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WR Dunkin, Simplex Grinnell - $43,398
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 as per the Elevators,Fire Protection,and Pumps installment purchase contract Application 26(WR Dunkin)June 2010 $ 27,560.00 Application 27(WR Dunkin)July 2010 $ 12,000.00 Application 20(Simplex Grinnell)July $ 3,838.00 2010 Grand Total Total Due: •, , r$;43;398:00 ❑ 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 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: ethci/c CITY OF CARMEL REDEVELOPMENT COMMISSION 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 ;r . $ ,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 Paid by Carmel Garage Development Company $ 78,200.00 May 2010 Paid by Carmel Garage Development Company $ 194,920.00 June 2010 Amount to be paid by Carmel Garage Development Company $ 27,560.00 July 2010 Amount to be paid by Carmel Garage Development Company $ 12,000.00 10 document G702/ arm — 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,44050 CPA APPLICATION NO:026 B Distribution to: Commission • 777 3rd Ave.S.W. OWNER: One Civic Square Carmel,IN 46032 PERIOD TO:June 30,2010 CONSTRUCTION MANAGER: Carmel,IN 46032 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 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 ayment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have b n paid by the Contractor for Work for which previous Continuation Sheet,MA Document G703,is attached. Certificates for Payment were issued and,"aym •t•. =ceived from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2,268,700.00 Pay ] 11 • 't ' " �'v due. 2.NET CHANGE BY CHANGE ORDERS $ 0.00 CoNTRACTit•. i%I ► IN �r, , , . ' 3.CONTRACT SUM TO DATE(Line 1*2) 5 2,268,700.00 B . / � � _illb,_.., Date: June 16,2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,650,490.00 State td:Indiana .47' 5.RETAINAGE: County of:Madison a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon 0703) $ 113,435.00 me this 16th day of June, 21' - b. 0 %of Stored Material Notary Public:Martha A.Carpenter ek/f.T41CL--•l(!ezz,r-(-4---' (Column F on G703) $ 0.00 My Commission expires:January 08,2017 , Total Retainage(Lines 5a+5b or Total in Column I of 0703) $ 113,435.00 CERTIFICATE FOR PAYMENT 6,TOTAL EARNED LESS RETAINAGE $ 1,537,055.00 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,509,495.00 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. ea- 8.CURRENT PAYMENT DUE $ 27,560.00 AMOUNT CERTIFIED $ 211£b4 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the auto applied.Initial all figures on this Application and on the Continuation Sheet tl• are than d to conform with the amount certified.) (Line 3 less Line 6) 5 731,645.00 CONS -UCTION M•, ER: �k B .I . 067)7.--Y/0 Y: I.,. �i ��i/.��'... Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHI"'#'-: �' Total changes approved in previous months by Owner $ 0.00$ 0.00 By: '� Date: 07...13�'X�r Q' Total approved this Month $ 0.00$ 0.00 This Certifica not ;otiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00$ 0.00 named herei . Issuan •, payment and acceptance of payment are without prejudice to any rights of the Owner•r Con =ctor under this Contract. NET CHANGES by Change Order $ 0.00 AIA Document G702/CMa""-1992.Copyright 0 1992 by The American Institute of Architects.All rights roserved.WARNING:This Ale Document is protected,by U.S:Copyright Law and International Treaties.Unauthorized•reproduction or distribution of thls,AlA5 Document,'or any portion of it,max result in severe civil and criminal penalties,and will'be prosecutedlto thernaximum extern-possible 1 under the law:This document was produced by AIA software at 10:48:47 on 06/21/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1867001679) • Mee'ale ' A ®cvi e t ;713Tfil = 1992 Continuation Sheet AIA Document,G702mt 1992,Application and Certification for Payment,or G736T t 2009, APPLICATION NO:026 Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE:06/16/2010 containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars, PERIOD TO:06/30/2010 Use Column Ion Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:25310 A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED e BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /o NO. WORK VALUE PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE THIS PERIOD DATE (G_C) APPLICATION (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) Steel Doors& 08110 Frarnes-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 31,350.00 0.00 0.00 31,350.00 95.00% 1,650.00 2,455.00 Flush Wood Doors- 08140 M 39,000.00 39,000.00 0.00 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 127,000.00 100,440.00 26,560.00 0.00 127,000.00 100.00% 0.00 1,134.00 Stile&Rail Wood 08144 Doors-L 34,000.00 2,000.00 1,000.00 0.00 3,000.00 8.82% 31,000.00 0.00 Sound Control Doors 08347 &Windows-M 352,000.00 70,000.00 0.00 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-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 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 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 AlA°• Document,or any portion of It,may rosult insevere,civil and criminal ponaltlos;and will bo 1 prosecuted to the maxiinum'oxte it possible under-the.law:This document was produced by AIA software at 10:33:19 on 06/21/2010 under Order No.016 84 2073 9_1 which expires on 06/10/2011,and Is not for resale. User Notes: (1212968792) A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) &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.Q0 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 186,000.00 176,000.00 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 48,000.00 0.00 0.00 48,000.00 100.00% 0.00 0.00 Wheelchair Lift- 14422 Permits 2,200.00 2,300.00 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 $1,556,930.00 $27,560.00 $66,000.00 $1,650,490.00 72.75% $618,210.00 $113,435.00 AIA Document G703 T"-1992.Copyright®1963,1965,1966,1967.1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S:Copyright Law and,Intornational Treaties:_Unauthorized reproduction or distribution of this MAT Document,or any portion of il,may result In severe civil and criminal penalties;and will be 2 prosecuted to the maximum eictent possible under the law.This document was produced by AIA software at 10:33:19 on 06121/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1212968792) AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X]PARTIAL [X]PAYMENT TO FOLLOW State of Indiana,County of Madison, SS Craig R. Dunkin , being duly sworn states that he is the President of W. R. Dunkin & Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Bid Package 4050-9eneral Trades for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by Cit`v of Carmel and does hereby further state on behalf of the aforementioned Contractor. Payment for Application # 26A for work performed through 06/30/10 , of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount,and which waiver shall be effective only upon receipt.of payment thereof by the undersigned. (PARTIAL WAIVER)that there is due from the contractor the sum of - One.Hundred Fifty-six Thousand Forty-five dollars and.45/cents ($ I56,045A5 ) Payment for Application # 26B for work performed through 06/30/10 , of which has been promised as the sole consideration of this Affidavit and Partial Waiver-of Lien which is given solely with respect to.said arnouurt, and which waiver shall be effective only upon receipt of payment thereof by the undersigned. (PARTIAL WAIVER)°that there is due from the contractor the sum Of Twenty-seven Thousand Five.Hundred Sixty dollars and 00/cents ($ 27,560.00 ) Application for Payment-# has been received for work performed through (FINAL WAIVER)that the final balance due from the Owner is the sum of dollars and 00/cents($ ) THEREFORE,the undersigned waives and releases unto the Owner of said premises,any and all lien or claim whatsoever on the above described property and improvements thereon on account Of LABOR or material or both, furnished by the undersigned thereto,subject to limitations or conditions expressed herein, ifany;and further certifies that no Other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project,and within the scope of this affid; • and°waiver W.R.Dunkin&Son,Inc. By Ad! A / Title:President WITNESS MY HAND AND NOTARIAL S 'AL,this 12a' day of July ,2010 �fI (Notary Publi/ My.Commission Expires:January 08,2017 Printed Martha A.Carpenter Residing in Madison County MARTHA A.CARPENTER NOTARY PUBLIC ,`l, STATE OF INDIANA Miy Commkutlon Expires 1.8-17 `-4- �, Av 1 ocuF;,cent G7021C a" ® 1992 3.s. Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,114050 CPA APPLICATION NO:027 -,6 Distribution to: Commission 777 3rd Ave. S.W. OWNER: One Civic Square Cannel, IN 46032 Carmel,IN 46032 PERIOD TO:July 31,2010 CONSTRUCTION MANAGER: FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co., Inc. CONTRACT DATE:May 08,2008 ARCHITECT: PO Box 2247 _ _ CONTRACTOR: CONTRACTOR: 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 ' ntractor's knowledge,information and belief the Work covered by this Application for P/m.. 1a•been completed in accordance with the Application is made for payment,as shown below,in connection with the'Contract. Contract Documents,that all at punts have be pa . by t1 Contractor for Work for which previous Continuation Sheet,MA Document G703,is attached. Certificates (Or Payment w issue •••d 'ayn -tits ceived from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ •2,268,700.00 Pa 'c �� �" ' ` 4111%► 2.NET CHANGE BY CHANGE ORDERS $ 0.00 ONTRACT a-• W R i d 't`, ' . ' 3.CONTRACT SUM TO DATE(Line 1±2) $ 2,268,700.00 ), : ______Itl_r Date: July 12,2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on 0703) $ 1,662,490.00 S of: Indiana 5.RETAINAGE: County ol•:Madison a. 5 %of Completed Work Subscribed and sworn to before (Column D+Eon 0703) $ 113,435.00 me this 12th day of July, 201 b. 0 %of Stored Material Notary Public:Martha A.Carpenter `,7,/lfC/ ��� �' (Column F on 0703) $ 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 $ 1,549,055.00 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,537,055 00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. • 8.CURRENT PAYMENT DUE $ 12,000.00 AMOUNT CERTIFIED $ QZi%1r ,' 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified Oilers m the amount applied.Initial all tgures on this . Application and on the Continuation Sheet tat are changed to conform with the amount certified.) (Line 3 less Line 6) $ 719,645.00 CONS RUCTION •NAGER: 9 By: .. .—re_�w _ - Date: 19712--,Sit a CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC TA;y''total changes approved in previous months by Owner$ 0.00$ 0.00 T/i/i,>`� 3,l 4�_ �' 4 .� '!By: '7s .y Date: Total approved this Month $ 0.00$ 0.00 This Certificates 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 G702ICMaTM—1992.Copyright©1992 by The American Institute of Architects.AJI rights reserved.WARNING:.This'AIA'.Document is;protected,by u.S:Copyright Law_and International Treaties.Unauthorized reproduction or distribution of this'AIA''Document,orany portion of it,may result in severe civil and criminal pentitties,.and will be prosecuted to the:maximum'extent possible under the law.This document was produced by AIA software at 13:11:26 on 07/16/2010 under Order No.0168420739_1 which expires on 05/10/2011',and is not for resale. User Notes: (961104469) * , Document G7 03 ° 1992 Continuation Sheet A1A Document,G702T l-1992,Application and Certification for Payment,or G736T11-2009, APPLICATION NO:027 Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE:07/12/2010 containing Contractor's signed certification is attached. In tabulations below, amounts are in US dollars. PERIOD TO:07/31/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:25310 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM • PRESENTLY COMPLETED % BALANCE TO RETAINAGE PREVIOUS: THIS PERIOD AND STORED TO (G_C) FINISH (IF VARIABLE NO. WORK VALUE STORED APPLICATIQN (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 31,350.00 . 0.00 0.00 31,350.00 95.00% 1,650.00 2,455.00 Flush Wood Doors- 08140 M 39,000.00 39,000.00 0.00 0.00 39,000.00 100.00% 0.00 878.00 08141 Flush Wood Doors-L 15,000.00 2,000.00 1,000.00 0.00 3,000.00 20.00% 12,000.00 200.00 Stile& Rail Wood 08143 Doors-M 127,000.00 127,000.00 0.00 0.00 127,000.00 100.00% 0.00 1,134.00 Stile& Rail Wood 08144 Doors-L 34,000.00 3,000.00 0.00 0.00 3,000.00 8.82% 31,000.00 0.00 Sound Control Doors 08347 &Windows-M 352,000.00 70,000.00 0.00 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. 