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General Pipingl - $548.40
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 Amount to be paid by Carmel Garage Development as per the Elevators,Fire Protection,and Pumps installment purchase contract Application 27(General Piping) January $ 548,40 2011 Grand Total 4N0 ..a* .; i 13n$ z48�40KZ:?; 13".=eL. S. f' 'V( 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: /Z 5711 CITY OF CARMEL REDEVELOPMENT COMMISSION 2 By /4 Les S. Olds Printed Executive Director - Title 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 $ - Pald by Carmel Garage Development Company $ 1,327.72 February 2010 Pald by Carmel Garage Development Company $ 4,177.72 March 2010 Paid by Carmel Garage Development Company $ 2,545.20 April 2010 Paid by Carmel Garage Development Company $ 3,746.40 May 2010 Paid by Carmel Garage Development Company $ 3,109.20 June 2010 Paid by Carmel Garage Development Company $ 8,799.60 July 2010 Paid by Carmel Garage Development Company $ 10,968.00 August 2010 Paid by Carmel Garage Development Company $ 5,484.00 September 2010 Paid by Carmel Garage Development Company $ 13,710.00 October 2010 Paid by Carmel Garage Development Company $ 2,742.00 November 2010 ._ Paid by Carmel Garage Development Company $ 2,460.00 January 2011 Amount to be paid by Carmel Garage Development Company $' '548.40 ,,,,1.42,i-AIA Document G732' - 2009 Application and Certificate for Payment, Construction Manager as Adviser Edition TO OWNER: City of Carmel PROJECT: CPAC 16% APPLICATION NO:27 b DISTRIBUTION TO: . OWNER PERIOD TO:January 31,2011 CONSTRUCTION MANAGER FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE June 11,2008 ARCHITECT CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:NA/2829/NA CONTRACTOR Indianapolis,IN 46234 FIELD CONTRACT FOR: General Construction ViA ARCHITECT: CSO Architects OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous AIA Document G703TM Continuation Sheet,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 CHANGES IN THE WORK $ 0.00 CONTRACTOR 3. CONTRACT SUM TO DATE(Line 1±2) $ 643,496.00 By: Date: January 21,2011. 4. TOTAL COMPLETED AND STORED TO DATE(Column G on G703)....$ 643,496.00 State of:Indiana / 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.I day of _icon. 201( , / b. 0 %of Stored Material Notary Public:Luke Roseboom , (Column F on G703) $ 0.00 M Commission ex b :J 07,2012 1 Total Retainage(Lines Sa+5b,or Total in Column I on G703) $ 54,549.71 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 588,946.29 In accordance with the Contract Documents,based on evaluations of the Work and the data comprising (Line 4 minus 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 $ 588,397.89 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in (Line 6from prier Certificate) accordance with the Contract Documents,and the Contractor is entitled to payment_of the AMOUNT CERTIFIED. _. 8. CURRENT PAYMENT DUE $ 548.401 AMOUNT CERTIFIED $ 548.40 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified dill from th nt applied.Initial all figures on this Application and on t{-Continuation Sh'4, + are c' • .+to conform with the amount certified.) (Line 3 minus Line 6) $ 54,549.71 CONS 'UCTION 11 ER: By: \_*L..% � Date: ® /( SUMMARY OF CHANGES IN THE WORK ADDITIONS DEDUCTIONS ARCH ."+ • Mu tiple Prime Contractors are responsible for performi porn s of the Total changes approved in previous months by Owner$ 0.00$ 0.00 Project,t A; ;'•C scation is not requ�i'red) C BY / Date: ozi, [ml,I Total approved this month including Construction Change Directives $ 0'�$ 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 IN THE WORK $ 0.00 AIA Document GT32"'—2009(formerly G702"6Nla—1992).Copyright©1992 and 2009 by The American instate of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to I the maximum extent possible under the law.This document was produced by AIA software at 13:45:36 on 01/21/2011 under Order No.9658147774 1 which expires on 05/13/2011,and is not for resale. User Notes: (1883974477) ,[1:1 A A 6 1, . " Document G703' ® 1992 Continuation Sheet AIA Document,G702114-1992,Application and Certification for Payment,or G736i1N-2009, APPLICATION NO:027 Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars. PERIOD TO: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:NA A B C _ D I E F G H I WORK COMPLETED TOTAL MATERIALS ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD (NOT IN D OR E) DATE (G-C) (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, 26,640.00 0.00 0.00 26,640.00 100.00% 0.00 2,530.81 64 Material 167,273.00 167,273.00 0.00 0.00 167,273.00 100.00% 0.00 16,727.30 65 Domestic Pumps 0.00 0.00 0.00 0.00 0.00 0.00% 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 54,291.60 548.40 0.00 54,840.00 100.00% 0.00 274.20 104 Material 111,082.00 111,082.00 0.00 0.00 111,082.00 100.00% 0.00 11,108.20 105 y Water Heater 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 106 Labor 4,080.00 41080.00 0.00 0.00 4,080.00 100.00% 0.00 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 0703' -1992.Copyright C 1983,1965,1966,1987,1970,1978,1983 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 Ale Document,or any portion of It,may result in severe civil and criminal penalties,and will be prosecuted to 11 the maximum extent possible under the law.This document was produced by AIA software at 13:43:10 on 01/21/2011 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (913919098) A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS ITEM DESCRIPTION OF' SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE 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 $642,947.60 $548.40 $0.00 $643,496.00 100.00% $0.00 $54,549.71 AIA Document G703"—1992.Copyright®1983,1965,1968,1967,1970,1978,1983 and 1992 by The American institute of Architects.Alt rights reserved.WARNING:This AIAe 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 2 the maximum extent possible under the law.This document was produced by MA software at 13:43:10 on 01/21/2011 under Order No.9656147774 1 which expires on 05/13/2011,and is not for resale. User Notes: (913919098) CONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT PROJECT: Carmel Performing Arts Center Upon receipt by the undersigned of a check from City of Carmel Rdvlpmnt Comm. in the sum of $548.40 payable to General Piping Inc. and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanic's lien, stop notice, any state or federal statutory bond right, any private bond right, any claim for payment and any rights under any similar ordinance, rule or statute related to claim or payment rights for persons in the undersigned's position, the undersigned has on the job of City of Carmel Rdvlpmnt Comm. located at 777 3rd Ave. SW, Carmel, IN 46032 to the following extent. This release covers a progress payment for labor, services, equipment or materials furnished to the jobsite or to City of Carmel Rdvlpmnt Comm. through 01/21/11 only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date or pending modifications and changes. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that furnished labor, services, equipment or material was not compensated by the progress payment. The undersigned warrants that he either has already paid or willluse the monies he receives from this progress payment to promptly pay in full all of his laborers, subcontractors, materialmen and suppliers for all work, materials, equipment or services provided for or to the above-referenced project up to the date of this waiver. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned. . DATE: I j 72.1 I 11 General Pipin Inc. (si ature C cC. �t 45• (ti le)