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WR Dunkin, Simplex Grinnell, General Piping - $311,458.60
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 Woi-k Scheduled Percent Amount of Amount of Value or Complete or Prior Current Contract Contract Authorized Authorized Amount Amount Owed Disbursement Disbursement Amount to be paid by Carmel Garage Development Company as per Detention and Foundation Installment Purchase Contract Application 24(WR Dunkin)'April 2010 $ 78,200.00 Application 25(WR Dunkin)May 2010 5 194.920.00 Application 18(Simplex Grinnell)April S 26,020.00 2010 Application 29(Simplex Grinnell)May $ 5,463.00 2010 Application 19(General Piping)April 2010 $ 3,746.40 Application 20(General Piping)May 2010 $ 3.109.20 Grand Total ++ ;To a).. DXI =5 3 i45 80 1 CRC has inspected the portions of the PAC Equipment completed by Borrower to confirm the Percent Complete.in the applicable column above. ❑ CRC either has received or waived receipt olconditional 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: 7//t/D CITY OF CARMEL REDEVELOPMENT COMMISSION By Les S. Olds Printed Executive Director Title Draft PAC Elevators and Doors (WR Dunkin) Up Through November 2009 (PC 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 Paid by Carmel Garage Development Company $ 67,200.00 April 2010 Amount to be paid by Carmel Garage Development Company $ 78,200.00 May 2010 Amount to be paid by Carmel Garage Development Company $ 194,920.00 •- : I ocu - ent 702/C 1992 t Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,44050 CPA APPLICATION NO:024 3 Distribution to: Commission 777 3rd Ave.S.W. One Civic Square Carmel,IN 46032 OWNER: Carmel.IN 46032 PERIOD TO:April 30,2010 CONSTRUCTION MANAGER: FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:May 08,2008 ARCHITECT: CONTRACTOR: PD Box 2247 MANAGER: PROJECT NOS:25310/2695.4050/2695 CONTRACTOR: Anderson,IN 46018 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 h=•n paid by the Contractor for Work for which previous Continuation Sheet,A1A Document G703,is attached. Certificates for Payment were issued a j'payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2,268,700.00 payment shown herein' ow d 2.NET CHANGE BY CHANGE ORDERS 5 0.00 iiii i.6-: W` +•: ,)tt�C 3.CONTRACT SUM TO DATE(Line 1±2) $ 2,268,700.00 / \ /iLtL�L✓ a Date: April 15,2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,428,010.00 S :e of:Indiana 5.RETAINAGE: • County of:Madi on a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 1 13,435.00 me this 15th day of April` ,010 b. 0 %of Stored Material Notary Public:Martha A.Carpenter GLt t lrl`Z 1A-, (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 $ 1,314,575.00 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 5 1,236,375.00 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. t 8.CURRENT PAYMENT DUE IS 78,200.001 AMOUNT CERTIFIED $ 7 Z 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if anoint certified dyers from the amoral applied.Initial all figure on this aQf Application and on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 954,125.00 CONSTRUCT10 MANAGE By. ! h� Date: l Z).. 2:(.' ■ o CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECv v Total changes approved in previous months by Owner$ 0.00$ 0.00 B �.�� By: Date: 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"'—1992.Copyright®1992 by The American Institute of Architects.All rights resolved.WARNING:'ThisAIAe Document is protected'by U.S:copyrlght'Law and.International Treaties.Unauthorized reproduction or distribution of ttiis AlAe Document,or any portion.of it,may result in severe civil and criminal penalties,and will be prosecute'to:the maximum extent,possible ,I under the law:This document was produced by AIA software at 15:18:02 on 04/19/2010 under Order No.0754240912_1'which expires on 08/10/2010,and is not for resale. User Notes: (1379087449) , F m ntG7 3 - 1992 Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO:024 containing Contractor's signed certification is attached. APPLICATION DATE:04/15/2010 In tabulations below,amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO:04/30/2010 ARCHITECT'S PROJECT NO:25310 A B C D I 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) 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 4,200.00 0.00 28,750.00 87.12% 4,250.00 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 2,000.00 0.00 2,000.00 5.88% 32,000.00 0.00 Sound Control Doors 08347 &Windows-M 352,000.00 45,000.00 0.00 0.00 45,000.00 12.78% 307,000.00 900.00 Sound Control Doors 08348 &Windows-L 50,000.00 9,000.00 0.00 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-I 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 30,000.00 0.00 59,520.00 33.82% 116,480.00 2,952.00 Alum.Framed Entrances/Storefronts 08411 -L 69,700.00 0.00 18,000.00 0.00 18,000.00 25.82% 51,700.00 0.00 08413 Interior Alum.Doors 17,000.00 340.00 0.00 0.00 340.00 2.00% 16,660.00 34.00 AlA Document G703TM-1992.Copyright 01963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIAe Documontls'protectad by U.S.Copyright Law and International Treaties..Unauthorized reproduction ordistribution'of thls,AlA4'Document,or any portion of It,may result in severe civil and criminal penalties,and will ho 1 prosecuted to the maximum extent possible'under the law:This document was produced by AIA software at 15:14:41 on 04119/2010 under Order No.07542409121 which expires on 05/10/2010.and is not for resale, User Notes: (1297238571) . A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED eta BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G_C) (NOT IN D OR E) (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 186,000.00 152,000.00 24,000.00 0.00 176,000.00 94.62% 10,000.00 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 2,200.00 0.00 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 $1,283,810.00 $78,200.00 $66,000.00 $1,428,010.00 62.94% $840,690.00 $113,435.00 AIA Document G703TM-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•AIA°Document,or any portion of it,may result In severe civil and criminal penalties;and'will bo 2 prosecuted to the maximum extent possible under the law-This document was produced by AIA software at 15:14:41 on 04/19/2010 under Order No.0754240912_1 which expires on(ism 012 010,and is not for resale, User Notes: (1297238571) Document 7 / ® 1992 i, Application and Certificate for Payment Construction Manager Adviser Edition 35 TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#4050 CPA APPLICATION NO:025-B Distribution to: Commission 777 3rd Ave.S.W. OWNER: One Civic Square Carmel,IN 46032 PERIOD TO:Ma 31,2010 CONSTRUCTION MANAGER: Cannel,IN 46032 May 31, 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 Anderson,IN 46018 FIELD: CONTRACT FOR: General Construction VIA ARCHITECT: CSO Architects OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of Contractor's knowledge,information and belief the Work covered by this Application for Pa t 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 een by the o tractor for Work for which previous Continuation Sheet,AIA Document 0703,is attached. Certificates for Payment we,- issued id dptents re • d from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2,268,700.00 payment shown herein is n• *due. / 2.NET CHANGE BY CHANGE ORDERS $ 0.00 CONT.Si 9 W ,: S I I I• . 3.CONTRACT SUM TO DATE(Line I±2) $ 2,268,700.00 t y /r/' i �-- Date: May 14,2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,622,930.00 a : 'C tn•tana 5.RETAINAGE: County of:Madison a. 5 %of Completed Work Subscribed and sworn to before +�,' - / (Column D+Eon G703) $ 113,435.00 me this 14th day of May,�/d if f�Tst' ��( Y�Y-> b. 0 %of Stored Material Notary Public:Martha A.Carpenter (Column F on G703) $ 0.00 My Commission expires:January 08,-0 if Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 113,435.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,509,495.00 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 $ 1,314,575.00 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. �q OD 8.CURRENT PAYMENT DUE $ 194,920.00 AMOUNT CERTIFIED $ ` ' Cit Z/21 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all fgua•es on this Application an.on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 759,205.00 CONSTRUCTIO MAN,G--. By: _/ L .1 it Date: 5 2.3.2-0(0 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE f Total changes approved in previous months by Owner$ 0.00$ 0.00 By: ri �� S29,•:1.L .1. Date: Total approved this Month $ 0.00$ 0.00 This Certi icate s 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 AlA Document G702JCMaTM—1992.Copyright a 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 roproduction or distribution ofthis AIA°Document,or any portion of it,may result in severe civil;and criminal penaitics,and will be prosecuted to tho.maxlmum extent possible 1 under the law.This document was produced by AA software at 11:14:28 on 05/20/2010 under Order No.0168420739 1 which'expireson 05/10!2011,'and is not for resale. User Notes: (1097617268) ma r. • `°¢- ,° A` Document G7 3n" ® 1992 1• Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO:025 containing Contractor's signed certification is attached. APPLICATION DATE:05/14/2010 In tabulations below,amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO:05/31/2010 ARCHITECT'S PROJECT NO:25310 A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS ED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND COMPLETED 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) 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 28,750.00 2,600.00 0.00 31,350.00 95.00% 1,650.00 2,455.00 Flush Wood Doors- 08140 M 39,000.00 8,780.00 30,220.00 0.00 39,000.00 100.00% 0.00 878.00 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 89,100.00 0.00 100,440.00 79.09% 26,560.00 1,134.00 Stile&Rail Wood 08144 Doors-L 34,000.00 2,000.00 0.00 0.00 2,000.00 5.88% 32,000.00 0.00 Sound Control Doors 08347 &Windows-M 352,000.00 45,000.00 25,000.00 0.00 70,000.00 19.89% 282,000.00 900.00 • Sound Control Doors 08348 &Windows-L 50,000.00 9,000.00 0.00 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-I 2,850.00 0.00 0.00 0.00 0.00 0.00% 2,850.00 0.00 Alutn.Frafned .. • Entrances/Storefronts 08410 -M 176,000.00 59,520.00 0.00 0.00 59,520.00 33.82% 116,480.00 2,952.00 Alum.Framed Entrances/Storefronts 08411 -L 69,700.00 18,000.00 0.00 0.00 18,000.00 25.82% 51,700.00 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®1983.1965,1966.1967.1970,1978,1983 and 1892 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document is protected by U.S.Copyrig fit Law and International Treaties:Unauthorized reproduction or distribution of this Ale Document,or any portion of it;may re suh"in severe civil and criminal penalties,and will be I prosecuted to the maximum extent posaailo'under the law.This document was produced by AIA software at 11:08:57 on 05/20/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1147815029) 1 A B C D l_ E F G H I WORK COMPLETED TOTAL MATERIALS 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 (NOT IN D ORE) 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 15,720.0D Etec.