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Certified Floorcovering - $69,554.70
The National Bank of Indianapolis 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 Authorized Disbursement' line in the "Amount of Authorized Disbursement" column below; and (b) accordance with the terms and conditions of the Agreement, the other Loan Documents, and the Disbursement Instructions. Purpose of Authorized Disbursement Amount of Authorized Disbursement Amount to be paid by Carmel Theater Development Company as per the Equipment and Improvements Installment Purchase Contract Application 1(Certified Floorcovering)April 2010 $ 4,320.00 Appticauon 2(Certified Floorcovering)May 2010 $ 61,15320 • April NBI Lender Attorney's Fee $ 1,790.00 May NBI Lender.Attorneys Fee S 2291.50. Total Authorized Dlsbursement k ,�$�69�554.70 ; ..a i All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement(Equipment and Improvements), dated February 23, 2010, by and between The Na ional Bank of Indianapolis and Carmel Theater Development Company; LLC.. Dated 7//i/1'6 CITY OF CARMEL REDEVELOPMENT COMMISSION By: Les S Olds. Printed: Executive Director Title: Draft Carpet and Resilient Flooring (Certified Floorcovering) April 2010 Amount to be paid by Carmel Theater Development Company $ 4,320.00 May 2010 Amount to be paid by Carmel Theater Development Company 5 61,153.20 APPI;ICATIOiv AND CERTIFICATE FOR PAYMENT 'PAGE.ONE OF AIA DOCUMENT G702/CMa PARCEL 7A, REGIONAL PERFORMING.ARTS CENTER To Contr: Project: Carmel Redevelopment Commission(Owner) Application#: 1 Distribution to: One Civic Square Carmel;IN 46032 Application Date: 4/14/2010 OWNER — Attn: Les Olds,:AIA;:Director of Redevelopment CONSTRUCTIO MGR _ From.Contractor: Period Ending: 4/30/2010 ARCHITECT Certified Floorcovering Services,Inc: VIA Construction Manager: Shiel Sexton Co.,Inc. CONTRACTOR 5150 West 84th Street — Indianapolls,lN 48268 Via Architect: CSO,Inc. Contract For. Contract Date#: 07/29/09. Carpet:&Resilient Flooring-Contract#2695-5130 Pencil copy.to Geoff Pratt(gpratt©shielsexton.com)by 15th of the month. Billing due 20th,of the month Is CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application Is made for payment as shown below,in connection with the Contract information and belief the Work covered by this application for payment has been Continuation Sheet,AIA Document G703 attached. completed in accordance.with the contract documents,that all amounts,have been paid by the Contractor for work for which previous certificates:for payment were Issued and 1.Original Contract Sum $440,900.00 payments received from the Owner and that current payment shown is herein now due 2.Net Change by Change Orders 2,885:00 Contractor. Certified Flaorcovering Services,Inc oral`, illiViice�P�jessi_d�nt 3.Contract'Sum To Date . 443,785.00 By: l' .'M`{� / �C1� DATE: April 14,2.010 State of: Indiana County Of: anon"" 4.Total Completed.8.Stored to Date 9,800.00 Notary Public: Sandra A.Knox Signed`. .wi C../...'. S:Retainage My Commission ExF 03/06/13 J��/.JC, a. 10.00%of Completed Work $480.00 ARCHITECT'S CERTIFICATION. b. 10.00%of Stored Material $0.00 In accordance with the contract documents,based on on-site observations and the data comprising this application,the Construction Manager and Architect certify io the Owner that Total Retainage: 480.00 to the best of their 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 6.Total Earned Less Retainage 4,320.00 Is entitled to payment of the AMOUNT,CERTIFIED. (.