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HomeMy WebLinkAboutWR Dunkin, Simplex Grinnell, General Piping - $112,443.70 r 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 Scheduled Percent Amount of Amount of Value or Complete or Prior Current Contract Contract Authorized Authorized Amount Amount Owed Disbursement Disbursement Amounts to be paid by Carmel Garage Development Company,LLC per the Elevators,Fire Protection,and Pumps Installment Purchase Contract March work(WR Dunkin) $67,200.00 March work(General Piping) $2,545.20 March work(Simplex Grinnell) $42,698.50 Grand Total ,Total'Due ' : $112,443.70 P/ CRC has inspected the portions of the PAC Equipment completed by Borrower to i ( confirm the Percent Complete in the applicable column above. CRC either has received or waived receipt of conditional lien waivers and other submittals 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 meanings 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, by and between the same parties. Dated: IA I I° CITY OF CARMEL REDEVELOPMENT /// COMMISSION itwa.....ii!„ By ' Les S. Olds Printed Executive Director Title 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 Reiumbursed to CRC $ 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 Paid by Carmel Garage Development Company $ 53,200.00 January 2010 IPC Amount for application 21 Completed and Stored to date $ 28,300.00 Retention held(based on 5%retention) $ 1,415.00 Paid by Carmel Garage Development Company $ 26,885.00 February 2010 Paid by Carmel Garage Development Company $ 76,000.00 March 2010 Amount to be paid by Carmel Garage Development Company $ 67,200.00 �` /4 • I �: i Document 7®2i a" ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#4050 CPA APPLICATION NO: 023 nj Distribution to: Commission 777 3rd Ave. S.W. OWNER: One Civic Square Carmel,IN 46032 Carmel,IN 46032 PERIOD TO:March 31,2010 CONSTRUCTION MANAGER: ARCHITECT: FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel 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: General Construction 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 pai. or'he Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment wers.¢s sued a a i.yi receive. 1 om the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2,268,700.00 pa - _ own-hereitris no,Idtfe. 2.NET CHANGE BY CHANGE ORDERS $ 0.00 ONTRAC .s• W R i,;� r''''.•- . S* , c. 3.CONTRACT SUM TO DATE(Line 1±2) $ 2,268,700.00 1 -� _` Date: March 15,2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,349,810.00 S e of:Indiana 5.RETAINAGE: County of:Madison a. 5 %of Completed Work Subscribed and sworn to before (Column D+E on G703) $ 113,435.00 me this 15th day of Mar h, 4.010 J , b. 0 %of Stored Material Notary Public:Martha A.Carpenter / /��; (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 113,435.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1.236,375.00 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 $ 1,169,175.00 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 $ 67,200.00 AMOUNT CERTIFIED $ 77 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fro e amount applied. Initial all, gurhis Application and on the Continuation Sheet tha hanged to conform with the amount certified.) (Line 3 less Line 6) $ 1,032,325.00 CONSTRUCTION GE" / Y ∎ ..`;:'/ma, __ Date: 03 1) i D CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCH ,, ((( Total changes approved in previous months by Owner$ 0.00$ 0.00 By: ' I Date: 04( f 63 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/CMar"-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 14:44:34 on 03/18/2010 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1935827527) *A , A Document G7ssy3TM - 1992 Continuation Sheet AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 023 containing Contractor's signed certification is attached. APPLICATION DATE:03/15/2010 In tabulations below,amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO:03/31/2010 ARCHITECT'S PROJECT NO:25310 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 AND STORED TO G_C FINISH (IF