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 EIec.Traction 14212 Elevators-L 186,000.00 176,000.00 0.00 0.00 176,000.00 94.62% 10,000.00 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 48,000.00 0.00 48,000.00 100.00% 0.00 0.00 Wheelchair Lift- 14422 Permits 2,200.00 2,200.00 0.00 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 $1,362,010.001 $194,920.00 $66,000.00 $1,622,930.00 71.54% $645,770.00 $113,435.00 AIA Document G703r"-1992.Copyright tD 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 grid Internationai Treaties.Unauthorised reproduction or distribution of this Ale Document,or.any'portion otit,may result in severe civil and criminal penalties,and will he 2 prosecuted-to tie maximum extent possible under thelaw.wThis document was produced by AIA software at 11:08:57'on 05/20/2010 under Order No.0168420739_1 which expires`on 05/10/2011.and is not for resale. User Notes: (1147815029) 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 Paid by Carmel Garage Development Company $ 42,696.50 April 2010 Amount to be paid by Carmel Garage Development Company $ 26,020.00 May 2010 Amount to be paid by Carmel Garage Development Company $ 5,463.00 P a Document G702IC ATM o 992 I' Application and Certificate for Payment Construction Manager Adviser Edition H3 TO OWNER: PROJECT: APPLICATION NO: 18 Distribution to: Carmel Redevelopment Comm. Parcel 7A Regional One Civic Square Performing Arts Center PERIODTO: 4/30/2010 OWNER ❑ 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 1 4280 I CONTRACTOR ❑ 11820 Pendleton PIke • Indianapolis, IN 46236 VIA ARCHITECT: FIELD ❑ 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 payment,as G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment vere issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615, 399.00 Payment shown herein i ow due. 2.Net change by Change Orders $ (429. 00$ONTRACT R: 3.CONTRACT SUM TO DATE(Line 1±2) $614,910. no BY: �r�- i,�/l Date: Apr i 1 19, 2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) 5577,633 . 91 State of. Indiana Michael M. Mac v. ." .-- --� - ,_.a. si 5.RETAINAGE: County of: Marion i PAULA K.LEWIS a. 5 %of Completed Work Subscribed and sworn to before Notary Public-Seal < State of Indiana (Column D+Eon G703) $ 30,746. 50 me this 19t ay of A• i 2010 ` My Commission Expires Aug i2,2017 b. %of Stored Material Notary Public : _ ` (Column F on G703) $ 0.00 MyCummiss nexpires:: — 2-2017 ���"' �����"� Total Retainage(Lines 5a+5b or Total in Column I of G703). $ 30,746 .50 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 5 4 Fi ,R R 7-41 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 $ 520,867. 41 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 $ 26 ,020.00 AMOUNT CERTIFIED $ 'IL?t e zo ° 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application a'rd on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $68,042.59 CONSTRU,TI N M, A, -•. By: _ s... i 1 Date: Lt• Z 7. 27 1 Cl CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE /' Total changes approved in previous months by Owner $ 4, 601 S(25,15 0) By: �1 Date: (,il•Z91. CI Total approved this Month $20, 120 $ .0 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $24,721 $(25,150) 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 $ (429 .00) CAUTION:'You'should sigh an original AlA Contract Document,on.which this text,appears in RED.An original assures;thatchanges vtiill'nof be:obscured: AIA Document G702/CMaTMM-1992.Copyright m 1992 by The American Institute of Architects.All rights reserved.WARNING:,Thls,AIAe'Document is protected.by'U.S:Copyright Law and International Treaties. Unauthorized.reproduetlon 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 niaxlmum 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,copyrighl@aie.org. Shappff xGrii ien DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 18 containing Contractor's signed Certification, is attached: CARMEL PERFORMING ARTS APPLICATION DATE: 04/15/2010 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO:04/30/20.10 Use Column I on Contracts where variable retainage for line items may apply. PROJECT NO.: 2695-4280. A B C D .E "P G H WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED PROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE APPLICATION THIS STORED AND STORED % TO (IFVARIABLE) (D+E) PERIOD (NOT IN TO DATE (G=C) FINISH RATE D OR E) (D+E+F) (C-G) 10000 ADMINISTRATION 10010 Bonds&Insurance $4,500.00" $4,380.00 $120.00 $0.00 $4,500.00 100% $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 Srvlces $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 517,910.00 $17,910.00 $0.00 $0.00 $171910.00 100% $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 $0.00 535;920.00 100% .$0.00 $0.00 20030 Standpipe $13,218:00 $13,218.00 $0.00 $0.00 $13,218.00 100% $0100 $0.00 20040 Basement 532,772.00 532,772.00 $0.00 $0.00 $32,772.00 100% $0.00 $0.00 20050 Plenum Level $13,310.00 513;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 $12,800.00 $0.00 $0.00 $12;800.00 100% $0.00 $0.00 20100 Balcony High Level S23;900.00 $23,900.00 $0.00 $0.00 $23,900.00 100% $0100 $0.00 20110 Attic 50 ft.Level $5,600.00 $5,600.00. $0.00 $0.00 $5,600.00 100% $0.00 $0.00 20120 Attic 66 It Level $8,805.00 $8;805.00 50.00 $0.00' $8,805.00 100% $0.00 $0.00 20130 Attic 80 ft.Level $12,335.00, $12,335.00. $0.00 $0.00 5121335.00 100% $0100 $0.00 20140 Pre-action $15,984.00 $15;984.00 $0.00 $0.00 $15,984.00 100% $0.00 50:00 30000• INSTALLATION 30010 Underground S3,714 100 $3,714.00 ,$0.00 $0.00 $3,714.00 100% $0.00 -50:00 30020 Fire Pump $12,381:00. .