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HomeMy WebLinkAboutWR Dunkin, Simplex Grinnell - $504,642.17 Disbursement-Instructions Regions Bank hereby is instructed to make a disbursement of Loan Proceedsfrom the Borrower Loan Account to(or for the account of) Borrower in: (a) the amount of the "Total D,ue" line in the "Amount of Current Authorized Disbursement"column below; and (b)accordance with the terms and conditions of the Agreement,the otherLoan Documents, and the Disbursement Instructions. Dc_scription.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 Cannel Garage Development Company,LLC as per the Elevators,Fire Prdteclion,and Pumps installment purctiasg contract Application28(W:R.Dunkin)August;2010 $ 92;650.00 Application 29(W;R.Dunkin)September 5 407;140.00 2010 Applicalion.21(Simplex Grinnell)August S 851.00 2010 Appiicatlon.23(Simplex Grinnell) 5 4,001.17 September 2010. Grand Total Sr504; t ❑ CRC has inspected the portions of the PAC Equipment completed:by Borrower to confirm the Percent.Complete ih the applicable'collinin 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 withouEdefinitibn 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:. /0 2G/e 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 5 1,122,310.00 Retention held(based on 5%retention) 5 56,115.50 Paid to date 5 1,066,194.50 Amount Reiumbursed to CRC $ 1,066,194.50 December 2009 IPC Amount for application 20 Completed and Stored to date 5 56,000.00 Retention held(based on 5%retention) 5 2,800.00 To be paid 5 53,200.00 Paid by Carmel Garage Development Company,$ 53,200.00 January 2010 IPC Amount for application 21 Completed and Stored to date 5 28,300.00 Retention held(based on 5%retention) $ 1,415.00 Paid by Carmel Garage Development Company S 26,885.00 February 2010 Paid by Carmel Garage Development Company $ 76,000.00 March 2010 Paid by Carmel Garage Development Company,S 67,200.00 April 2010 Paid by Carmel Garage Development Company S 78,200.00 May 2010 Paid by Carmel Garage Development Company,$ 194,920.00 June 2010 Paid by Carmel Garage Development Company,$ 27,560.00 July 2010 Paid by Carmel Garage Development Company S 12,000.00 August 2010 Amount to be paid by Carmel Garage Development Company S 92,650.00 September 2010 Amount to be paid by Carmel Garage Development Company $ 407,140.00 35 � t `' `r D �cu ent G7 02/C aT� = 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,#4050 CPA APPLICATION NO:028B Distribution to: Commission 777 3rd Ave.S.W. OWNER: One Civic Square Cannel,IN 46032 CONSTRUCTION MANAGER: Cannel,IN 46032 PERIOD TO:August 31,2010 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:253 10/2695-4050/2695 FIELD: Anderson,IN 46018 CONTRACT FOR: General Construction VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payme.1 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 en pa; •y to-Cent ctor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment we - issued . d p, "t• received rom the Owner, and that current • 1.ORIGINAL CONTRACT SUM $ 2.268,700.00 payment shown herein' n edue. 2.NET CHANGE BY CHANGE ORDERS $ 0.00 C•NT'' !r, W R%+ NKIN S e.. I C. 3.CONTRACT SUM TO DATE(Line 1±2) $ 2,268,700.00 B 40`�j __ Date: August 16,2010 1-•-a 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,755,140.00 Sta- • : diana 5.RETAINAGE: County of Madison a. 5 %of Completed Work Subscribed and sworn to before }-' (Column D-I•E on G703) $ 113,435.00 me this 16th day of August., 10 �,�� C� �/�� b. 0 %of Stored Material Notary Public:Martha A.Carpenter iii C (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+Sb or Total in Column I of G703) $ 113,435.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,641,705.00 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 $ 1,549,055.00 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. 1 r , _ 8.CURRENT PAYMENT DUE $ 92,650.00 AMOUNT CERTIFIED $ b z. (1:496 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fro? the amount applied.Initial all figures on this Application and on the Continuation Sheet th• • changed to conform with the amount certified.) (Line 3 less Line 6) $ 626,995.00 CON TRUCTI•t ANAGER: / Q n.j / By: `'/�i+ea.