VARIABLE APPLICATION THIS PERIOD DATE ( ) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) Steel Doors& 08110 Frames-M 73,000.00 73,000.00 0.00 0.00 73,000.00 100.00% 0.00 7,300.00 Steel Doors& 08111 Frames-L 33,000.00 24,550.00 0.00 0.00 24,550.00 74.39% 8,450.00 2,455.00 Flush Wood Doors- 08140 M 39,000.00 8,780.00 0.00 0.00 8,780.00 22.51 % 30,220.00 878.00 08141 Flush Wood Doors-L 15,000.00 2,000.00 0.00 0.00 2,000.00 13.33% 13,000.00 200.00 Stile&Rail Wood 08143 Doors-M 127,000.00 11,340.00 0.00 0.00 11,340.00 8.93% 115,660.00 1,134.00 Stile&Rail Wood 08144 Doors-L 34,000.00 0.00 0.00 0.00 0.00 0.00% 34,000.00 0.00 Sound Control Doors 08347 &Windows-M 352,000.00 9,000.00 36,000.00 0.00 45,000.00 12.78% 307,000.00 900.00 Sound Control Doors 08348 &Windows-L 50,000.00 0.00 9,000.00 0.00 9,000.00 18.00% 41,000.00 0.00 Overhead Coiling 08355 Doors-M 20,750.00 0.00 0.00 0.00 0.00 0.00% 20,750.00 0.00 Overhead Coiling 08356 Doors-1 2,850.00 0.00 0.00 0.00 0.00 0.00% 2,850.00 0.00 Alum.Framed Entrances/Storefronts 08410 -M 176,000.00 29,520.00 0.00 0.00 29,520.00 16.77% 146,480.00 2,952.00 Alum.Framed Entrances/Storefronts 08411 -L 69,700.00 0.00 0.00 0.00 0.00 0.00% 69,700.00 0.00 08413 Interior Alum.Doors 17,000.00 340.00 0.00 0.00 340.00 2.00% 16,660.00 34.00 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 1 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:45:42 on 03/18/2010 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1412516969) . .+.. A B C D E F G H I WORK COMPLETED TOTAL. MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRLPTION 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) &Frames-M 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 66,000.00 67,380.00 97.65% 1,620.00 6,738.00 Revolving Door 08424 Entrances-L 9,500.00 0.00 0.00 0.00 0.00 0.00% 9,500.00 0.00 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- 14211 Material/Equipment 452,000.00 452,000.00 0.00 0.00 452,000.00 100.00% 0.00 43,574.00 Elec.Traction 14212 Elevators-L 186,000.00 132,000.00 20,000.00 0.00 152,000.00 81.72% 34,000.00 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/Equipment 183,000.00 183,000.00 0.00 0.00 183,000.00 100.00% 0.00 18,300.00 Hydraulic Elevator- 14243 Labor 63,000.00 63,000.00 0.00 0.00 63,000.00 100.00% 0.00 6,300.00 Wheelchair Lift- 14421 Material/Equipment 48,000.00 0.00 0.00 0.00 0.00 0.00% 48,000.00 0.00 Wheelchair Lift- 14422 Permits 2,200.00 0.00 2,200.00 0.00 2,200.00 100.00% 0.00 0.00 Wheelchair Lift- 14423 Labor 14,000.00 0.00 0.00 0.00 0.00 0.00% 14,000.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 GRAND TOTAL $2,268,700.00 $1,216,610.00 $67,200.00 $66,000.00 $1,349,810.00 59.50% $918,890.00 $113,435.00 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 2 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:45:42 on 03/18/2010 under Order No.0754240912_1 which expires on 05/10/2010,and is not for resale. User Notes: (1412516969) Draft PAC Piping and Pumps (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 Reiumbursed to CRC $ 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 Paid by Carmel Garage Development Company $ 3,615.96 January 2010 IPC amount for application 16 Completed and stored to date $ 1,327.72 No retention was held $ - Paid by Carmel Garage Development Company $ 1,327.72 February 2010 Paid by Carmel Garage Development Company $ 4,177.72 March 2010 Amount to be paid by Carmel Garage Development Company $ 2,545.20 $774AIA Document G702/ ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: City of Carmel PROJECT: CPAC 16% APPLICATION NO: 18 nj Distribution to: OWNER: ❑ PERIOD TO:March 31,2010 CONSTRUCTION MANAGER:❑ FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT: ❑ CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:NA/2829/NA CONTRACTOR: ❑ Indianapolis,IN 46234 FIELD: ❑ CONTRACT FOR: General Construction 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 $ 643,496.00 payment shown herein is now due. i 2.NET CHANGE BY CHANGE ORDERS $ 0.00 CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1±2) $ 643,496.00 