$12,257.19 $0.00 $0.00 $12;257.19 99% $123.81 $0.00 30030 Standpipe $17;024.00 $12;768.00 $2;554.00 $0.00 $15,322.00 90% $1,702.00 $0.00 30040 Basement $49,602:00 $49,105:98 $0.00 $0.00 $49,105.98 99% 5496.02 $0.00 Si vple ferhaoe it DETAIL AND CONTINUATION SHEET APPLICATION AND_CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: I S containing Contractor's signed Certification, is attached. CARMEL PERFORMING ARTS APPLICATION DATE: 04/15/2010 In tabulations below,amounts are.stated to the nearest dollar. PERIOD TO: 04/30/2010 Use Column I on Contracts'where variable retainage for line items.may apply. PROJECT NO.: 2695-4280 A B C; D E F 0_ 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. (GrC) FINISH RATE D OR E) (D+E+F) (C-G) 30050 Plenum Level .$17,179.00' .517,007:21 :$0.00." $0.00' 517,007:21 .99% $171.79 :50:00 30060 Orchestra Low Level $26,620.00 $26,353180 "$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 $8,525.00 $0.00 529;046.00 92% $2,526.00 $0100. 30090 Balcony Low Level $16,328:00 $1,633.00 $13,062.00 $0.00 $14;695.00 90% S 1,633.00 50,00 30100 Balcony High Level S34,822:00 $31,339.851 $0.00 ,$0.00 $31,339.85 90% 53,482,15 .$0100 30110 Attic 50 It Level $4,333.00 $3,899.00 $0.00 $0.00 $3:899.00 '90% $434.00 '$0.00 30120 Attic 66 ft.Level $9,673.00 $8,706.00 $0.00. $0.00 $8,706.00 90% $967.00 $0.00. 30130 Attic 80 ft.level $15,554.00 $13,999.00 $0.00 $0.00 $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 4280A-001 S1,940.00 $1,940.00" .50 100 $0.00. $1,940.00 100% $0.00 $0.00 4280A-002 .5911.00 $911.00 $0.00 '$0.00 $911.00 100% $0 100 $0.00 4280A-003 Reduction ,$25,000.00 .50:00- 50.00 50.00 $0.00 0% '525,000.00 $0.00 4280A-004 $531.00 5531.00 S0.00 S0.00 $531.00 100% $0.00 $0.00 4280A-005 $5,064.00 $5,064.00 $0.00 $0.00 $5,064.00 100% $0.00 $0.00 4280A-006 5614:001 5614.00 50:00 $0.00 5614.00 100% 50.00 50.00 4280A-007 $14,236.00 $14,236.00 $0.00 $0.00 $14,236.00 100% $0.00 $0.00 2695-4280-04 Addtion S17,235.00 ,$0:001 '$0.00 $0.00 $0:00 0% $17,235.00 .50.00 4280A=009 52,765:00 $0.00 $2,765.00 $0.00 $2,765.00 100% 50.00 $0.00 CHANGE ORDERS "$0:00 $4.00 $0.00 $0.00 0% $0:00 $0.00' Change Order 1-RFQ 006 $4,601.00 $4,601.00 $0.00 $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) .50:00. Change'Order 2' $20,120.00. $0.00 $0.00 50.00 0% $20,120.00 $0.00 TOTALS S614,930.00'_ $550,607.91 $27,026.00 $0.00 $577,633:91 .94% $37,296.09. $0.00 two • Fire& Security Simple t erin ell 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$87 ,:804.91 payable to SimplexGrinnell and when thecheck has been properly endorsed and has been paid by the bank upon which it is drawn, this document .shall become.effective to release any mechanic's lien, stop notice or bond right the undersigned has on the job of Carmel Redevelopment • (Owner) located at Carmel Perdorminct Arts Center (Job Description) to the following extent. This release covers a progress payment for labor, services, equipment or material furnisled to Carmel Redevelopment (Your Customer) through April 15 . 2010only and does not coverall); retention or items furnished after said (Date) date, nor disputed claims in the amount of$ . Before any recipient of this document relies.on.it, the party should verify evidence of payment.to the undersigned. DATED: April 15, 2010 Sim IexGrinn-ll , (Company N nir BY: Michael M. MacDonald Offices 8:Representatives iii Principal Cities throughout the World STATEMENT OF COMPLIANCE Payroll •lumber Payroll Payment Contract Number. Date Processed Status Final �(f/+ �3�/g19/2010 331-93�75�711^7�-02 3/19/2010 Company Paid BP GLORIA.J. G�.EN, �-tC do hereby evenly.under penalty of peclurv: iN,onc of,q;o.nuny puma 1liii (1)'Ibat I pay or supervise ihr payment oil the pet sons employed by __ SingdesGrinnell I.P un lit _GAlv:T'L I'ERFOR\1ING AI%__ --jCoimtrotn i-St ilirumi.t7� that dining the paytoll period commencing on tlw 05 day of Mar. 20_10 and ending 11w_.1/ day of Mas. 2U 10. all pt•tsol is employed tat said pi It I'd have been paid the lull archly wages (suited that no rhinos have been tit trill 1w made other dintelly m indhvrtly to 111 on behalf t, said SintplexCtinnell I_P _-_frunt the full weekly wage earned ned by any pets!,and that 1111 drduclilns irate burn mull rthlt ..`" I�nn'inirut uSiibronuiiion . du trtly m inditcrtly hoot the lull wages rained by any pet sun.mho than pen missible deductions as defined in Regtilntiuns.l':n 13 12111 CFR Subtitle Al. issued by the Secretary tf Labor inlet the Copeland Act.as Amuvtdid 4111 Stat.P-Is.113 Stat. 11111.72 Stat.1,167:Ili Stat.357: IN U.S.C.27cc1.and drsci tbed below. FIT;FICA;STATE;INSURANCE • (2)Thal any payiulls otherwise maim This eunirart 111111111 1111 w be submitted for the:slime pet ltd ate ruuect and complete:11101 the wage talcs rot labun•ts m mechanics tunlained therein are nut less than 1111 applicaIir wagl r1tes r11nmined in any wage tintnmiwnion intmpnt auvl uuu the ninth Thal the clasSiffrallots set(milt therein fur CIJCII laborer or mechanic runlet nt w int the wort:pet lot med. (3)That any appientires employed in the above pt•t rod are duly rt,gist led in It Ionia tide applentit whip prttgrtut Iegisti ird„tih a Stale apps entire 1.11(0 agtnry trrugtiied by Ihr Ittitea,of Appiendreship and•Ilaining.Utmrd Stairs I tep:uuurnt ul Lahti.ut iI no sorb urinnitt•d agent v raises in:t State.are irgisu•ird with the bureau of Appit,tireshtp and Trailing.landed Stan,Ilt•parunr11t tI 