0 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 Alun.Fram ed 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 AlA Document G703""-1992.Copyright®1963,1965,1986,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:Tills Ale Document is.protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAW Document;'or any.portion'of it,may result In severe cii/ii'and.criminal penalties;and will he. 1 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 13:13:16 on 07/16/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1379415395) A B C D E T F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM . PRESENTLY COMPLETED BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH ((F VARIABLE 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 186,000.00 176,000.00 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 48,000.00 0.00 0.00 48,000.00 100.00% 0.00 0.00 Wheelchair Lift- .t 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 11,000.00 0.00 11,000.00 78.57% 3,000.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 GRAND TOTAL $2,268,700.00 $1,584,490.00 $12,000.00 $66,000.00 $1,662,490.00 73.28% $606,210.00_ $113,435.00 AlA Document 6703 r"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale'Document is-protected by U.Sr Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA" Document,or any portion of it may result in severe civil and criminal penalties,and will be 2 prosecuted to the•maxirnum extent possible under the law.This document was produced by AIA software at 13:13:18 on 07/16/2010 under Order No.0168420739_1 which expires on 05/10/2011',and is not for resale. User Notes: (1379415395) AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X] PARTIAL [X] PAYMENT TO FOLLOW State of Indiana,County of Madison. SS Bradley Tyler , being duly sworn states that he is the Project Manager of W. R. Dunkin & Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Bid Package 4050-General Trades for a project known as Parcel 7A. Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by City of Cannel and does hereby further state on behalf of the aforementioned Contractor. Payment for Application # 27A for work performed through 07./31/10 . of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount,and which waiver shall be effective only upon receipt of paymerit"thereof by the undersigned. (PARTIAL WAIVER)that there is due froth the contractor the sum of One Hundred Forty-four Thousand Five Hundred Ninety-six dollars and 45/cents ($ 1.44,596.45 ) Payment for Application # 27B for work performed through 07/3 1/1 0 . of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned. (PARTIAL WAIVER)that there is due_from the contractor the sum of Twelve Thousand dollars and 00/cents ($ 12,000.00 ) Application for Payment ## has been received for work performed' through (FINAL WAIVER)that the final balance due from the Owner is the sum of dollars and 00/cents($ THEREFORE,the undersigned waives and releases unto the Owner of said preinises, any and all lien or claim whatsoever on the above described property and improvements thereon on account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations or-conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of aann r work performe• or t teri I furnished to the, undersigned for said project,and within the scopDft''s .i s.vit a.+�giver. l � F W.R.Dunkin.&Son,In B A`agi,/ ..4112116.. - Title: Project.Manaaer WITNESS MY HAND AND NOTARIA SEAL, this 16'1' day of July .2010 (Notary Put) My Commission Expires:Jantiary 08;2017 Printed Martha A. Carpenter Residing in Madison County 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 $ 42,698.50 April 2010 Paid by Carmel Garage Development Company $ 26,020.00 May 2010 Paid by Carmel Garage Development Company $ 5,463.00 July 2010 Amount to be paid by Carmel Garage Development Company $ 3,838.00 -MN A 1 ,riilitiv.e' % i A Document G702/CiVia TM = 1992 Application and Certificate for Payment Construction Manager-Adviser Edition 1/3 TO OWNER: PROJECT: APPLICATION NO: 20 Distribution to: Carmel Redevelopment Comm. Parcel 7A Regional PERIOD TO: 7-31-2010 OWNER ❑ One Civic Square Performing Arts Center Carmel, IN 46032 