By: Date: 3/141/ !o 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 591,928.40 State of:Indiana 5.RETAINAGE: County of:Hendricks a. 100 %of Completed Work Subscribed and sworn to before II (Column D+Eon G703) $ 54,549.71 me this Ali day of 1V1 pi xi.,t acto 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) $ 54,549.71 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 537,378.69 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 $ 534,833.49 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 $ 2,545.20 AMOUNT CERTIFIED $2,545.20 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differ rom the amount applied.Initial all figures on this Application and on the Continuation Shee are changed to conform with the amount certified.) (Line 3 less Line 6) $ 106,117.31 CONS RUCTION MA 'GER: By: ' i'\t♦��iv / • Date: �� ?� t0 4. CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC �/ Total changes approved in previous months by Owner$ 0.00$ 0.00 By: C,i ( / I• Date: "TI4tY .1 . Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CER 11FHED 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 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 08:03:13 on 03/24/2010 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (681719438) =N Document 703 ® 1992 �7 Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 18 containing Contractor's signed certification is attached. APPLICATION DATE:03/15/2010 In tabulations below,amounts are stated to the nearest dollar. Use Column Ion Contracts where variable retainage for line items may apply. PERIOD TO:03/31/2010 ARCHITECT'S PROJECT NO:NA A B C D E F G H I WORK COMPLETED TOTAL MATERIALS ITEM SCHEDULED FROM PRESENTLY COMPLETED To BALANCE TO RETAINAGE DESCRIPTION OF WORK PREVIOUS AND STORED FINISH (IF VARIABLE NO. VALUE APPLICATION THIS PERIOD STORED NOT TO DATE (G_C) (C-G) RATE) IN (D+E) D OR E) (D+E+F) 62 Sewage Ejector/Triplex Pumps 0.00 0.00 0.00 0.00 0.00 0.00 % 0.00 0.00 63 Labor 26,640.00 25,308.00 0.00 0.00 25,308.00 95.00 % 1,332.00 2,530.81 64 Material 167,273.00 167,273.00 0.00 0.00 167,273.00 100.00 % 0.00 16,727.30 65 Domestic Pumps 0.00 0.00 0.00 0.00 0.00 0.00 To 0.00 0.00 66 Labor 4,440.00 3,996.00 444.00 0.00 4,440.00 100.00 % 0.00 0.00 67 Material 27,066.00 27,066.00 0.00 0.00 27,066.00 100.00 % 0.00 2,706.60 102 Plumbing Fixtures 0.00 0.00 0.00 0.00 0.00 0.00 To 0.00 0.00 103 Labor 54,840.00 6,032.40 0.00 0.00 6,032.40 11.00 % 48,807.60 274.20 104 Material 111,082.00 111,082.00 0.00 0.00 111,082.00 100.00 % 0.00 11,108.20 105 Water Heater 0.00 0.00 0.00 0.00 0.00 0.00 % 0.00 0.00 106 Labor 4,080.00 612.00 2,040.00 0.00 2,652.00 65.00 % 1,428.00 20.40 107 Material 62,669.00 62,669.00 0.00 0.00 62,669.00 100.00 % 0.00 6,266.90 136 HVAC Pumps 0.00 0.00 0.00 0.00 0.00 0.00 % 0.00 0.00 137 Labor 6,120.00 6,058.80 61.20 0.00 6,120.00 100.00 % 0.00 0.00 138 Material 28,061.00 28,061.00 0.00 0.00 28,061.00 100.00 To 0.00 2,806.10 142 HVAC Equipment 120,532.00 120,532.00 0.00 0.00 120,532.00 100.00 % 0.00 9,039.90 GPI#23B-Storm Water 212 Control Panel 30,693.00 30,693.00 0.00 0.00 30,693.00 100.00 % 0.00 3,069.30 GRAND TOTAL $ 643,496.00 $ 589,383.20 $ 2,545.20 $ 0.00 $ 591,928.40 91.99 % $ 51,567.60 $ 54,549.71 AIA Document G703TM-1992.Copyright CO 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 1 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 08:05:33 on 03/24/2010 under Order No.1000389341_1 which expires on 5/13/2010,and is not for resale. User Notes: (7716825) 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 Reiumbursed to CRC $ 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 Paid by Carmel Garage Development Company $ 76,965.00 January 2010 Paid by Carmel Garage Development Company $ 1,779.91 February 2010 Paid by Carmel Garage Development Company $ 9,060.00 March 2010 Amount to be paid by Carmel Garage Development Company $ 42,698.50 t% r 0 'k* /1. I, , TM i111.0151 , Application and Certificate for Payment Construction Manager-Adviser Edition 1(3 TO OWNER: PROJECT: APPLICATION NO: 17 Distribution to: Carmel Redevelopment