1ab111. (•II Ihm. (a) WHERE FIlINGF IiENL•'Ffrs APE.PAID 70 AI'I'R(Wlirl PLANS.I-UNUS.OH PROGRAMS In addition to the basic 1lnnly wage tan_s paid it rnrh IaI11t et 111 uteth;otir listed ill II r a1111ce t•htrlrrd ptwdl payment,ill hinge 10 benefits as listed in Ihr tilt have 111111 on will be made to appuipttated pi tigrams lor the benefit uI such etipl,tees.except as noted in Stctiun 1l10 below. (bl WHERE FRINGE 11ENFITS Allll I'All)IN CASII I'arh I about 11r nurhatiit listed in Ihr obis Iefet1.111 rd 11,11 toll In,beet paid as radii ated 1111 nIu•po ll.an 0111,1111 nut less ih,11t die FlS11111 ul Ihr iipplir■blr basil-httuly wugr tare plot•ihr mutuut 111 the Ieilutrtl Image hrnrhls ie.listed 111 Ih•111tilt•u I.ra •pl:IS 111111111 in NV1.111111 1111.1 brluu. (c) IiXCLI'IIIINS F\CEl'fIONS(CRAFT) NONE R.1-arks Company Paid BP /7,4 Name and Tide SignarV� / The willful falsification of any of the above Stattnurnts tray ntil,l it 1).tr rutnactor or subcnnt itrrJr‘l,civil nr t i itni 1.11 pruseculiun.See set-lion 1001 of title IN and sec-that 231 of title 31 ui the United Shires rude. 4t ][ Document G702/C. la — 1992 t. Application and Certificate for Payment Construction Manager-Adviser Edition y3 TO OWNER: PROJECT: APPLICATION NO: 19 Distribution to: Carmel Redevelopment Comm. Parcel 7A Regional PERIOD TO: 5-31-2010 OWNER ❑ One Civic Square Performing Arts Center Carmel, IN 46032 CONSTRUCTION MANAGER XI FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6-20-2009 ARCHITECT ❑ S.implexGrinnell LP Shiel Sexton Co. PROJECT NOS: 2695 / 4280 / CONTRACTOR ❑ 11820 Pendleton Pike • VIA ARCHITECT: Indianapolis, IN 46236 FIELD ❑ CONTRACT FOR: 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, for Document payment,as 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 fro n the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615.359 .00 Payment shown herein is ow du / 2.Net change by Change Orders $ (429.00)ONTRACTTO 2' _ / 3.CONTRACT SUM TO DATE(Line 1 ±2) $•614,930 . 0013y: L , _ Date: May 19 , 2010. 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 583,0 9 6. 91 State of: Indiana 'M>_ 'hae ' . Mac o o aid 5.RETAINAGE: County of:Marion T a. 5 %of Completed Work Subscribed and sworn to before ` t PAULA K.LEWIS (Column D+Eon G703) $ 30,746 .50 me this 19th y 01 14 y r, 20 N.�tNotary Public—Seal - b. %of Stored Material Notary Public: /I a State of Indiana (Column F on G703) $ 0_0 0 My Commission expires:8-12-2017 My Mynatimmission,Expires Aug 12,12017. Total Retainage(Lines 5a+5b or Total in Column I of 0703).. $ 30,746.50 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based On on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 552,350 .41 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 $546,887 .41 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 $ 5 ,463.00 AMOUNT CERTIFIED $ SIL Kg Oa... 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach egrlanation if amount certified differs front the amount applied.Initial all figures on this Application at don the Cc nintration Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 62,579 .59 CONSTRUCT N N M' s By: . 1":".'"-- , Date: 5--,—2— 2.0( 0 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECW• - i Total changes approved in previous months by Owner $2 4, 7 21 $ 2 5, 1 0 By: �1 .�_'y Date: '29 ` Of Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $24 , 721 $ 2 5 ,15 0 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ (429 . 00) the Owner or Contractor under this Contract. CAUTION:You_should sign-an;originel AIA Contract Document;,on whicii this text•appbars,In'RED:An-originai assures that;change§will noibe obscured: AIA Document G702/CMai a—1992.Copyright ©1992 by The American institute of Architects.All rights reserved.WARNING:This AlA0 Document Is protected by U.S Copyright Law and international Treaties. 'Unauthorized reproduction or distritiution of this,AlA0 Document,or any portion 01.11,may.result in severe'civil and'criminal'penr sties;-and vitii 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. Si©vpdeKer©r ave©, DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 19 containing ContracIo's signed Certilication,..is attached. CARMEL PERFORMING ARTS 'APPLICATION DATE: 05/15/2010 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 05/31/2010 Use Column I on Contracts where variable retainage for line items may apply: PROJECT NO.: 26954280 A 0 C D E. F G H ■ WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED ,FROM PREVIOUS. PRESENTLY' COMPLETED BALANCE RETAINAGE NO. VALUE APPLICATION THIS STORED AND STORED ".4, TO 11F VARIABLE) (D+E) PERIOD (NOT IN TO DATE (G=C) FINISH RATE DOR E) (D4-E-F) 1C-G1 10000 ADMINISTRATION 10010 Bonds&Insurance $4,500.00 '$4,500.00 $0.00 $0.00 $4,500.00 100% $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 $13,218.00 $0.00 $0.00 $13,218.00 100% $0.00 $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 $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 $0.00 201'10 Attic.50 ft.Level $5,600.00 $5,600.00 $0.00 $0.00 $5,600.00 100% $0.00 $0.00 20120 Attic:66'ft Level $8;805:00 $8;805.00 $0.00 . $0.00 $8,805.00 100% $0.00 $0.00 20130 Attic•80.1t Level $12,335.00 612:335.00 $0.00 $0.00 $12,335.00 100% $0.00 $0.00 20140 Pre-action $15,984.00 $15;984.00 $0.00 $0.00 $15,984.00 100% $0.00 $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 $12,257.19 $0.00 $0.00 612,257119 99% $123.81 $0.00 30030 Standpipe $17,024.00 $15,322.00 $851.00 $0.00 $16,173.00 95% $851.00 $0.00 ,30040 Basement $49;602.00 $49,105.98 $0.00 $0.00 $49,105.98 