-11,L-4i_. ?a► Date: 6 o z-I /o CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC ' T: Total changes approved in previous months by Owner$ 0.00 5 0.00 By: --.11111, Date: P73130110/ C/u l 30110/ Total approved this Month $ 0.00$ 0.00 This Certific e is no egotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00$ 0.00 named he z n. Isst ce, payment and acceptance of payment are without prejudice to any rights of the Owner • •ttractor wider 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 reserved.WARNING:This Ale Document Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this ALA°Document,or-any portion'of it.may result In severe civil and criminal penalties,and will be prosecuted to-the maximtim extent possible I under the.law.This document was produced by AIA software at 14:47:36 on 08/19/2010 under Order No.0168420739 1 which expires on 05/10/2011,and is not for resale. User Notes: (1633900910) if;�_ ,f\ y^ p pip TM k Ft *CLItl ent 6703 ® 1992 Continuation Sheet AiA Document,G70217`1-1992,Application and Certification for Payment,or G736-111-2009, APPLICATION NO:028B Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE:08/16/2010 containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars. PERIOD TO:08/31/2010 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 eke 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) 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 Frarnes-L 33,000.00 31,350.00 1,650.00 0.00 33,000.00 100.00% 0.00 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 3,000.00 5,000.00 0.00 8,000.00 53.33% 7,000.00 200.00 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 14,000.00 0.00 17,000.00 50.00% 17;000.00 0.00 Sound Control Doors 08347 &Windows-M 352,000.00 70,000.00 70,000.00 0.00 140,000.00 39.77% 212,000.00 900.00 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:Fratned 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 G7031'-1992.Copyright m 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document is protected by U.S;Copyright Law.and International Treaties.Unauthorized reproduction or distribution of this AIAe Document,or any portion of it,may rosuit,in sovero,civil and criminal penalties.and will be. 1 prosecuted to the mazimum.extent possible under tho law.-This document was produced by AIA software at 14:46:03 on 08/19/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1869169711) A B C D 1 E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF 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.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 2,200.00 0.00 0.00 2,200.00 100.00% 0.00 0.00 Wheelchair Lift- 14423 Labor 14,000.00 11,000.00 2,000.00 0.00 13,000.00 92.86% 1,000.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 GRAND TOTAL $2,268,700.00 $1,596,490.00 $92,650.00 $66,000.00 $1,755,140.00 77.36% $513,560.00 $113,435.00 MA Document G703^'-1992.Copyright 01963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this.AlAe Document,or any portion of it,may result in severe civil and criminal penalties;and will be 2 prosecuted to the maximum extent possible under the law.This document was produced by AlA software at 14:46:03 on 05/19/2010 under Order No.0168420739 1 which expires on 05/10/2011,and is not for resale. User Notes: (1869169711) AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X]PARTIAL [X]PAYMENT TO FOLLOW State of Indiana,County of Madison.SS Bradley Tyler , being duly sworn states that he is the project Manager of W. R. Dunkin & Son. Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Bid Packaee 4050-General Trades for a project known as Parcel 7A. Carmel Reeional Performing Arts Center located at Carmel. Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Payment for Application # 28A for work performed through 08/31/10 . of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount,and which waiver shall be effective only upon receipt of payment thereof by the undersigned. (PARTIAL WAIVER)that there is due from the contractor the sum of Two Hundred Eiehty-one Thousand Six Hundred Eieht dollars and 00/cents ($ 281,608.00 ) Payment for Application # 28B for work performed through 0 8/3 1/10 . 