Comm Parcel 7A Regional Performin One Civic Square Arts Center PERIOD TO: 3/31/2010 OWNER Carmel, IN 46032 CONSTRUCTION MANAGER r • FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6/20/2009 ARCHITECT ❑ SimplexGrinnell LP Shiel Sexton Co. PROJECT NOS: 2695 / 4280 / CONTRACTOR 0 11820 Pendleton Pike Indianapolis , IN 46236 VA ARCHITECT: FIELD CSO Architects CONTRACT FOR: Auto Fire Protection 0 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the hest 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 pp p y 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 payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM S6 15, 359 .00 payment shown herein is n w due. 2. Net change by Change Orders $(20, 549 . 00) CONTRACTOR. 3.CONTRACT SUM TO DATE(Line 1 +2) 5594 , 810 . 00 B' __ ��/'(! / _ Date: M�r_Ch 9 . 20...1_0 4.TOTAL COMPLETED&STORED TO DATE(Column 0 on 0703) S550, 607 1 State of: Mic el M. MacDonald Indiana 5.RETAINAGE: County of: ,,,,,��.,—4,_a,e,�s,, Marion a• 5 %of tRPTIOMMQVXContract Value Subscribed and sworn to before snra GLORIA J.GALLEN ,, �,,+�f Notary Public,State Windom (Column 0+Eon 0703 $ 2 9_j 7 4 0 . me this 19th tY "f Ma h ' , ;iii .,r Marion county My Commission Expires b. %of Stored Mrterial Notary Public: .. `4 ,;� e�'w E (Column F on 0703) • S 0_,_0_0___ My ContmiasittiT expires:1— 2018 January 11,2018 Total Retainage(Lines Sa+5h or Total in Column I of 0703). $ 7 74_Q_.5Q CERTIFICATE FOR PAYMENT In accordance with the Contract Documents. based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $5_2 0 , 8 6 7 . 41 this application. the Construction Manager and Architect certify to the Owner that to the hest of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality or the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT S 478 , 695 5 0 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. S Cr 8.CURRENT PAYMENT DUE $ 42, 698 . 50 j AMOUNT CERTIFIED S Li Zi(Q°t1 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from unomu applied. Inirial all figures on this Appliratrnn artd rm t a C•ontinuatirrrr Slz•,t that a ri,ed to crita/hrm tirirlt the amount certified.) (Line 3 less Line 6) $ 73 , 842 . 59 CONS ' CTION M'¢GEr / By wit! ,''<. i ��� Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE T: Total changes approved in previous months by Owner I $ —4 , 601 5 25 , 1 L 0 By; ` , ` Date: y e Oar Total approved this Month S $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor • " TOTALS S4 , 601 S 25, 150 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order i S (2 0 ,549 . 00) i the Owner or Contractor under this Contract. CAUTION:You should sign an original AMA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702ICMasM—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ate Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA°D 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. SimplearGrinisell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO,: 17 containing Contractor's signed Certification,is attached. CARMEL PERFORMING ARTS APPLICATION DATE: 03/15/2010 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 03/31/20I0 Use Column I on Contracts where variable retainage for line items may apply. PROJECT NO.: 2695-4280 A B C 0 E F G II 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 L) (D-Il+F) (C-O) 10 ' ADMINISTRATION 1(,..,i 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 S0.00 $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%' S0.00 $0.00 10040 Drarwing&Drafting Srvices $33,638.00 S33,638.00 $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 $13,218,00 $0.00 $0.00 $13,218.00 100% $0.00 $0.00 20040 Basement $32,772.00 $32,772.001 $0.00 . $0.00 $32,772.00 100% 50.00 $0.00 20050 Plenum Level $13,310.00 . $13,310.00 1111 $0.00 $0.00 $13,310.00 100% $0.00 $0.00 '20060 'Orchestra Low Level $18,977.00 $18,977.00 1 $0.00 S0.00 $18,977.00 100% $0.00 $0.00 2 Orchestra High Level $12,010.00 $12,010.00 I $0.00 $0,00 $12,010.00 100% $0.00 $0.00 20080 Box Tier Level $21,950.00 $21,950.001 $0.00 $0.00 $21,950.00 100% $0.00 $0.00 