� 7.Less Previous Certificates for Payment 0.00 AMOUNT CERTIFIED a.i 3CO 8.Current Payment Due $4,320.00 (Attach explanation if amount certified differs.from the amount applied for. Initial.ell figures on this application and on the continuation sheet that are 9.Balance Due to Finish,IncludingRetalnage $439,465:00 changed to conform to the amount certife C�!STRUC 11.... . AGER- Change Order Summary Additions Deductions By\`!.; �i 4 Date: 1 Total changes approved in �' �' previous months by owner 2,885.00 - ARCHITECT401 Total approved this (April-10) By: Date: 4 2�1 Totals 2,885.00 - Net change by Change Order: 2,885:00 This certificate is not negotiable The amount certified is payable only to the Contractor named herein.Issuance;payment&.acceptance ofpayment are without prejudice to any,rights of the owner or contractor;under this•contract. APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE OF AlA DOCUMENT G702/CMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER. To Contc i Project: Carmel Redevelopment Commission(Owner) Application it:, 1 Distribution to: One Civic Square Carmel,IN 46032 Appiication.Date:, 4/14/2010 OWNER. _ Attn: Les Olds,AIA,Director of Redevelopment CONSTRUCTIO MGR From Contractor. Period Ending: 4/30/2010 ARCHITECT _ Certified Floorcovering Services,Inc VIA Construction Manager: Shiel:Sexton,Co.,Inc. CONTRACTOR 5150 West 84th Street Indianapolls,IN 48268 Via Architect: CSO;Inc. Contract For. Contract Date&#: 07/29/09 Carpet&Resilient Flooring-Contract#2895=5130 APPLICATION FOR PAYMENT-CONTINUATION SHEET A B C D E F G H'' I ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL CP& % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE WORK THIS PERIOD MATERIALS STORED TO DATE (G/C) FINISH(C=G) 10.00% 1. BASEMENT 0.00 0.00 0.00 0.00 0.00 0.00% .0.00 0.00 2 Resilient Material 5,500.00 0.00 0.00 0:00 0:00 0.00% 5,500.00 0.00 3 Resilient Labor 3;000:00 0.00 0.00 0.00 0.00 0.00% 3,000.00 0:00 • 4 Carpet Material 17,000.00 0.00 0.00 0.00 0.00. 0.00% 17;000.00. 0.00 5 Carpet Labor 3,100.00 0.00 0.00 0:00 0.00 0.00% 3,100.00. 0.00 6 Grout System Material 0.00 0.00 0:00 0.00 0.00 0.00% 0.00. 0.00 7 Grout System Labor 0:00 0:00 0.00 0.00 0.00. 0.00% 0.00 0.00 8. PLENUM 0.00 0.00 0.00 0.00 0.00 0.00% .0.00 0.00 9 Resilient Material 2,400.00 0.00 0.00 0.00 0.00 0.00% 2,400.00 0.00; 10 Resilient'Labor 1,300.00 0.00 0.00 0.00 0.00 .0.00% 1,300.00 0.00 11 Carpet Material 29,000.00 0.00 0:00 0.00 o:oo 0.00% 29,000.00 0.00 12 Carpet Labor 6,100.00 0.00 0.00 0.00 0.00 0.00% 6;100.00 .0.00 13'. Grout System Material 4,680.00 0.00 0.00 0.00 0.00 0.00% 4,680.00 0.00 14 Grout System Labor '3,600.00 0.00 0.00 0.00 0.00 0.00% 3;600.00" 0.00 15 ORCHESTRA LOW 0.00 0:00 0.00 0:00 0.00 0.00% 0.00 0.00 16 Resilient Material 8,500.00 0.00 0.00 0.00 0.00 0.00% 8;500.00 0:00 17 Resilient Labor 4,400.00 0.00 0.00 0.00 0.00 0.00% 4;400.00 0.00 18 Carpet Material 12,000.00 0.00 0.00 0.00 0.00 0.00% 12,000.00 0.00 19 Carpet Labor 2,100.00 0.00 0.00 0:00 0:00 0.00% 2,100.00 0.00 20 Grout System Material' 2,600.00 0.00 0.00 0.00 0.00 0.00% 2,600.00' 0:00 21 Grout System Labor 2,000.00 0.00 0.00 0.00 0.00 0.00% 2,000.00 0.00 22 ORCHESTRA HIGH, 0.00 0.00 0.00 0.00. 0.00 0.00% 0.00 0.00 23 Resilient Material 900.00 0.00 0.00 0:00 0:00 0.00% 900.00. 0:00 24. Resilient.Labor 400.00 0:00 0.00 0.00 0:00 . 0.00% 400.00 0.00 25 Carpet Material. 36,000.00 0.00 0.00 0.00 0.00 0.00% 36,000.00 0.00 26' Carpet Labor 6,300.00 0.00 0.00 0.00 0.00 0.00% 6;300.00 0.00 27 Grout System Material 3,510.00 0.00 0.00 0.00 0.00 0.00% 3;510.00 0.00 28 Grout.System Labor :2,700:00 0:00 0.00 0:00 0.00 0.00% 2',700.00 0.00 29 BOX TIER 0.00 0:00 0:00 0:00 ,0.00% 0.00 0.00 30 Resilient Material 5,100.00 0:00 0:00 0.00 0:00 0.00% 5:100.00 0.00 31 Resilient Labor .2,900.00 0.00 0.00 0.00 0.00. 