99% $496.02 $0.00 SSi pge ragionaBl DETAIL AND CONTINUATION SHEET APPLICATION AND-CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 19 containing Contractor's signed Certification, is attached. CARMEL.PERFORIVIING.ART S- APPLICATION DATE: 05/15/2010 In tabulations below.amounts are stated to the nearest dollar. PERIOD TO: 05/31/2010 Use Column I on Contracts where variable.retainaue 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 RETAIN AGE NO. VALUE APPLICATION THIS STORED AND STORED % TO (IF VARIABLE (D+E) PERIOD ,(NOT IN TQ DATE (G+C) FINISH RATE D OR Et (D+E+F) (C-G) 30050 Plenum Level $17,179.00, $17,007.21 $0.00 $0.00 $17,007.21 99% $171.79 $0.00 30060 OrchestracLow 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 $29,046.00 $0.00 $0.00 $29,046.00 92% $2,526.00 $0.00 30090 Balcony Low Level $16,328.00. $14,695.00 $0.00 $0.00 $14,695:00 90% $1,633.00 $0.00 30100 Balcony High Levet 534;822.00 $31,339.85 $0.00 $0,00 $31;339:85 90% $3,482.15 $0.00 30110 Attia50 ft Level $4;333.00 $3;899.00 $434.00 $0.00 $4,333.00 100% $0.00 $0.00 30120 Attic'66 ft..Level $9,673.00 $8,706.00 $967.00 $0.00 59:673.00 100% $0.00 $0.00 30130 Attic 80 ft.level $15,554.00 $13,999.00 $1;555.00 $0.00 $15,554.00 100% $0.00 $0.00 ALLOWANCE $0100 $0:00 $0.00 $0.00 $0.00 0% $0.00 $0.00 4280A-001 $1,940 100 $1,940.00 $0,00 $0.00 '$1,940.00 100% $0.00 $0.00 4280A-002 $911.00 '$911.00 $0 100 $0.00 $911.00 100% 50:00 $0.00 4280A-003 Reduction 525.000:00 $0:00 $0:00 $0.00 $0.00 0% $25,000:00 $0.00 4280A-004 $531.00. $531.00 $0.00 $0.00 $531.00 100% 50:00 $0.00 4280A-005 $5,064.00 $5,064.00 $0.00. $0.00 .$5:064.00 100% $0.00 $0:00 4280A-006 $614.00 '5614:00, $0.00 $0'.00 $614.00 100% $0.00 $0.00 4280A-007 $14,236.00 '$14,236.00 $0.00. $0.00 $14,236.00 100% $0.00 $0.00 2695-4280-04 Addtion '5.17,28100 50100 50.00, $0:00 $0.00 0% S17,28100' $0.00 4280A-009 $2,765.00 $2,765.00 $0.00 $0.00 $2,765.00 100% $0.00 $0.00 4280A-010 $1;656100 $0:00 $1,656.00 '$0.00 $1,656.00 100% $0.00 $0.00 CHANGE ORDERS $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 Change Order-1 RFC!006 $4,601.00 $4,601.00 $0,00 $0:00 $4,601.00 100% $0,00 $0100 Change Order 1 (525,150.00) $0.00 $0.00' 50:00 0% ($25,150.00) $0:00 Change Order 2 $20,120.00 $0:00 $0.00 $0.00 0% $20;120.00 .50:00 TOTALS ,$614;930:00 $577;633:91 $5,463.00 $0.00' $583,096':91 95% $31,833.09 $0.00' tqc ; Fire& • Security S®Iatrplext rinneII CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check fronm Carmel Redevelopment (Maker of Check) in the sum of$ 41 , 4'77. 00 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 Cannel Perfforminq 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 5-17-2010 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: 5-19-20'10 :SimplexGrinnell (Company Na ) BY: -" Gt/ Offices&Representatives in Principal Cities throughout the world STATEMENT OF COMPLIANCE Payroll Number Payroll Payment Contract Number Date Processed Status Final i• 5/14/2010 33a-9375717-02 5/14/2010 Company Paid BP GLORIA J. G ALJF-9FR( , do het rlt}'rcrlily.under penalty of pcljtny: 0.ueul ornn.amy is ily) 1b0,,I II)Ihal I puy of aupetrisr the Payment of the Persons employed by SimpleXCrinnell I.fint cue CA) EL PI RIN012101NC.AR rr: tht nr Sribnmu onterl`- ---_. _�_.._ that during Ow payroll period commencing encing ou the 3.0 day of 'Apr,211 10 and ending the_06- day of MaY.11310,all Persons employed on said innjell have been Pall the fu)).weeldy wages earned that no rebates have been or will he made either-directly u- iudin•ctiy to or on behalf on said SimplexCfittttell-LP front the fall weekly wage earned by any person and that tin deductions have been made tithe! `j�rr—a SuFurnurartu?S din'rtli'or inditorily lium lire full wages earned by any person.other than permissible deduc'Unns as-deRned lit Rrgttlatluns.P:ir1 3 (21)CFR Subtitle Al, issued by the Scrtemty of Labor under the Copeland Act,as Amended(d8 Stat.i18.G3 Stat. IOR.72 Suit,117;71 Stat.357;-0t)U.S.C.27fiel,and described below: EIT;FICA''STATE;INSURANCE 12)that any payrolls udtcrwise under rliis contract required to ice submitted for the above period ale coned]and complete:Mal the wage rates for Iabntols or mechanics contained therein are not less than the applicable wage rates contained in any wage determination Incorporated into the cnntrari: that the classifications set lot th therein for each laborer nr mechanic conform wall the omit performed. • 13)'1hat any zippiest'ices employed in the above period ate duly«gisieted lu It bona tide apinetrticeshi)west:no tegisteted with a State ablirenticc, ship agency tetngtdu:d by the Bureau of Apprenticeship and Training,United Stares Oeparunent of Labor.Or it no sui-In tei-ugtiitrd agency c..isls Li a State.are registered With the Bureau of Apprenticeship and Training,United Stales Depat uncut it Labor. 14)110: lal 1\'IIERIi FRINGE BENEFITS ARE PAID'f0 APPROVED PLANS.FUNDS.OR I'ROGRAIS � In addition to the leash;)molly'wage rates paid to each laborer or mechanic iisled.in the aboyge lellerlrCtl Paylui1 payments o1 fringe' N71 benefits as listed iu the contract have been or a ill be made to opprupriated programs for the benefit of such employees.except as noted in Section.1(c)below. Iir) huh IEEE FRINGE BINFITS'ARE.PAID IN CASH Peeh Lnhnu•t ur mechanic Iisted in the shore trfereneed-payudl has Loco paid as indicated tin chi,pn}'t cull,:m.mwiut net loss than rho t l sour of the applicable basic huutly wage rate plus the amount o)the requited fringe benefits as listed-in the emittact,eyu•p1 as noted t in semen Mel Below, (c) EXCEl'lit)NS • EXCEP'floNs(CRAI f) NONE Remarks Company Paid BP /7 tame•' 1• sign ULU J. GALLEN, HRC I he willfid falsification of any of the-above statements may subject he contractor or suhco actor-to civf)or criminal prosecution.See .sect inn-11)11) of title 18 arid-section 231 of title 31 of the United Slates curie. 