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 Ninety-two Thousand Six Hundred Fifty dollars and 00/cents (S 92,650.00 ) 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(S ) 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, if any; and further certifies that no other party has any claim or right to a lien on account of any work perk rined or material furnished to the undersigned for said project,and within the scope of this a: it d waiv . W.R.Dunkin&Son.In a) Title:Project Manaeer WITNESS MY HAND AND NOTARIAL SEAL,this 16th day of Aueust ,2220010 /. (Notary Pub lcI )� My Commission Expires:January 08.2017 Printed Martha A.Carpenter Residing in Madison County 6,7$ A P i TM - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Cannel Redevelopment PROJECT: Parcel 7A,114050 CPA APPLICATION NO:029E Distribution to: Commission 777 3rd Ave.S.W. OWNER: One.Civic Square Carmel,IN 46032 CONSTRUCTION MANAGER: Carmel,IN 46032 PERIOD TO:September 30,_010 ARCHITECT: FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:May 08,2008 CONTRACTOR: TOR: CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310 1 2695.405012695 FIELD: Anderson,IN 46018 CONTRACT FOR: General Construction VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document 0703,is attached. Certificates fo ayment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2,268,700.00 Payment sh• terein is now due. 2.NET CHANGE BY CHANGE ORDERS $ 0.00 CONTRA 0 r R l'n n & Son, Inc. • 3.CONTRACT SUM TO DATE(Line 1±2) $ 2,268,700.00 By: J(_ / li. , „ • Date: September 15,2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,162,280.00 State of:Indiana 5.RETAINAGE: • County of:Mad .on a. 5 %of-Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 113,435.00 me this 22nd day of September 2010 /) b. 0 %of Stored Material Notary Public:Martha A.Carpenter � �!ti C A.,{ ,,,,C-64.-- ' (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 5 2,048,845.00 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 $ 1,641,705.00 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 AMOUN� (Line 6 from prior Certificate) CERTIFIED. ,�j 8.CURRENT PAYMENT DUE $ 407,140.00 AMOUNT CERTIFIED $ `� •,', 7 a t% 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 ar i aged to conform with the amount certified.) (Line 3 less Line 6) $ 219,855.00 CONSTRUCTION M' GE-. .. . )19/2-7//0 BY i1:1A�������L� _ Date: I CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: •i, Total changes approved in previous months by Owner // ? g PP P Y $ 0 00$ 0.00 By: !'f 1 n._ — Date: gzi (g.tot Q 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 AlA Document G702JCMaTM—1992,Copyright®1992 by The American Institute of Architects.All rights reserved:WARNING:This AlAe Document is protected by U.S:Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAe Document,or any portion of It,may result In severe civil and^criminal penalties.and will bo prosecuted to the maximum extent possible 1 under the law.This document was produced by ALA software at 14:06:51 on 09/22/2010 under Order No.0168420739 1 which expires on 05/10/2011,and is not for resale: User Notes: (930698073) I Awe I (,,cument G7O3N 1992 Continuation Sheet AIA Document,G702T7'1-1992,Application and Certification for Payment,or G736T14-2009, APPLICATION NO:029B Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE:09/15/2010 containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars. PERIOD TO:09/30/2010 Use Column Ion Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:25310 A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO % FINISH (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED (G 4-C) APPLICATION (NOT IN D ORE) 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 33,000.00 0.00 0.00 33,000.00 100.00% 0.00 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 8,000.00 3,000.00 0.00 11,000.00 73.33% 4,000.00 200.00 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 17,000.00 5,000.00 0.00 22,000.00 64.71 % 12,000.00 0.00 Sound Control Doors 08347 &Windows-M 352,000.00 140,000.00 200,000.00 0.00 340,000.00 96.59% 12,000.00 900.00 Sound Control Doors 08348 &Windows-L 50,000.00 9,000.00 20,000.00 0.00 29,000.00 58.00% 21,000.00 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 59,520.00 116,480.00 0.00 176,000.00 100.00% 0.00 2,952.00 Alum.Framed Entrances/Storefronts 08411 -L 69,700.00 18,000.00 40,000.00 0.00 58;000.00 83.21 % 11,700.00 0.00 08413 Interior Alum.Doors 17,000.00 340.00 16,660.00 0.00 17,000.00 100.00% 0.00 34.00 AlA Document