0.00% 2,900.00 0.00 32 Carpet Material.. 56,000:00 0;00 0.00 0.00 0.00 0.00% 56,000.00 0.00 33 Carpet Labor 10,500.00 0.00 0.00 0.00 0.00 0.00% 10,500.00 0.00 34. Grout System Material 42,770.00 0.00 0.00 0.00 0.00 0.00% 42,770.00 0.00 APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE OF AIA,DOCUMENT G702/CMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER To Contr: i Project: Carmel Redevelopment Commission(Owner) Application ft: 1 Distribution to:. One Civic Square: Carmel,IN 46032 Application Date: 4/14/2010 OWNER _ Attn::Les Olds,AIA,Director of Redevelopment CONSTRUCTIO MGR _ From.Contractor: Period Ending: 4/3012010- ARCHITECT Certified Floorcovering Services;Inc, VIA Construction:Manager: Shiel Sexton Co.,Inc: CONTRACTOR 5150 West 84th Street Indianapolis,IN'46268. Via Architect: CSO,Inc. Contract For: Contract.Date#: 07/29/09 Carpet&Resilient Flooring Contract#2695-5130 APPLICATION:FOR PAYMENT-•CONTINUATION SHEET A ,B C D E F G. H I ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL.CP.& % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE WORK THIS PERIOD MATERIALS STORED TO DATE (G/C) FINISH(C-G) 10% 35 Grout System Labor 31,056.00 0.00 0.00 0.00 0.00 0.00% 31,056.00 0.00 36 BALCONY LOW 37 Resilient Material 1,500.00 0:00 0.00 .0.00 0.00 0.00% 1;500.00 0:00 38 Resilient Labor 800:00 0.00 0.00 0:00 0:00 .0`00% 800:00 0:00 39 Carpet Material 19;800,00 0.00 0.00 0.00 0:00 0.00% 19;800:00 0:00 40 Carpet Labor 4,000:00, 0.00" 0.00 0.00 0:00 0.00% 4,000.00. 0:00 41 Grout System Material 7;800.00 0.00 0:00 0.00 0.00 0:00% 7,800.00 0.00 42 Grout System Labor 6,000.00 0.00 0.00 0.00 0:00 0.00% 6,000:00 0.00 43 BALCONY HIGH: 0.00. 0.00 0.00 0.00 '.0.00% 0:00 0.00 44 Resilient Material 1,300.00 0:00 0.00 0:00 0.00 0.00% 1,300:00 0:00 45 Resilient Labor 800.00 0.00 0.00 0.00 0.00 0.00% 800.00 0.00 46 Carpet Material 26,800.00 0.00 0.00 0:00 0.00 0.00% 26,800.00 0:00 47 Carpet Labor 5,200.00. 0.00 0:00 0:00 0.00 0:00% 5,200.00 0`00 48 Grout System Material 20,384.00 0.00 0.00 0.00 0.00 .0.00% 20;384:00 0:00 49 Grout System Labor 14,100.00• 0.00 0:00 0.00 0.00 0.00% 14,100100 0:00 50 ATTIC 0:00 0.00 0.00 0:00 0.00% 0:00 0.00. 51 Resilient Material 600.00 0:00 0:00 0 o0 0:00 0.00% 600:00 0:00 52 Grout System Labor 400.00 0.00 0:00 0:00 0:00 ;0.00% 400.00 0.00 53 ALLOWANCE#5 15,000.00 0.00 0.00 0.00 0.00 0.00% 15,000.00 0.00 54 ALLOWANCE#6 CAD DRAWINGS 5;000.00 0.00 0:00 0:00 0:00 0.00% 5,000.00 0.00 55 BOND/SUBMITTALS/CLOSEOUT 6,000:00 0.00 4,800:00 0.00 4,800.00 80:00% 1,200.00 480.00. 56 CO#1 RCP PAC 006 Changes 2,885 00 0.00 0 00 0,00 0:00 0:00% 2;885:00. 0..00" 57 0.00 0.00 0.00 TOTALS: $,443,785:00 $0:00 $4,800.00 50:00 $4,800.00 50.00 $438,985.00 5480:`00 AFFIDAVIT AND WAIVER OF LIENS ❑ Final X Partial a Payment to.Follow State of Indiana, SS County of Marion Carol S. Milli, being duly sworn states that she is the Vice-President of Certified Floorcovering Services; Incorporated having contracted with Carmel Redevelopment Commission to furnish certain materials and/or labor as follows:FLOORING;for a project known as: Parcel 7A, Regional Performing Arts Center and owned by Carmel Redevelopment Commission and does hereby further state on behalf of the aforementioned subcontractor/supplier; (PARTIAL WAIVER)that there is due from the contractor sum of Four Thousand Three Hundred Twentu Dollars and 00/100($4,320.0Q). • [X]receipt of which is hereby acknowledged;or [ 1 the payment 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; (FINAL WAIVER)that the final balance due from the contractor is the sum of ) [ j receipt of which is hereby acknowledged;or [ 3 the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. 