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 Cannel Garage Development Company $ 1,327.72 February 2010 Paid by Carmel Garage Development Company, $ 4,177.72 March 2010 Paid by Carmel Garage Development Company $ 2,545.20 April 2010 Amount to be paid by Carmel Garage Development Company $ 3,746.40 May 2010 Amount to be paid by Cannel Garage Development Company $ 3,109.20 ,.=. , ":yror: Document G702/C a 1992 2' Application and Certificate for Payment Construction Manager-Adviser Edition vg by TO OWNER: City of Carmel PROJECT: CPAC 16% APPLICATION NO:019 0 Distribution to: OWNER: PERIOD TO:April 30,2010 CONSTRUCTION MANAGER: FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June II,2008 ARCHITECT: CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:NA/2829/NA CONTRACTOR: Indianapolis,IN 46234 FIELD: CONTRACT FOR: 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 payment 1. ORIGINAL CONTRACT SUM $ 643,496.00 shown herein is now due, 2. NET CHANGE BY CHANGE ORDERS $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1±2) $ 643,496.00 By: Date: t112Z/i 6 4. TOTAL COMPLETED & STORED TO DATE(Column G on G703) $ 595,674.80 State of:Indian 5. RETAINAGE: County of:Hendricks a. 100 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 54,549.71 me this 2.2 day of Mb r 1[ t 2,o 1 0 b. 0 %of Stored Material Notary Public:Luke Roseboo t (Column F on G703) $ 0.00 My Commission expires:July 07,2012 r Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 54,549.71 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 541,125.09 In accordance with the Contract Documents,based on on-site observations and the data comprising this (Line 4 Less Line 5 Total) application,the Construction Manager and Architect certify to the Owner that to the best of their 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 537,378.69 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 $ 3,746.401 AMOUNT CERTIFIED $ 3,746.40 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation ifamount 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) $ 102,370.91 CONSTRUCTI N MANAGER: ,,11 _ BY: (4 ,%,.1�a _ Date: .2-7. 2 U Il' CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE Total changes approved in previous months by Owner$ 0.00$ 0.00 By: �' Date: q.29•l Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor named TOTALS $ 0.00$ 0.p0 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 AlA Document G7021CMaT"—1992.Copyright CI 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document Is,protected by U."9:Copyright Law and International ;Treatlosr`Unauthodzod reproduction or distribution of this Ale Document;or anyportlon 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 AlA software at 13:00:54 on 04/22/2010 under Order No.9656147774 1 which expires on 05/13/2011.and is not for resale. User Notes: (894202953) �: yo =! � _ li Document 7®3r" 1992 maw I. Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO:019 containing Contractor's signed certification is attached. APPLICATION DATE:04/08/2010 In tabulations below,amounts are in US dollars. Use Column Ion Contracts where variable retainage for line items may apply. PERIOD TO:04/30/2010 ARCHITECT'S PROJECT NO:NA A B C D I 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 OR E) DATE (C-G) RATE) (D+E) (D+E+F) Sewage Ejector/Triplex 62 Pumps 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 63 Labor 26,640.00 25,308.00 532.80 0.00 25,840.80 97.00% 799.20 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% 0.00 0.00 66 Labor 4,440.00 4,440.00 0.00 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% 0.00 0.00 103 Labor 54,840.00 6,032.40 2,193.60 0.00 8,226.00 15.00% 46,614.00 274.20 104 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 2,652.00 1,020.00 0.00 3,672.00 90.00% 408.00 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 6,120.00 0.00 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% 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 212 Water Control Panel 30,693.00 30,693.00 0.00 0.00 30,693.00 100.00% 0.00 3,069.30 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00%, 0.00 0.00 AIA Document G703TM-1992.Copyright m 1963.1965,1965.1967,1970,1975.1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe Document Is protected by U.S. Copyright Law and International Treaties.Uneuthorked reproduction or distribution of this AIA°Document.or any portion of It,may result in seveie civil and criminal penalties,and will be prosecutod,to' 1 the-maximum extent-possible under the law.