G703"1-1992.Copyright®1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved:WARNING:ThIs-AIA°Document is protected by U.S.Copyright•Law and International Treaties.Unauthorized reproduction or'dlstribution of this AIA° Document,or any portion of it,may result in severe ci"il.and criminal penalties;and will be: 1 prosacutod to the maximum extent possible under the law,This document was produced by AIA software at 14:04:45 on 09/22/2010 under Order No.0168420739 1 which expires on 05/1012011,and is not for resale. User Notos: (1698283083) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (C-G) RATE) (D+E) (D+E+F) &Frames-M _ Interior Alum.Doors 08414 &Frames-L 6,000.00 0.00 6,000.00 0.00 6,000.00 100.00% 0.00 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- 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 13,000.00 0.00 0.00 13,000.00 92.86% 1,000.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 GRAND TOTAL $2,268,700.00 $1,689,140.00 $407,140.00 $66,000.00 $2,162,280.00 95.31% $106,420.00 $113,435.00 MA Document G703"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is by U.S.Copyright Law'and International Treaties.Unauthorized reproduction or distribution of this Ale Document:or any portion of it.may result in severe civil and criminal penalties;and wlllbe 2 prosecuted to the maximum extont'possible under the law.This document was produced by MA software at 14:04:45 on 09/22/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1698263083) AFFIDAVIT AND WAIVER OF LIEN [ 1FNNAL [X]PARTIAL [X]PAYMENT TO FOLLOW State of Indiana,County of Madison.SS Craig R. Dunkin , being duly sworn states that he is the President/Treasurer of W. R. Dunkin & Son. Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Bid Package 4050-General Trades for a project known as Parcel 7A. Carmel Regional Performing Arts Center located at Carmel. Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Payment for Application # 29A for work performed through 09/30/10 of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount,and which waiver shall be effective only upon receipt of payment thereof by the undersigned. (PARTIAL WAIVER)that there is due from the contractor the sum of Eighty-nine Thousand Seven Hundred Thirty-one dollars and 00/cents ($ 89,731.00 ) Payment for Application # 29B for work performed through 09/30/10 . 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 Four Hundred Seven Thousand One Hundred Forty dollars and 00/cents ($ 407,140.00 ) 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, if any; and further certifies that no other party has any claim or right to a lien on acco t of any work performed or material furnished to the undersigned for said project,and within the scope of this a d/it and N aiver. W.R.Dunkin&Son.Inc. By JZAI' Title:President/Treasurer WITNESS MY HAND AND NOTARIAL SEAL,this 22nd day of September ,2010 5494 /X 2, 7o4 (Notary Pune) My Commission Expires:January 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 Paid by Carmel Garage Development Company $ 3,838.00 August 2010 Amount to be paid by Carmel Garage Development Company $ 851.00 September 2010 Amount to be paid by Carmel Garage Development Company $ 4,001.17 AAe m \�ih/�. A , r TM 6 v© I Document G7O2IC.\1a o _ 992 A I Application and Certificate for Payment Construction Manager-Adviser Edition �I3 TO OWNER: PROJECT: APPLICATION NO: 21 Distribution to: Carmel Redevelopment Comm. Parcel 7A Regional One Civic Square Performing Arts Center PERIODTO: August 31, 2010 OWNER ❑ Carmel, IN 46032 CONSTRUCTION MANAGER IX] FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6-2 0-2 0 0 9 ARCHITECT ❑ SimplexGrinnell LP Shiel Sexton Co. PROJECT NOS: ! / CONTRACTOR ❑ 11820 Pendleton Pike 2695 4280 , Indianapolis, IN 46236 VIA ARCHITECT: FIELD ❑ CONACT FOR:Auto Fire Protection CSO Architects TR .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, or Document G703,is attached. Contract Documents,that a l amounts have been paid by the Contractor for Work for which previous Certificates for Payment vere issued and payment: received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $615,359 . 0 0 payment shown herein is ow due. 2.Net change by Change Orders $ (429 .00)CONTRACTO-: 3.CONTRACT SUM TO DATE(Line l ±2) $614 , 930 . 