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 performed or material furnished to the undersigned for said project and within the scope of this affidavit and waiver. Certified Floorcovering Service, Incorporated By Carol S.Milli, Vice-President. ,�! Signed: � � _ /i�f[ Carol S. Milli/Vice President WITNESS MY HAND AND NOTARIAL SEAL, this 30th day of June , 20 10 My Gom y mission Expires:03_.06-2013 Sandra A. Knox Residing in Marion County APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE OF 58 AIA DOCUMENT G702/CMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER `' To Contr: Project: Cannel Redevelopment Commission(Owner) Application#: 2 Distribution to. One Civic Square Carmel,IN 46032 Application Date: 5/11/2010 OWNER Attn: Les Olds,AIA,Director of Redevelopment CONSTRUCTIO MGR From Contractor: Period Ending: 5/31/2010 ARCHITECT Certified Floorcovering Services,Inc VIA Construction Manager: Shiel Sexton Co.,Inc. CONTRACTOR 5150 West 84th Street Indianapolis,IN 46268 Via Architect: CSO,Inc. Contract For: Carpet&Resilient Flooring-Contract#2695-5130 Contract Date#: 07/29/09 Pencil copy to Geoff Pratt(gpratt@shlelsexton.com)by 15th of the month. Billing due 20th of the month CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application Is made for payment as shown below,in connection with the Contract information and belief the Work covered by this application for payment has been Continuation Sheet,AIA Document G703 attached. completed in accordance with the contract documents,that all amounts have been paid by the Contractor for work for which previous certificates for payment were issued and 1.Original Contract Sum 5440,900.00 payments received from the Owner and that current payment shown is herein now due 2.Net Change by Change Orders 2,885.00 Contractor. Certified Floorcovering Services,Inc Caro S.M i4{ is President 3.Contract Sum To Date 443,785.00 By: I/! -1--.1 DATE May 11,2010 State of: Indiana County Of: Marion 4.Total Completed&Stored to Date 72,748.00 Notary Public: Sandra A.Knox Signed: xfot ,z.Q. My Commission Ex f 03/06/13 5.Retainage a. 10.00%of Completed Work 57,274.80 ARCHITECT'S CERTIFICATION b. 10.00%of Stored Material 50.00 In accordance with the contract documents,based an on-site observations and the data comprising this application,the Construction Manager and Architect certify to the Owner that Total Retainage: 7,274.80 to the best of their 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 6.Total Earned Less Retainage 65,473.20 is entitled to payment of the AMOUNT CERTIFIED. 7.Less Previous Certificates for Payment 4,320.00 AMOUNT CERTIFIED GI its-?22. 8.Current Payment Due I 561,153.20 I (Attach explanation if amount certified differs from the amount applied for Initial all figures on this application and on t. ..ntinuation sheet that are 9.Balance Due to Finish,Including Retainage 5378,311.80 changed to conform to the amount certifi:i 9 Summary C : TR �T .NAG,� Change Order Summa Additions Deductions BY: *•. _ T Date: 19 24/I 0 Total changes approved in Y _.rii/r' _ previous months by owner 2,885.00 - ARCHI /!t Total approved this month(May-10) - - By: --- - Date: S .Zct . 