20090 Balcony Low Level . $12,800.00 $12,800.00 $0.00 $0.00 $12,800.00 100% $0.00 • $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 ' $5,600.00 $0.00 i $0.00 $5,600.00 100% $0.00 $0.00 20120 Attic 66 ft Level $8,805,00 $8,805.00 $0.00 I $0.00 $8,805.00 100% 50.00 $0.00 20130 Attic 80 ft Level $12,335.00 $12,335.00 $0.00 $0.00 $12,335.00 100%, $0.00 $0.00 20140 Pre-action $15,984.00 $7,992.00 $7,992.00 $0.00 515,984.00 100% $0.00 $0.00 30000 INSTALLATION 30010 Underground $3,714.00 $3,714.00 $0.00 i $0.00 $3,714.00 100% $0.00 $0.00 30020 Fire Pump $0.00 $0.00 $12,257.19 99% $123.81 $0.00 $12,381.00 $12,257.19 I 30030 Standpipe $17,024.00 $12,768.00 1 $0.00 $0.00 $12,768.00 - 75% $4,256.00 $0.00 30040 Basement $49,602.00 $49,105.98 I $0.00 $0.00 $49,105.98 I 99%1 $496.02 $0.00 Sinop Mitt-Grinnell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 17 containing Contractor's signed Certification,is attached. CARMEL PERFORMING ARTS APPLICATION DATE: 03/15/2010 in tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 03/31/2010 Use Column I on Contracts where variable retainage for line items may apply. PROJECT NO.: 2695-4280 A 13 C D E F - G ( H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED • BALANCE RETAINAGE NC). VALUE APPLICATION THIS STORED AND SPORED % TO (IF VARIABLE) (D-i-13) PERIOD (NOT IN TO DATE (G+C) FINISH RATE _ D OR 13) (D+E+F) (C-G) 31 Plenum Level $17,179.00 $17,007.21 $0.00 I $0.00 $17,007.21 99% $171.79 $0.00 3G,�0 Orchestra Low Level $26,620.00 $26,353.80 $0.00 $0.00 $26,353.80 99% $266.20 $0.00 30070 Orchestra High Level $15,012.00 $14,861.88 $0.00 $0.00 $14,861.88 99% $150.12 $0.00 30080 Box Tier Level $31,572.00 $20,521.00 $0.00 , $0.00 $20,521.00 65% $11,051.00 $0.00 30090 Balcony Low Level $16,328.00 $1,633.00 $0.00 $0.00 $1,633.00 10% 514,695.00 $0.00 30100 Balcony High Level $34,822.00 $31,339.85 $0.00 $0.00 $31,339.85 90% $3,482.15 $0.00 30110 Attic 50 ft Level $4,333.00 $1.083.00 $2,816.00 ' $0.00 $3,899.00 90% $434.00 $0.00 30120 Attic 66 ft.Level $9,673.00 $2,420.00 $6,286.00 $0.00 $8,706.00 90% $967.00 $0.00 30130 Attic 80 ft.level $15,554.00 $3,888.00 $10,111.00 $0.00 i $13,999.00 90% $1,555.00 $0.00 ALLOWANCE $1,704.00 $0.00 $0.00 $0.00 $0.00 0% $1,704.00 $0.00 14280A-001 $1,940.00 $1,940.00 $0.00 it $0.00 $1,940.00 I 100%I $0.00 $0.00 4280A-002 $911.00 $911.00 $0.00 i $0.00 $911.00 100% $0.00 $0.00 14280A-003 Reduction $25,000.00 S0.00 $0.00 $0.00 $0.00 0% $25,000.00 $0.00 14280A-004 $531.00 $531.00 $0.00 $0.00 I S531.00 100% $0.00 $0.00 4280A-005 $5,064.00 $5,064.00 $0.00 S0.00 $5,064.00 100% $0.00 $0.00 4280A-006 $614.00 $614.00 $0.00 $0.00 3 $614.00 100% $0.00 , $0.00 4280A-007 $14,236.00 $0.00 $14,236.00 $0.00 , $14,236.00 100% $0.00 $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 $4,601.00 $0.00 t $0.00 $4,601.00 100% $0.00 $0.00 Change Order 1 ($25,150.00), $0.00 $0.00 $0.00 0% ($25,150.00) $0.00 $0.00 $0.00 $0.00 ; $0.00 0% $0.00 $0.00 TOTALS $594,810.00 $509,166.91 $41,441.00 $0.00 $550,607.91 93% $44,202.09 $0.00 SimplexGrinnell 11820 Pendleton Pike,Indianapolis,IN 46236 tqco Fire & Security Simp!exerinneel CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from Carmel Redevelopment (Maker of Check) in-the sum of$ 48 , 294 . 70 payable to SimplexGrinnell and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanic's lien, stop notice or bond right the undersigned has on the job of Carmel Redevelopment (Owner) located at Carmel Perlorminq Arts Center (Job Description) to the following extent. This release covers a progress payment for labor, services, equipment or material furnished to Carmel Redevelopment (Your Customer) through March 15 , 20'Only and does not cover any retention or items furnished after said (Date) date, nor disputed claims in the amount of$ N/A . Before any recipient of this document relies on it, the party should verify evidence of payment to the undersigned. DATED: March 15 , 2010 SimplexGrinne (Company N. ) ` BY: chae M. MacDonald District Business Manager Offices& Representatives in Principal Cities throughout the World