00 By: i, `f . Date: August 17 , 2010 4;TOTAL COMPLETED&STORED TO DATE(Column 0 on 0703) 5587, 785 . 91 State of:Indiana ' Mic ae l M. MacDonald 5.RETAINAGE: County of: Marion ` ■ a. 5 %of Completed Work Subscribed and sworn to before PAULA K.LEWIS ' (Column D+Eon G703) $ 30,746 . 50 me this 17 t tv of����Auguus , 2010 t Notary Public-Seal b. Si of Stored Material Notary Public::„G2.,,,<_ t/r z State of Indiana , (Column F on 0703) $ 0. 0 0 My Commission expires: 8-12-2017 My Commission Expires Aug 12,2017 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 $ 557,039. 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 $ 556, 188 .41 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. (Line 6 from prior Certificate) �� 16'9--8.CURRENT PAYMENT DUE $ 851.00 AMOUNT CERTIFIED $ 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attack explanation if antotmt certified differs fr to amount applied. Initial all figures on this Application and on the Continuation ,et duo are c ranged to cartfarm with the amount certified.) (Line 3 less Line 6) $ 57, 890 . 59 CON RUCTION t ANA 4f--: �p l By: NI►-.iP,e►�:_g I1.. L 1----...... Date: ©lJ 7/7/IO ADDITIONS DEDUCTIONS i`-� 11! CHANGE ORDER SUMMARY ARCH Total changes approved in previous months by Owner $ 24,721 $ (25, 150) By: Date:. 'J l�lJ Total approved this Month $ $ i to c is not a gotiablc. The AMOUNT CERTIFIED is payable on to the Contractor Pp This Ccruf b p y y TOTALS $ 24,721 $ (25, 150) named her n. Isst• cc, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ (429 . 00) the Owne or •uractor under this Contract. CAUTION:You should sign an original AlA Contract Document;on which this text appears in RED..An original assures that changes will not be obscured. AlA Document G702/CMaM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA°Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. 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 plemer'oHs ii DETAIL AND CONTINUATION SHEET APPLICATION A.ND,CERTIFICATEFOR.PAYME-NT,, SiniplexGrinnell:LP rAPPLICATION NO.: 2] containing Contractor's signed Certification; is attached. CARMEL PERFORMING ARTS APPLICATION DATE: 0S/15/2010 In tabulations below.:amounts are stated to the nearest dollar.. PERIOD'TO: 08/31/2010, Utie Colurnn Ion Contracts where.variable retainage="for line items may apply. PROJECT NO.: 269 -4280 A B C D E F G. H I WORK".COMPLETED MATERIALS TOTAL • ITEM DESCRIPTION OF WORK SCHEDULED. FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE APPLICATION THIS STORED AND STORED % TO (IF VARIABLE) '(D+E) PERIOD (NOT IN TO DATE (G=C) FINISH RATE . D OR'E) (DtE+E) (C-G) 10000 ADMINISTRATION 10010 Bonds:& Insurance $4,500.00 $4,500.00: $0.00 $0.007 $4;500:00. 100% $0.00 $0.00 10020 Permits&.Fees $500:00 $500.00 $0.00 $0.00. $500.00 100% $0100 .$0.00 '10030 . Submittals $20,307.00 $20,307100 $000 $0.00 $20;307:00, 100% $0.00 $0.00 10040 Drarwing&Drafting Srvices $33;638100 $33,638:00 $0:00 $0100 $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 '835,920:00 • $35,920:00 $0.00 $0.00' $35,920.00 100% $0.00 $0:00 20030 Standpipe ,813,2.1800 $13,218.00 $0.00. $0.00, $13,218.00 100% 80:00 80:00 20040 Basement. $32.77200 532,772100. $0.00. $0.00 $321772.00 100% $0.00. $0100 20050 Plenum Level $13,310.00 $13,310100 50.00: $0.00 $13,310.00 100% 50:00 $0.00, 20060 Orchestra Low.Level .$18;977:00 $18,977:00 $0:00 $0.00 $18,977.00 1,00% $0.00 $0.00, 20070 Orchestra High'Level $12,010.00' $12.010.00, $0100 -$0.00 512;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 :812,800:00. $0:00, $0.00 512.800.00 100% $0:00 $0:00 20100 Balcohy..High Level $23,900.00 $23.900100 $0.00 $0.00' $23,90000 100% $0100 $0.00 20110 Attic.50 IL Level $5,600.00 $5.60000 '$0.00: $0.00 $5,600.00 100% $0.00 $0.00' " 201'20 Attic 66 ft Level $8,805.00 $8,805:00 $0.00. $0.00 '58805.00 100% $0.00 $0:00 20130 Attic 80 ft::Level $12,335:00 $12,335':0; $0.00 $0.00 $12,335100 100% $0.00 $0.00. 20140• Pre-action $15,984:00 :$15,984;00, .$0.00 $0.00. $15;984.00 100% so: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 512,381:00 $12,257.19 50.00 $0.00: $12,257.19 99% $123.81 $0.00' 30030 Standpipe 517.024.00 $16,173:00 $851:00 .