1* Totals 2,885.00 - Net change by Change Order: 2,885.00 This certificate is not negotiable The amount certified is payable only to the Contractor named herein.Issuance,payment&acceptance of payment are without prejudice to any rights of the owner or contractor under this contract. APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE OF AIA DOCUMENT G702/CMa- PARCEL 7A, REGIONAL.PERFORMING ARTS CENTER To Contr: Project: Carmel Redevelopment Commission(Owner) Application#: 2 Distribution to: One Civic Square Carmel,IN 46032 Application Date:_ 5/11/2010 OWNER Attn: Les Olds,AIA;Director of Redevelopment CONSTRUCTIO MGR From Contractor: Perioo.Endin 5/31/2010 ARCHITECT - Certified Floorcoverin Services,Inc - g VIA Construction Manager:Shiel SextonGo.,Inc.f CONTRACTOR 5150 West 84th Street - Indianapolis,IN 46268 Via Architect::CSO,Inc. Contract For Contract Date#: 07/29/09 Carpet&Resilient Flooring-Contract#2895-5130 APPLICATION FOR PAYMENT-CONTINUATION SHEET A B. C D E .F G H I ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL CP& % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE WORK, THIS PERIOD MATERIALS STORED TO DATE (G/C) FINISH(C-G) 10.00% 1 BASEMENT 0.00. 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 2 Resilient Material 5;500:00 0.00 0.00 .0.00 0.00 0:00%; 5,500.00 0.00 3 Resilient Labor 3;000.00 0.00 0.00 0.00 0.00 0.00% 3,000.00 0100 4 Carpet Material 17,000.00 • 0.00. 0.00 0:00 0.00 0:00% 17,000.00 0:00 5 Carpet Labor 3,100.00 0:00 0.00 0.00 0.00 0.00% 3,100.00 0.00 6 Grout System Material 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 7 Grout System Labor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0:00 8 PLENUM 0.00. 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 9 Resilient Material 2,400.00 0:00 0.00 0:00 0:00 0:00% 2,400.00 0.00 10 Resilient Labor 1,300:00. 0.00: 0.00 0.00 0.00 0.00% 1,300.00 0.00 11 Carpet Material 29,000.00 0.00 0.00 0.00 0.00 0.00% 29,000.00 0.00 12 Carpet Labor 6;.100.00 0.00 0.00 0.00 0.00 0.00% 6,100.00 0.00 13 Grout System Material 4,680:00 0.00 0:00 0.00 0.00 0.00% 4,680.00 0.00 14 Grout System Labor 3,600:00 0.00 0.00 0.00 0.00 0.00% 3,600.00 0.00 15 ORCHESTRA LOW ,0:00' 0.00. 0.00 0.00 0.00 0.00% 0.00 0.00 16 Resilient Material 8,500.00 0.00 0.00 0.00 0.00 0.00% 8,500.00 0.00 17 Resilient Labor 4,400.00 0.00 0.00 0.00 0.00 0:00%0 4,400:00 0.00 18 Carpet Material 12,000.00 0.00 0.00 0.00 0.00 0.00% 12,000.00 0.00 19 Carpet Labor 2„100:00. 0.00: 0.00 0.00 0.00 .0:00% 2,100.00 0.00 20 Grout System Material 2,600.00 0.00 0.00 0.00 0.00 0:00% 2,600.00 0.00 21 Grout System Labor 2,000.00 0.00 0.00 0.00 0.00 0:00% 2,000.00 0.00 22 ORCHESTRA HIGH 0.00 .0.00. 0.00 0.00 0.00 0.00% 0.00 0.00 23 Resilient Material 900.00 0.00 0.00. 0.00 0.00 0.00% 900.00 0.00 24 Resilient.Labor 400.00 0.00 0.00 0.00 0.00 0.00% 400.00 0.00 25 Carpet Material 36,000.00 0.00 0.00 0.00 0:00 0.00% 36,000.00 0.00 26 Carpet:Labor 6,300.00 .0:00 0.00 0:00 0.00 0:00% 6:300.00 0.00 27 Grout System Material 3,510.00 0.00 0.00 0.00 0.00 0..00% 3,510.00 0.00 28 Grout System Labor 2,700.00 0.00 0.00 .0.00 0.00 0:00% 2,700:00 0.00 29 BOX TIER 0.00 :0.00 0.00 0.00 0:00% 0.00 0.00 30 Resilient Material 5:100.00. 0.00 .0.00 0.00 0:00 0:00% 5,100.00 0:00 31 Resilient Labor 2,900.00 0.00 0.00 0.00 0.00 0.00% 2,900.00 0.00 32 Carpet Material 56,000.00 0.00 0.00 0.00 0.00 0.00% 56,000.00 0.00 33 Carpet Labor 10,500.00 0:00 0.00, 0.00 0.00 0.00% 10,500.00 0.00 34 Grout System Material 42,770.00 0.00 21,385.00 0.00 21,385.00 50.00% 21,385.00 2,138.50 APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE OF AIA.DOCUMENT G702/CMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER To Contr. Project: Carmel Redevelopment Commission(Owner) Application#: 2. Distribution to: One Civic Square Carmel,IN 46032 Application Date: 5/.1112010 OWNER