT CER'1'll-IhD is payable onl to the Contractor TOTALS $ 1,776.00$ 24,090.00 named h' suance,payment and acceptance of payment are without prejudice to any rights of the 0 _ . .r Contractor under this Contract. NET CHANGES by Change Order $ -22,314.00 AIA Document G702/CMa**'—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 12:50:02 on 03/18/2009 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (758254341) chi, =y�� Document G702/C Man' — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Carmel Performing Arts Center APPLICATION NO:005 Distribution to: OWNER:❑ PERIOD TO:February 16,2009 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 Payment shown herein is now due. 2.Net change by Change Orders $ -22,314.00 CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1 t 2) $ 4.113,686.00 By: a o✓ Date: 420/09 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,613,445.10 State of:Indiana 5.RETAINAGE: County of:Hendricks a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 161,344.51 me this 20 day of6 2lcg 1:-./ b. 0 %of Stored Material Notary Public:Luke Roseboom (( (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 161,344.51 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,452,100.59 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,249,519.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 202,581.591 AMOUNT CERTIFIED $202,581.59 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if anwunt certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 2,661,585.41 CONSTRUCTION MANAGER: By: _ Date: "2/'25/6°I CHANGE ORDER SUMMARY ADDTITONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner$ 1,776.00$ 24,090.00 l BY ' /_ _ Date: Z•�7 Total approved this Month $ 0.00$ . 0.00 This Certificate .. not •e_.' e. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 1,776.00$ 24,090.00 named herein. scan••,payment and acceptance of payment are without prejudice to any rights of the Owner or only tor under this Contract NET CHANGES by Change Order $ -22,314.00 AIA Document G702/CM.TM—1992.Copyright ©1992 by The American Institute of Architects. All rights reserved. WARNING:This AlAe Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAe Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law. This document was produced by AIA software at 15:06:27 on 02/20/2009 under Order No.1000356186_1 which expires on 5/13/2009,and is not for resale. User Notes: (283216986) , _, ' AIA Document 6702/CMaTM °- 1992 '' ; ? ��� ®oC ,� /' - , Application and Certificate for Payment Construction Manager-Adviser Edition 14),t, �Y 9/, ��TO OWNER: City of Carmel PROJECT: Carmel Performing Arts Center APPLICATION N0: �� ,� ?j Distribution to: °`,..,r OWNER:❑ PERIOD TO:January 20,2009 CO STRUCTION MANAGER: ❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,ALA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 Payment shown herein is now due. 2.Net change by Change Orders $ -22,314.00 CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,113,686.00 By: -- 41„---' Date: I(22(01 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,388,354.44 State of:Indiana 5.RETAINAGE: County of:Hendricks a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 138,835.44 me this *22_ day of faun 20 01 /2— ----- b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on 0703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 138,835.44 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,249,519.00 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,003,364.47 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CER"FINED. 8.CURRENT PAYMENT DUE Is 246,154.53 AMOUNT CERTIFIED $246,154.53 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 2,864,167.00 CONSTRUC ANAGER: By: Date: 1 Z' a; CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner$ 1,776.00$ 24,090.00 / By: / fir. Date: jJ i. Total approved this Month $ 0.00$ 0.00 This e� is not negotiable. The AMOUNT CER'T'IFIED is payable on ' to the ontractor TOTALS $ 1,776.00$ 24,090.00 n.it 00 n."Issuance,payment and acceptance of payment are without prejudice to any rights of the .• er or Contractor under this Contract NET CHANGES by Change Order $ -22,314.00 MA Document G702/Clatite—1992.Copyright 4111992 by The American Institute of Architects. Alt rights reserved. WARNING:This Ale Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible i under the law. This document was produced by AIA software at 08:34:32 on 01/22/2009 under Order No.100035918e_1 which expires on 5/13/2009.and is not forresale. User Notes: (2155554402) *AIA Document G702/CMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Carmel Performing Arts Center APPLICATION NO:003 Distribution to: OWNER:❑ PERIOD TO:December 15,2008 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. 2.Net change by Change Orders $ -22,314.00 CONTRACTOR' 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,113,686.00 By: -e„ f...........„ Date: December 15,2008 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,114,849.41 State of:Indiana 5.RETAINAGE: County of:Hendricks a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 111,484.94 me this I 5- day of ,tbCC. 2eo$ leJ _. b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 111,484.94 CERTIFICATE FOR PAYMENT -__` 6.TOTAL EARNED LESS RETAINAGE $ 1,003,364.47 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 805,318.70 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 198,045.77 AMOUNT CERTIFIED $ 198,045.77 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) 0 li-V U $ 3,110,321.53 CONSTRUCTION MANAGER: By: 'OP 411 Date: ,0fr.L/C'? CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner$ 1,776.00$ 24,090.00 By: Date: i 2•rap* Total approved this Month $ 0.00$ 0.00 This Certificate ' t negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 1,776.00$ 24,090.00 named herein • ante, payment and acceptance of payment are without prejudice to any rights of the Owner!