CONSTRUCTION MANAGER $J FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6-20-2009 ARCHITECT ❑ SimplexGrinnell LP Shiel 'Sexton Co. PROJECT NOS: 2695 / 4280 / CONTRACTOR ❑ 11820 Pendleton Pike Indianapolis, IN 46236 VIA ARCHITECT: 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 Contract Documents,that,t9amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AiA Document G703,is attached. - Certificates for Payment % ere issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $615, 359 .00 payment shown herein is w due. /7 2.Net change by Change Orders $ (429 .00) CONTRACTO • 3.CONTRACT SUM TO DATE(Line 1 ±2) $614 , 930.00 By: s, _ �` ` Date: July 19 , 2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $586 , 934.91 State of: Indiana 5.RETAINAGE: County of: Marion - a. %of Completed Work Subscribed and sworn to before ' PAULA K.LEWIS (Column D+Eon G703) $10, 746 . 50 me this 19th 'iY of Ju/�l I/2010 + Notary Public-Seal b. %of Stored Material Notary Public:�� /� ii'Gv1-c) 4 State of Indiana (Column F on G703) $ 0-00 My Commission expires:8-12-2017 My Commission Expires Aug 12,2017 Total Retainage(Lines 5a+5b or Total in Column I orG703).. $ 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 $ 55 6,18 8 . 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 $ 55 2,35 0 .41 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. B.CURRENT PAYMENT DUE $ 3', 838 . 00 AMOUNT CERTIFIED $ �' �� 9.BALANCE TO FINISH,INCLUDING RETAINAGE l (Attach explanation if all/01111f certified differs fron re amount applied.Initial all figures on this Application and o he Continuation Sheet that a•c clic irged to canfornt with the amount certified.) (Line 3 less Line 6) $ 58,741. 59 CONSTR.CCTION G R: / I By: liCI .As.ri._��► - - ±■ ■ Date: ©712-3//C> CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE ! 4T' _ tit f p�/ Total changes approved in previous months by Owner $24,721 $25, 150 By: dt ,el)7 IJ-%"f Date: ���� �+ Total approved this Month $ $ This Certiftca 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 NET CHANGES by Change Order $ (429 . 00) the Owner or Contractor under this Contract. CAUTION:You should sigman original AIA.Contract Document;on whichdhis text?appears in RED:An original°assures•that changes wiIl not be'obsdured. AIA Document G702/CMaT1-'—1992.Copyright m 1992 by The American Institute of Architects.All rights reserved.WARNING:This.Ale Document is protected by U:S:.Copyright Law and International Treaties: Uneuthorized:repioduction or'dlstributiomot thls•A1A9 Document,or any portion of it,mayresult in severe clv[I and criminal penalties;and will be prosecuted to the maximum extent possible under tfie law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of MA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. Sib,Ipll kkrifl geiB DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO:: 20 containing Contractor's signed Certification. is'attached. CARMEL PERFORMING ARTS APPLICATION DATE: 07/15/2010 In tabulations below. amounts are stated to the nearest dollar. PERIOD TO: 07/31/2010 Use Column I on Contracts where variable retainage for line items may:apply. PROJECT NO.: 2695-4280 A B C D E F G_ H I . WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE. NO. VALUE . APPLICATION THIS STORED AND STORED % TO (IF VARIABLE) (D4E1 PERIOD (NOT IN TO DATE 1G+C) FINISH RATE D OR E) (D+E+F) (C-G) 10000 ADMINISTRATION 10010 Bonds&Insurance $4;500.00 . $4;500.00 $0.00 $0.00 $4,500.00 100% 50.00. S0.00 10020 Permits&Fees $500.00 . $500.00 $0.00 $0.00 $500.00 100% $0.00 S0.00 10030 Submittals $20;307.00 $20,307.00. $0.00 $0.00 520,307:00 100% $0.00 $0.00 10040 Drarwing&Drafting Srvices $33,638.00, $33,638.00 $0.00 $0.00 $33,638.00 100% 50:00 $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 50.00 20030 Standpipe 513;218.00 $13,218:00 $0.00 $0.00 $13,218.00 100% $0.00 50.00 20040 Basement $32;772.00 532,772:00 $0.00 $0.00 $32,772.00 100% $0.00 $0.00 20050 Plenum Level $13,310:00 $13,310.00 50:00 $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 BoxTierLevel $21,950.00 $21,950.00 $0.00 $0.00 $21,950.00 100% 80.00 $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 $0.00 55,600.00 100% $0.00 $0.00 20120 Attic 