Attn: Les.Olds,AIA,Director of Redevelopment CONSTRUCTIO MGR _ From.Contractor. Period Ending: 5/31/2010 ARCHITECT _ Certified Floorcovering Services,:Inc VIA Construction Manager ShieI Sexton Co.,Inc. CONTRACTOR _ 5150 West 84th Street Indianapolls;IN`46268 Via Architect: CSO;Inc. • Contract For: Contract Date#: 07/29/0.9 Carpet&.Resilient Flooring-Contract#2695-5130 APPLICATION FOR PAYMENT-CONTINUATION SHEET A B C. D E F G < H I ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL CP& % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE WORK THIS PERIOD MATERIALS STORED TO DATE '(G/C) FINISH(C-G) 10% 35 Grout System Labor 31,056.00 0.00 .15;528:00 0.00 15,528.00 50.00% 15,528.00 1,552:80 36 BALCONY LOW 37 Resilient Material 1,500.00 0.00 0.00 0.00 0.00 0.00% 1,500.00 0.00 38 Resilient Labor .800.00 . 0.00 0.00 0.00 0.00 0.00% 800.00 0.00 39 Carpet Material 19,800.00 0.00 0.00 0.00 0.00 0.00% 19,800.00 0.00 40 Camel Labor 4,000.00 0.00. 0.00 0.00 0.00 .0.00% 4,000:00 0.00 41 Grout System Material .7,800:00 0.00 0.00 0.00 0:00 0.00% 7;800.00 0.00 42 Grout System•Labor 6,000.00 :0:00 0.00 0.00 0.00 0.00% 6,000:00 0.00 43 BALCONY HIGH 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 44 Resilient Material 1,300.00 0.00 .0.00 0.00 0.00 0.00% 1,300.00 0.00 45 Resilient Labor 800.00 0.00 0.00 0.00 0.00 0.00% 800.00 0.00 46 Carpet Material 26,800.00 0.00 0.00 0.00 0:00 0.00% 26,800.00 0.00 47 Carpet Labor 5,200.00 0.00 0.00 0.00 0.00 0.00% 5,200.00 0.00 48 Grout System Material 20,384:00: 0.00 18,345.00 0.00 18,345.00 90.00% 2,039.00 1;834.50 49 Grout System Labor 14,100.00 0.00 12,690.00 0.00 12,690:00 90.00% 1,410.00 1,269.00 50 ATTIC 0.00 0:00 0:00 0.00 0:00% 0.00 0.00 51 Resilient Material 600.00 0.00 0.00 0.00 0.00 .0.00%' 600.00 0.00 52 Grout System Labor 400:00 .0.00, 0.00 0.00 0.00 0.00% 400.00 0.00 53 ALLOWANCE#5 15,000.00 0.00 0.00 0.00 0.00 0:00% 15,000:00 0.00 54 ALLOWANCE#6 CAD DRAWINGS 5,000.00 0.00 0.00 0.00 0.00 0.00% 5,000.00 0.00 55 BOND/SUBMITTALS/CLOSEOUT 6;000.00 4;800.00 0.00 0.00 4,800.00 80.00% 1,200.00 480.00 56 CO#1 RCP PAC,006 Changes' 2,885.00 0.00' 0.00 0:00 0.00 0:00°° 2;885:00 0.00 57 0.00 0.00 0.00 TOTALS: 5443,785:00 54:800.00' 567,948.00 $0.00 572,748.00 $0:00 $371,037.00 $7,274.80 AFFIDAVIT AND WAIVER OF LIENS ❑ Final X Partial a Payment to.Follow State of Indiana, SS County of Marion Carol S_M(Ili, being duly sworn states that she is the.Vice-President of Certified Floorcovering Services, Incorporated having contracted with Carmel Redevelopment.Commission to furnish certain materials'and/or labor as follows:FLOORING;for a project known as: Parcel.7A, Regional Perforrnina Ms Center and owned by Carmel Redevelopment.Commission and does hereby further state on behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there Is due from the contractor sum of Sixty-One Thousand One Hundred Fifty three Dollars and 20/100($61.153.20). [X]receipt of which is hereby acknowledged; or [ ]the payment 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; (FINAL WAIVER)that the final balance due from the contractor Is the sum of [ ]receipt of which is hereby acknowledged;or [ ]the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver o f Lien which shall become effective upon receipt;of such.payment, 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 performed or material furnished to the undersigned for said project and within the scope of this affidavit and.waiver. Certified Floorcovering Service, Incorporated By Carol S. Milli,Vice-President. Signed: Carol S. Milli/Vibe President WITNESS MY HAND AND NOTARIAL SEAL, this 