$0.00 $17,024:00 100% $0.00. $0.00: 30040 Basement $49,602:00 $49,105.98 80100 $0:00 $49,105.98 99% 5496102 50.00: SOL7mp®e arginibOM DETAIL AND CONTINUATION SHEET APPLICATION AND-CERTIFICATE FOR PAYMENT, SiniplexGrigiiell LP APPLICATION NO:: 21 containing Contras ton's:signed'Certification, is attached. CARMEL PERFORMING.ARTS AI?PLICATION'.DATE:.08/15/2010 .In tabulations below.amour is are stated to the nearest:dollar.. PERIOD TO;0813:1/2010. Use.Column Ion Contracts Where A'ariable retainage.for'line'items may apply. PROJECTNO.: 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 'X, TO (-IF VARIABLE), (Di-E) PERIOD (NOT IN TO DATE (G-C) FINISH RATE DOR"E) (DwE F) (CG) 30050 Plenum Level $17,179.00 $.17,00721 so:00 $0.00 $17,007.21 99% $171.79 $0.00 30060 Orchestra Low Level $26,620.00 $26.353:80- $0:00 $0.00 $26:353:80 .99% $266.20 $0'00, 30070 ' Orchestra High'Level $15.012.00 $14,861.88 $0:00 $0.00: $14,861:88 99% $150.12 $0.00. 30080 • Box Tier Level $3.1.572.00 $29,046:00 $0.00 $0.00' $29.046.00, 92% $2,526.00 $0.00: 30090 Balcony Low Level $16:328.00- $14,6'95:'00 $0.00 $0.00' 514,695.00. 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, 301.10 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 $1'5;554.00 100% $0.0(1 $0':00 ALLOWANCE $0.00 $0.00 $0.00., $0.00 $1100 0% $0.00 .$0.00 4280A-001 $1:940:00' $1,940.00. 50:00 $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_ .50.00. '50:00, $531.0 100% $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' 50:00 $614:00 100% $0.00- $0.00: 4280A-007 $14,236:00; $14:236:00 50:00. $0.00 $14,236.00 100% $0.00 $0:00 2695,4280-04.Addtion '$13,445`.00 $0.00 $0.00: $0.00, $0.00 0% 513,445:00- $0.00. • 4280A-009 $2,765:00 $2,7.65.013' $0:00, $0:00, $2;765.00 1,00% $0:'00, $0.00. 4280A-010 51,656:00 51,656:00 $0:00• $0:00, $1:6$6.00 100% $0:00' $0:00 ' 4280A-012 $1,361.00 $1;361.00' $0.00' $0.00' .51:361.00 100% $0:00 $0100, 4280A:013 '$501.00' $501.00' .$0:00 $0:00. $501:00 100% $0.00 $0.00 4280A-014 $1,976:00 $1,976'.00 .$0.00. $0.00, $1,976.00 100% $0.00 '$0.00 CHANGE-ORDERS •$0',00- $0.00 ' $0.00 '$0.00 0% so:00 $0.00. Change.Orderl RF.Q,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) :50:00. '$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; • Si:Y.,vp 10..K+ f,kar,z'ell DETAIL AND CONTINUATION SHEET APPLICATION AND,CERTI MATE TOR PAYMENT. SinlplexGrinnell.LP APPLICATION:NO.: 2.1 containing Contractor'saiened.Certifi'cation. is attached: CARMEL PERFORMING ARTS APPLICATION DATE: 08/1"5/2,010 In tabulation's below.:amounts aretated.to the nearest dollar. PERIOD'TO: O8/3I/20I0 Use Calumn:Lon Contracts where varirble'retainaue for-line items may apply. .PROJECT NO.: 2695-4280 rA B C 0 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) (Di-El PERIOD (NOT II TO,DATE (G=C) FINISH RATE ' DOR'E) (D±E+F) (C-G1 TOTALS $614:930.00 $586,934.91 $851.00 '$0:00 a587,7859T 96% $27044.09 $0:00 SimplexGrinnell 11820 Pendleton Pike, Indianapolis,IN 46236 tqc ,Fire & Security $in.0 kkdd Green fD w fl CONDITIONAL,WAIVER AND RELEASE UPON,PROGRESS PAYMENT Upon•receipt by the undersigned of a check from Cap tne.l Redev,elo_o nen:, (Maker of Cheek) in the sunr•of:fi ;851 . 00 payable to SimplcxGrinnell and when the check has been properly endorsed and,has been paid by the hank upon which it-is drawn, this th current shill become effective to relcase any mechanic''slien, stop notice or bond right the undersigned has on the job of . C,airmel Re.developntent— (Owner) It>c tted at Carmel Perifiozrn n39-_Arils Ce.n te.r. — — .._--•--_.. __. •(Job Description) rr,t the following cxtent. This release covet~ a proerc:;s payment for labor. iiervit.es. equipment or toatt:ri;tliftrnishittl a rine 1 lie,clC_Vt::•1Lt :rnK?11 f, • (' ;it''(:; tin ter) ti r ough — __ only and floes not cover any itaenir ut trr itt:nt:; furni_;ht tl ;flier :;a i i i (Date) d;tie, not disputed elttinis in the amount of:S 14cfmx of this dt,i;untint,relies on it, the party should vciify evideuce.oi'paymeiit to the undi isil�nt 1. DATED: _Octiob:er 2.1 , _2010 Simplex iiitineiy„.4 f f: f 131': �.--��•t�::f.' (,• Michae.lf M. MacDonald Off ices&.Representatives in Principal Cities throughout the World 4A]I .