66 ft.Level $8,805.00 $8,805.00 $0.00 50.00 58,805.00 100% $0.00 $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 $15.984:00 $0.00 $0.00 515:984.00 100% $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 $12,257:19 99% $123.81 $0.00 30030 Standpipe $17,024.00 $16;173.00 $0.00 $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 Simpileitirerganellg DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT. SimplexGeinnell•LP APPLICATION NO.: 20 containing Contractor's signed Certification. is attached. CARMEL PERFORMING ARTS APPLICATION DATE: 07/15/2010 In tabulations below.amounts are stated to the nearest dollar. PERIOD TO: 07/31/2010 Use Column I.on Contracts where variable..retail age for line items may,apply. PROJECT NO.: 2695-4280 A 13 -C D E - F G - I-1 I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION.OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE , APPLICATION THIS STORED AND STORED % TO (IF VARIABLE) (D+E) PERIOD (NOT IN TO DATE (G-C) FINISH RATE D OR E) f DY±.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 Orchestra Low Level $26,620.00 r $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 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 .$4,333.00 $0.00 $0.00 $4,333.00 100% $0.00 $0.00 30120 Attic 66 ft. Level $9,673.00 $9,673.00 $0.00 $0.00 $9:673.00 100% $0.00 $0.00 30130 Attic 80 ft.level $15,554.00 $15,554.00 $0.00 $0.00 $15,554.00 100% $0.00 $0.00 ALLOWANCE $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 4280A-001 .$1,940.00 $1,940.00 $0.00 $0.00 $1,940.00 100% $0.00 $0.00 4280A-002 $911.00 $911.00 $0.00 $0.00 $911.00 100% $0.00 $0.00 4280A-003 Reduction $25,000.00 $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% $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 $614.00 $614.00 $0.00 $0.00 $614.00 100% $0.00 $0.00 4280A-007 $14,236.00 , $14,236.00 $0.00 $0.00 514,2361)0 100% $0.00 $0.00 2695-4280-04 Addlion $13,445.00 :k $0.00 $0.00 $0.00 $0.00 0% $13,445.00 $0.00 4280A-009 $2,765.00 52765.00 $0,00_ $0.00 $2,765.00 100% $0.00 $0.00 4280A-010 $.1,656:00 -$1,656.00 $0.00 $0.00 $1,656.00 100% $0.00 $0.00 4280A-012 $1,361.00 $0.00 $1;361:00 $0.00 $1,361.00 100% $0.00 $0.00 4280A-013 $501.00 $0.00 $501.00 $0.00 $501.00 100% $0.00 $0.00 4280A-014, $1,976.00 $0.00 51:976.00 $0.00 $1',976.00 100% $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 $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 Change-Order 2 $20,120.00 $0.00 $0.00 $0.00 0% $20,120.00 $0.00 Sh Lp8 zieriffeIi DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT. SimplexGrinnell LP APPLICATION NO.: 20 containing Contractors signed Certlltcation,is,attached. CARMEL PERFORMING ARTS APPLICATION DATE: 07/15/2010 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: (17131/201(1 Use Column I on Contracts where variable retainage for line items may apply. PROJECT'NO.: 2695-4230 A B C D E F 0 H I WORK COMPLETED MATERIALS TOTAL rrEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE., , APPLICATION THIS STORED AND STORED % TO (IF VARIABLE) (D-FE) PERIOD (NOT IN TO DATE (G=C) FINISH RATE DORE) (D+E+F) (C-G) -TOTALS $614$30.00. $583,096.91 $3.838.00 $0.00 _ $586;934.91 '95% $27.995.09 $0.00 SimplexGrinnell 11820,Pendleton Pike,Indianapolis,IN 46236 Ai tqc Fire & Security SimplexGr®nnefl CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from Carmel Redevelopment (Maker of Check) in the sum of$ 3 , $38, Q0 payable to SimplexGrinnell and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanic's.lien, stop notice or bond right the undersigned has on the job of .Carmel Redevelopment .. • - (Owner) located at Carmel. Pe.rcforrainq Arts Center (Job'Description) to the following extent. This release covers a progress payment for labor, services, equipment or material Furnished to Carmel Redevelopment (Your Customer) through July 19, 2010only and does not cover any retention or items furnished after said (Date) date, nor disputed claims in the amount of$ N/A . Before any recipient of this document relies on it the party should verify evidence of payment to the undersigned. DATED: July 19 . 2010 SimplexGrinne// (Company N, e BY: c-114 Offices C Representatives in Principal Cities througliotit the World