30'day Of June ,20"10 My Commission Expires:03-06-2013 andra x a C-ly Residing in Marion County � i 3 BANFç y 107 N. Pennsylvania Street "�' �� � OLIS Indianapolis, Indiana 46204 r Bill To: Due Date Carmel Theater Development Company, LLC Date ATTN: Lanny Sledge Payable within 1.1711 N. Pennsylvania Street 5/25/2010 15 Days. Suite 200 Carmel, IN 46032 • Lender Account Number JRB 604077801 • Fee(s) Due . Description Amount Attorney's Fee Hall, Render, Killian, Heath&Lyman, P.S.C. 1,790:00 Remit Payment to:The National Bank of Indianapolis 57''/ D-‘‘C Attn: Debbie Thompson 107 N. Pennsylvania St., Ste 700 \p} C Indianapolis, IN 46204 Au- b9i 61- ,\\459) \7 hi9 e • J✓ pil\61 • Thank you for choosing The National Bank of Indianapolis! Total $1,790.00 HALL, RENDER, KILLIAN, HEATH & LYMAN, P.S.C. PLEASE SEND PAYMENT TO: 39778 Treasury Camor C6lcogo,II.60694.9700 (3171 633.4.884 Federal IDd:35.1427161 Invoice No. : 178'.982 National Bank of Indianapolis Billing Atty: JJU Attn: Jason Boyewsky 107 North Pennsylvania Street May 13, 2010 Indianapolis, IN 46204 Matter umber: 104332-000001 Carmel Redevelopment Commission Financing . • FOR. PROF.ESSIONAL SERVICES RENDERED • 04/01/10 JAM Review disbursement request received from REI 90 Real Estate Services and CRC; review questions received from REI and respond; telephone conference with D.Thompson at.. NBofI regarding disbursement request 04/08/10 JAM Review e-mail and documents received from .60 J.Shoup regarding Second Amendment to Installment Contract • 04/09/10 JAM Review opinions, CRC Certificate, wood flooring 2.20 Installment Contract, CTA Installment Contract; prepare closing checklist and financing statement; forward same to J.Boyewsky; send comments on documents to J.Shoup 04/12/10 JAM Review Carmel Theater Development Company .70 closing certificates and authorizing documents; revise closing checklist 04/13/10 JAM Review Second Amendment to Collateral . .70 Assignment; forward same to J.Boyewsky; email J.B'oyewsky regarding closing of, Second Amendment to Collateral Assignment 04/14/10 JAM Review and respond to questions regarding bank .80 statements received from D.Thompson 1 National Bank of Indianapolis Page 2 Matter Number: 104332-000001 May 13, 2010 Invoice No: 178982 04/15/10 JAM Telephone conference with D.Thompson to review .10 lender fee question 04/16/10 JAM Review form of disbursement instructions .10 received from CRC counsel • 04/20/10 JAM Prepare for closing of Second Amendment, to .60 Collateral Assignment; revise closing checklist; Organize documents in preparation of, closing 04/21/10 JAM Attend closing at CRC counsel offices; review 1.70 documents related to Second Amendment to Collateral Assignment to ensure conformance with • documents. circulated and completeness; finalize financing statement; organize documents for slotting into. file transcript and forward to . Bank; telephone conference with D.Thompson regarding disbursement request • 04/21/10 LMP File UCC-1 with Secretary of State. for Wood/CTA .60 Flooring 'contract 04/22/10 JAM Organize executed documents related to Second .10 Amendment of Collateral Assignment; forward same to J,Boyewsky 04/27/10 JAM Organize• documents for inclusion in transcript 1.70 • FEE SUBTOTAL $2, 523 .0.0 DISBURSEMENTS 04/23/10 Civic Net - - - IN.gov UCC Filing on 3/19/10 3 .00 DISBURSEMENTS SUBTOTAL $3.00 TOTAL THIS INVOICE $2,526.00 LESS APPLIED CREDIT(S) ( $736.00 ) TOTAL BALANCE NOW DUE $1,790.00 National Bank of Indianapolis Page 3 Matter. Number: 104332-000001 May 13, 2010 Invoice No: 178-982 • • • • All invoices are due and payable upon: receipt. Interest will accrue at a rate of 10 per month on balance not paid within 30 days of the 'invoice date. HALL, RENDER, KILLIAN, HEATH & LYMAN, P.S.C. PLEASE SEND PAYMENT T0: 39778 Treasury Center Chicago.IL 60694.9700 13171 63344894 Federall0#:36.1427161 Invoice. NO. : 178982 National Bank of Indianapolis Billing Atty: JJU Attn: Jason Boyewsky May 13, 2010 '107 North Pennsylvania Street • Indianapolis, IN 46204 • • Matter Number:•. 