• o Document G702/ClitaTM = 1992 Application and Certificate for Payment Construction Manager-Adviser Edition 111 TO OWNER: PROJECT:. APPLICATION NO:23 Distribution to: Carmel Redevelopment Comm ParceL7A Regional One Civic Square Performing Arts Center PERIOD TO: September 30, 2010 OWNER ❑ Carmel, IN 46032 CONSTRUCTION MANAGER X7 FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 6-20-2009 ARCHITECT ❑ SimplexGrinnell LP Shiel Sexton Co. PROJECT NOS: 2695 / 4280 / CONTRACTOR ❑ 11820 Pendleton Pike VIA ARCHITECT: FIELD ❑ Indianapolis, IN 46236 CSO Architects CONTRACT FOR: Auto Fire Protection ❑ .CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below-in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet, for Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment w re issued and payments receive( from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 615,539.00 payment shown herei is (v due. ji.....L./2.Net change by Change Orders S 4 9 ,5 71. 0 0 CONTRACT : Ar3.CONTRACTSUMTODATE(Line1 ±2) $.664 ,930. 00 BY: itr✓ Date: September 20, 201( 4.'TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 6 41 ,7 8 7 . 0 8 State of: ndiana Michael M. MacDo , 5.RETAINAGE: County of:Marion PAULA K.LEWIS ' ' Notary Public-Seal a. %of Completed Work ' 5 p Subscribed and sworn to before (Column D+E on G703) $ 30 ,746 .50 me this 20th day of S e to/ er, 2010 State of Indiana . b. %of Stored.tvlaterial Notary Public: 6f� o "l w•>;° 4 My Commission Expires Aug 12,2017 . (Column F on 0703) $ 0 . 00 My Commission expires: 8-12-20'17 - 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 $611,040 . 58 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 $607,039.41 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. (Line 6 from prior Certificate) 97 8.CURRENT PAYMENT DUE $4',001. 17 AMOUNT CERTIFIED $ 4U)(d7 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if( mount certified differs.' mn lie amount applied.Initial all figures on this Application and. the Continuation Sheet tl it ar changed to conform tritlr the amount certified.) (Line 3 less Line 6) $ 53 ,889 . 42 CONST'UCTION.■ • R: / I/ f BY: sb ��i�■. _ Date: 99/2-//). /�/). O CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCH -rT: '7'� , `~ (((( /// ( i� Total changes approved in previous months by Owner $74721. 0 0 S (25 ,150. 00)3y: �I,;.�1_f - �""""'�- Date: � ��Q'-�� Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $7 4721 . 00$ (25, 150 . 00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 49 ,571. 0-0 the Owner or Contractor under this Contract. CAUTION:You should sign an'origlnal.AlA.Contract.Docuinent,on which this.text appears in RED.An original assures that changes will not be obscured. AIA Document G702/CMaTu—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document is protected by U.S.Copyright Law and International.Treaties. Unauthorized reproduction or distribution of this Alp°'Document,or any portion of It,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. Sor en; riOxigeilmme 0 DETAIL AND CONTINUATION SHEET APPLICATION.AND CERTIFICATG,FOR PAYMENT, SimplexGrinnell LP' APPLICATION NO: 23 coritainirm'Contractor'S,sibned'Certification, is-attached. CARMEL PERFORMING ARTS APPLICATION DATE: 09/20/2010 In tabulations below,amounts are stated to'the nearest dollar: PERIOD'TO: 09/30/2010 Use Column4 on Contracts where'variable retainage for line items may apply. PROJECT'NO.: 2695-4280 A B C D E F G I•I 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 DOR.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% $0.00 $0.00 10020- Permits&Fees $500.00 $500.00 $0.00 $0.00 $50000' 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 Dranaing.&Drafting Srvices $33,638.00 $33;638:00 $0.00 $0.00 $33,638.00' '100% $0.00 $0.00 1,0050 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 $0100, 20030 Standpipe $13,218.00 $13,218.00 $0100 $0.00 $13,218.00 100% $0.00 $0.00 20040 Basement $32,772.00 $32,772 100 $0.00 ,$0 100 $32,772 100 100% $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 26.070 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 LowLevel $12.800.00 $12,800•.00. $0.00, $0100 $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 $0:00 204=10 Attic:50 fu.Level $5,600:00 $5;600.00 $0100 $0100 $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 Atti0801t'Level $12.335:00 $12,335.00 $0.00 $0.00 $12,335.00, 100,% $0.00- •$0.001 20140 'Pre-action .