•This document was produced by AIA software at 13:00:25 on 04/22/2010 under Oider'No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1212899960) A B C D I E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED e BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /a NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G_C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) GRAND TOTAL $643,496.00 $591,928.40 $3,746.40 $0.00 $595,674.80 92.57% $47,821.20 $54,549.71 • AIA Document G703'—1992.Copyright®1963,1965,1966,1987,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.VUARNING:,This AIA°Decumont Is protected by 11.8. Copyright L'awand,lntematlonal Treaties:Unauthortted reproduction or distribution of this AIA°Document,,or any portion of it,may result In sevemcivll and criminal penalties;,and will be'prosocutod;to_ 2 the.maximum extent possible under the taw.This document was produced by AlAsoftware at 13:00:25 on 04/22/2010 under Order No.9656147774_1 which expires on 05/13/2011,and Is not for resale. User Notes: (1212899960) 34-b- . — 4 li 0 Document 7 a ® 1992 t• Application and Certificate for Payment Construction Manager-Adviser Edition '9 TO OWNER: City of Cannel PROJECT: CPAC 16% APPLICATION NO:020 0 Distribution to: OWNER: PERIOD TO:May 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: 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 payment 1. ORIGINAL CONTRACT SUM $ 643,496.00 shown herein is now due. 2. NET CHANGE BY CHANGE ORDERS $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1±2) $ 643,496.00 By: Date: May 24,2010 4. TOTAL COMPLETED & STORED TO DATE(Column G on G703) $ 598,784.00 State of:Indiana 5. RETAiNAGE: - County of:Hendricks a. 100 %of Completed Work Subscribed and sworn to before (Column D+Eon 0703) $ 54,549.71 me this 2't day of Y"( .a io b. 0 %of Stored Material Notary Public:Luke Roseboom ( t lG� (Column F on G703) $ 0.00 My Commission expires:July 07,2012 ~-- Total Retainage(Lines 5a+5b or Total in Column I of 0703) $ 54,549.71 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 544,234.29 In accordance with the Contract Documents,based on on-site observations and the data comprising this (Line 4 Less Line 5 Total) application, the Construction Manager and Architect certify to the Owner that to the best of their 7, LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 541,125.09 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 $ 3,109.201 AMOUNT CERTIFIED $ 3,109.20 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 Cot inflation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 99,261.71 CONSTRUCT 0 M• r GE' Pr By: it:.sir Date: 5 z c.'Z (0 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE Total changes approved in previous months by Owner$ 0.00$ 0.00 By: � t` Date: 5"Z e IY Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor named - TOTALS $ 0.00$ 0.00 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"—1992.Copyright tO 1992 by The American Institute of Architects.All rights r000rvod.WARNING:This AIAe Document Is protected by tl.S:Copyright Law and International Troatios.Unauthorized reproduction or distribution of this AiA Oocumont,or any portion of it,may mutt in severe civil and criminal penalties;"and will be proeecutod to the maximum extent possible 1 under tho.law.This document was produced by AIA sonware at 09:31:04 on 05/24/2010 under Order No.9656147774 1 which expires on 05/13/2011,and is not for resale. User Notes: (1953579625) `; . - A Document G70371 ® 1992 • Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO:020 containing Contractor's signed certification is attached. APPLICATION DATE: In tabulations below,amounts are in US dollars. Use Column Ion Contracts where variable retainage for line items may apply. PERIOD TO: ARCHITECTS PROJECT NO:NA A B C D I 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 OR E) DATE (C-G) RATE) (D+E) (D+E+F) Sewage Ejector/Triplex 62 Pumps 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 63 Labor 26,640.00 25,840.80 0.00 0.00 25,840.80 97.00% 799.20 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% 0.00 0.00 66 Labor 4,440.00 4,440.00 0.00 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% 0.00 0.00 103 Labor 54,840.00 8,226.00 2,742.00 0.00_ 10,968.00 20.00% 43,872.00 274.20 104 Material 111,082.00 1I1,082.00 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 3,672.00 367.20 0.00 4,039.20 99.00% 40.80 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 6,120.00 0.00 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% 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 . 9,03.9.90 GPI#23B-Storm 212 Water Control Panel 30,693.00 30,693.00 0.00 0.00 30,693.00 100.00% 0.00 3,069.30 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00 0.00 0.00_ 0.00% 0.00 0.00 AIA Document G703TM-1992.Copyright m 1963,1965,1966,1967,1970,1978,1983 and 1982 by The American Institute of Architects.AS rights reserved.WARNING:This'Ale Document is p`rotectod'by U.B. Copyright Law and'Intemattonal 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, 1 the maxlmum;oxtont possible under tho law.This document was produced by AIA software of 09:25:33 on 05/24/2010 under Order No.9656147774_1 which expires on 05113/2011.and is not for resale. User Hates: (959136168) A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED , BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY /o PREVIOUS AND STORED TO FINISH (IF VARIABLE NO. WORK VALUE THIS PERIOD STORED DATE E (G-C) (C-G) RATE) APPLICATION (NOT IN D OR E) (D+E) (D+E+F) GRANO TOTAL $643,496.00 $595,674.80, $3,109.20 $0.00 $598,784.00 93.05% $44,712.00 $54,549.71 AIA Document G703^1—1992.Copyright O 1963,1965,1966.1967.1970,1978,1983 and 1992 by The,American Institute of Architects.All rights reserved.WARNING:'.Thia Ale Document is protected by.U;S. .Copyright Law and International Treaties.Unauthorlied reproduction or distribution of this AIA°Document,•or any.portion of It.may result In severe civil and crtniinai penalties;'and will be prosecuted to_ 2 the maximum extent possible under the law.This document.was produced by AIA software et 09:25:33 on'05/24/2010 under r Omer No.9656147774 1 which expires on 05!13/2011,and not for resale. User Notes: (959138168)