104332-000001 * .& • Carmel Redevelopment Commission Financing REMITTANCE PARE $2,523 .00 TOTAL FEES FOR THIS INVOICE • TOTAL DISBURSEMENTS .FOR THIS INVOICE $3.00 $2,526..00 TOTAL THIS INVOICE ( $736:00 ) LESS, APPLIED CREDIT(S,) • $1,790.00 TOTAL BALANCE NOW DUE • • PLEASE RETURN THIS PAGE WITH YOUR PAYMENT. NA1• IOICIAI 107 N. Pennsylvania Street t4 � BANK'It\ DIANAPOLIS Indianapolis, Indiana 46204 -sv Bill To: Due Date Carmel Theater Development Company, LLC - ATTN: Lanny Sledge Date Payable within 11711 N. Pennsylvania Street 7/2/2010 15 Days Suite 200 Carmel, IN 46032 •• • Lender Account Number JRB 604077801 • Fee(s) Due Description , Amount Attorney's Fee Hall, Render, Killian, Heath & Lyman, P.S.C. 2,291.50 Remit Payment to: The National Bank of Indianapolis Attn: Debbie Thompson 107 N. Pennsylvania St., Ste. 700 Indianapolis, IN 46204 • Thank you for choosing The National Bank of Indianapolis! Total $2,291.50 HALL, RENDER, KILLIAN, HEATH & LYMAN, P.S:C. PLEASE SEND PAYMENT TO: 38778 Treasury Cantor Chicago,(L.6069,4-8700 1317)633-4084 Fedora)ID#:36-1427161 Invoice No. : 180884 National Bank of Indianapolis Billing Atty:. JJU Attn: Jason Boyewsky 107 North Pennsylvania Street June 18, 2016 Indianapolis, IN 46204 • • Matter Number: 104332.000001 , • Carmel Redevelopment Commission Financing • FOR PROFESSIONAL SERVICES :RENDERED 05/13/10 JAM. Review email regarding disbursement and .80 additional collateral received from K.Haas; review documents received from J.Shoup. 05/18/10. JJU Consider proposed Shapiro loan disbursement 1.30 05/18/10 JAM Attorneys' conference with JJU to review 6.40 structure of proposed transaction taking over First Financial Bank loan; review related Installment Contract, Guarantees, Assignment of Equipment and Lease Interests, Replacement Lease,. Loan Guarantees., National Bank of Indianapolis Mortgage, Amendment to Collateral Assignment and related opinions; note comments thereon 05/25/10 JAM Review question received from L,Sl'edge with 'REI .2,0 Real Estate regarding administrative payment; respond to question received and CRC, counsel regarding administrative payment FEE SUBTOTAL $2,291.50 DISBURSEMENTS 05/24/10 Civic Net - - -- IN.gov SOS UCC Filing 4/21/10 3.00 National Bank of Indianapolis Page 2 Matter Number: 104332-00,0001 June 18, 2010 Invoice No: 180884 DISBURSEMENTS SUBTOTAL $3 .00 TOTAL THIS INVOICE $2,294.50 TOTAL BALANCE NOW DUE $2,294.•50 • • • • • All invoices are due and payable upon receipt. Interest will accrue at a rate of 1% per month on balance not paid within 30 days of the invoice date. HALL, RENDER, KILLIAN, HEATH & LYMAN, P.S.C. PLEASE.SEND PAYMENT TO: 39778 Treasury Canter Chicago.IL 60884.9700 13171 633-4884 Fedora!IDP:35.1427161 Invoice Nod 180884 Billiri Att ' JJU National Bank of Indianapolis 5 y� Attn: Jason Boyewsky 107 North Pennsylvania Street June 18, 2910 Indianapolis, IN 46204 • Matter Number: 104332-0'00001 Carmel. Redevelopment.Commission Financing REMITTANCE PAGE TOTAL FEES FOR THIS INVOICE $2,291.-.50 • TOTAL DISBURSEMENTS FOR THIS INVOICE $3.00 TOTAL, THIS INVOICE $2,294.50" TOTAL BALANCE NOW DUE $2,294,50 PLEASE RETURN THIS PAGE WITH YOUR PAYMENT.