—'ontractor under this Contract NET CHANGES by Change Order $ -22,314.00 r. AIA Document G702/CMaTM-1992.Copyright ®1992 by The American institute of Architects. All rights reserved. WARNING:This Ale Document is protected by U.S.Copyright Law and international Treaties.Unauthorized reproduction or distribution of this AlAe Document,or any portion of it,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law. This document was produced by AIA software at 08:01:36 on 12/15/2006 under Order No.1000356186 1 which expires on 5/13/2009,and is not for resale. User Notes: (50006472) _'=A I A Document G702/CMa - 1992 Application and Certificate for Payment Construction Man-is,: -A v r Edition TO OWNER: City of Carmel PROJECT: Carmel Pert g Art titer '",APPLICATION NO:002 Distribution to: �,• L! `1� OWNER:❑ � �,,, ' /PERIOD T0:November 15,2008 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shye on �A .. CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: '' CONTRACTOR:❑• Indianapolis,IN 46234 f/ PROJECT NOS:N/A/2829/N/A FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects ; j% OTHER:❑ CONTRACTOR'S APPLICATION FOR PAYMENT m�'The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and . belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown herein is now due. 2.Net change by Change Orders $ -22,314.00 CONTRACTO 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,113,686.00 By: Date: 1(113 in 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 894,798.56 State of:Indiana 5.RETAINAGE: County of:Hendricks a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 89,479.86 me this (r? day of kW. 2acq / b. 0 To of Stored Material Notary Public:Luke Roseboom (Column F on G703) $ 0.00 My Commission expires:July 07,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 89,479.86 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 805,318.70 In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 288,847 80 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CER11HED. 8.CURRENT PAYMENT DUE $ 516,470.90 AMOUNT CERTIFIED $516,470.90 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 3,308,367.30 CONSTRUCTION MANAGER: By: .4111�=- —, Date: i//L ir/ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: !�` Total changes approved in previous months by Owner$ 0.00$ 0.00 By: A / Date: to Total approved this Month $ 1,776.00$ 24,090.00 This Ce •'• . not le. The AMOUNT CERTIFIED is payable only to a Contractor TOTALS $ 1,776.00$ 24,090.00 named he • ssuance,payment and acceptance of payment are without prejudice to any rights of the Ow. • Contractor under this Contract NET CHANGES by Change Order $ -22,314.00 AIA Document G702/CMaT1I—1992.Copyright ®1992 by The American Institute of Architects. All rights reserved. WARNING:This AIA® Document is protected by U.S.Copyright Law and international Treaties.Unauthorized reproduction or distribution of this AlAe Document,or any portion of It,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law. This document was produced by AIA software at 14:01:10 on 11/13/2008 under Order No.1000356186_1 which expires on 5/13/2009,and is not for resale. User Notes: (1651554332) tr-itAIA Document G702/CMa' — 1992 \- _ 4 reas ' gl Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: Carmel Performing Ms Center APPLICATION NO ``? - " Distribution to: OWNER:❑ PERIOD TO:October 20,2008 CONSTRUCTION MANAGER:❑ FROM v= ocitAIRlpt a,1nc_ VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT:❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:N/A/2829/N/A CONTRACTOR:❑ Indianapolis,IN 46234 FIELD:❑ CONTRACT FOR: Bid Package No.4300 VIA ARCHITECT: CSO Architects OTHER:0 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,ALA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,136,000.00 payment shown here' now due. 2.Net change by Change Orders $ 0.00 CONTRACT.a I 3.CONTRACT SUM TO DATE(Line 1±2) $ 4,136,000.00 By: ' _j.J P Date: 10/29/08 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 320,942.00 State of: •diana 5.RETAINAGE: County of:Hendricks a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 32,094.20 me this 2.41t day of 04 co'oe(1 2m0 S( b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on 0703) $ 0.00 My Commission expires:July 07,2012 • Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 32,094.20 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 288,847.80 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their T.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 0.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 288,847.80 J.MOUNT MOUNT CERTIFIED $288,847.80 V. 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 3,847,152.20 CONSTRUCTION MANAGER: . , By: Date: l0/1.1/08 CHANGE ORDER SUMMARY ADDITIONS= DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner $ 0,00$ 0.00 By: Date: l ia 13 �y 2 L Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00$ 0.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order $ 0.00 AIA Document G702/CMa*a—1992.Copyright ®1992 by The American Institute of Architects. All rights reserved. WARNING:This AlA®Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible y under the law. This document was produced by AIA software at 08:58:21 on 10/29/2008 under Order No.1000356186_1 which expires on 5/13/2009,and Is not for resale. User Notes: (3555614228)