$15,984.00 -$15,984,00 '$0:00 $0100 $15,984.00 100/ $0100 50 100 30000 INSTALLATION 30010 Underground $3,714:00' $3,714.00 $0.00 $0:00 $3:714.00 100% $0:00 $0:0 • 30020. Fire:Pump $12,381:00: $12,257.19 $0.00: $0.00, $12,257.19 .99P/0 $123.81. $0.00. 30030 Standpipe '$17,024.00 $17,024.00' $0.00• $0.00, $17 1024.00 100%0 $0100 $0.00 30040. Basement. '$45602 100; $49,105.98 $496.02 $0.00 $45602;00 100% $0.00: $0:00 • S©c ppw erimme DETAIL AND CONTINUATION. SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 23 containing'Contractor's,.signed Certification,,.is-attached. CARMEL PERFORMING ARTS APPLICATION DATE: 09/20/2010 • In-tabulations below,amounts'are stated to..the.nearest•dollar. PERIOp'TO:09/30/201'0 Use COlumn I.on•Coritracts where variable'retaihage for line items inay;apply, PROJECT NO.: 269 -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) (D4-E) PERIOD (NOT IN TO DATE (G+C) FINISH RATE DOR.E) (D=E±F) (C-G) 30050 Plenum Level $17;179.00 $17;007.21, $0.00 $0:00 51.7,007121 99% $171.79 $0.00 30060 Orchestra Low Level $26,620.00 $26;353:80 $0:00 $0.00 $26;353.80 99% $266.20 $0.00 30070 Orchestra High Level $15;012.00 $14,861.88 $0.00 $0.00 $14,861.88 99% $150.12 $0.00 30080 Box Tier Level $31572.00 $29:046.00 $947100 $0.00 529,993:00 95% $1,579.00 $0.00 30090 Balcony-Low Level $16,328.00 $14,695.00 $817:00 $0.00 $15,512:00 95% $816.00 $0.00 30100 Balcony High Level $34;822.00 $31,339.85 $1,741.15 $0.00 $33,081.00 95% $1;741.00 $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 59,673.00' 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 51;940.00' $1;940.00 .$0.00 -$0.00 $1,940.00 100% $0.00 '80:00 ' 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% 525,000:00 $0:00' 4280A-004 $531.00 $531.00 80 100' $0.00.: $531'.00 100% $0.00 $0.00 4280A-005 85,064:00 55,064:00: $0:00 $0.00 $5;064.00, 100% $0.00: '$0.0Q 4280A-006 .$614.00 561400' $0:00 :$0.00, $614:00 100% $0.00: 50:00 4280A-007 $14,236.00. $14,236:00' $0100. 50'.00 $14,236.00 100% -$0.00 ;$0'.00 2695-4280-04 Addtion .$13,445.00 $0.00 $0.00 $0.00 $0:00 0% $13,445100' $0.00 4280A-009 52,765.00. $2,765.00' 10100 $0;00 $2,765.00 100% $0:00. -$0.00. 4280A-010 81,656:00. $1.656.00 $0.00' $0.00 $1,656.00 100% 50.00 5.0.00 4280A-012 $1;361:00 $1,361.00 :50.00 50:00 $1;361'.00 100% '5.0.00, $0,00 4280A-013 5501.00 $501:00 $0.00 $0.00 $50,1.00 100%0 50:00 50.00 4280A-014 $1,976.00', $1,976.00 $0.00 $0.00 $1,976.00 100% '$0100 50.00 CHANGE ORDERS, $0.00, $0.00 50.00 $0.00 0% $0.00 $0.00 Change.Order'l RFC)006 $4,601.00 54;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% ( 25,150:90) $0.00 Change Ordet.2 $20,120.00 $0.00 $0.00 $0:00 0% $20,120.00 $0.00 5112PpleMerigagnell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR:PAYMENT, ' SimplexGrinnell LP APPLICATION'NO.: 23 containing Contractor's siw ed Certification, is attached. CARMEL PERFORMING ARTS APPLICATION.DATE: 09/20/2010 In•tabulations below, amounts are stated.to the nearest dollar. PERIOD-TO: 09l30/20I0 Use Column I on Contracts where variable retainage'.f'or.line;items'may.apply. PROJECT NO.: 2695-4280 A B C 0 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 ANOSTORED % TO (IF VARIABLE) (D+E) PERIOD (NOT IN TO DATE (G=C) FINISH RATE D OR E) (D+E+F) (C-G) Steel Issue $50,000.00 $50;000.00 $0.00 $0.00 550,000:00 100% $0.00 $0:00, "TOTALS $664,930:00. $67.785.91 $4,001.17 $0.00, $641,787.08 97% $23,142.92 $0:00 SimplexGr1nnell 11820 Pendleton Pike,Indianapolis,IN 46236 tgcED F.ire& Security CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of'a check from Carmel Redevelopment (Maker of Cheek) in the sum of's 4,001 .17 payable to SimplexGrinnell and when the check has been properly'endorsed'and lias been paid by the.batik 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 al Carmel Perdorminq Arts Center (7'ob Description) to the following extent. This release covers a progress payment for labor; services, equipment or materi'al'furnished.to Carmel Redevelopment. (Your Customer) through only and does not cover any retention or items fufnished.after said (Date) 'date, nor.disputed claims in the amount of S. N/A . Before any recipient of this document relies on'it, the party should verify evidence of payment to,the undersigned. DATED: September 20 , 2010 SimplexGrinnell (Company Ni ii � BY: `? Michael! M. MacDonald Offices&Representatives in Principal Cities throughout ihc,world