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HomeMy WebLinkAboutCincinnati Floor - $12,965 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 as per the Wood Flooring installment purchase contract Application 8(Cincinnati Floor Company) June 2011 $ 2,965.00 Application 9(Cincinnati Floor Company) June 2011 $ 10,000.00 Total Authorized Disbursement $ 12,965.00 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 Nation I Bank of Indianapolis and Carmel Theater Development Company, LLC. Dated: '? 2� /I CITY OF CARMEL REDEVELOPMENT COMMISSION By: Les S. Olds Printed: Executive Director Title: Draft Wood Flooring (Cincinnati Floor Company) May 2009(Application 1) Amount reimbursed by Carmel Theater Development Company $ 4,911.30 August 2010 Paid by Carmel Theater Development Company $ 89,228.70 September 2010 Paid by Carmel Theater Development Company $ 383,103.00 October 2010 Paid by Carmel Theater Development Company $ 94,292.00 November 2010 Paid by Carmel Theater Development Company $ 59,735.00 April 2011 Paid by Carmel Theater Development Company $ 23,174.88 April 2011 (2) Paid by Carmel Theater Development Company $ 24,723.00 June 2011 Amount to be paid by Carmel Theater Development Company $ 2,965.00 June 2011 (2) Amount to be paid by Carmel Theater Development Company $ 10,000.00 k+/h Document G702/CMaTM - 1992 5-V Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: 8 Distribution to: One Civic Square Carmel Regional Performing Arts Center PERIOD TO: 1U>7C 30, 2011 OWNER ❑ Carmel, In 46032 777 3rd Ave. S.W. CFC JOB# IW443 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: March 23, 2009 ARCHITECT ❑ Cincinnati Floor Company, Inc PROJECT NOS: 2695 / / CONTRACTOR ❑ 8320 Brookville Rd, Suite M CFC INVOICE# 36759 Indianapolis IN 46239 VIA ARCHITECT: CSO DATE OF INV: 6/24/2011 FIELD ❑ CONTRACT FOR: Brazillian Cherry Sleeper/Subfloor SALESMAN: KAP ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all amounts have been paid by the Contractor.for Work for which previous 689,495.00 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,963.50 payment shown herein is now due. 2.Net change by Change Orders $ 694,458.50 CONTRACTOR: Cincinnati Floor Co, Inc. 3.CONTRACT SUM TO DATE(Line 1 +;2) $ By: W. `m V Date: /, 692,1 2.88 b/2.41201,1.,. 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ State of: . • IN Zack Maricle, Contract Manager 5.RaPINAGE County of: MARION pEGGY.IAf?i�fE a. %of Completed Work Subscrib and sworn to bef ' 10,000.00 `J' f�lE, 2011 NOTARY PUkl JO,j • 1Aolumn D+Eon G703) $ me this day •of SEAL i ' STATE OF.INDIANA b. %of Stored Material Notary Public: Ility enminisiinn ExpiresJuty4 ,,,,1y M (Column F on G703 $ My Commission Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 10,000.00 CERTIFICATE FOR PAYMENT , 68213288 In accordance with the Contract Documents, based on on-site observations and the data comprising , . 6.TOTAL EARNED LESS RETAINAGE $ 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 $ 679167.88 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 2,965.00 AMOUNT CERTIFIED $ 2 jbs 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if mount certified differs fro i the an )unt:applied. Initial ail figures on this Application and on tl ontinu ation Shee/ t ire chan,ed to conform with the amount certified.) (Line 3 less Line 6) $ 12,325.62 CONS L CTIO. , ; •/ 'flit►1; / / By: %CV ►Iptg∎AirL����- ._ Date: r) f CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCH TECT: Total changes approved in previous months by Owner $ $ By: Date: or tt C t Total approved this Month $ $ This Certificate • eegotiable. The AMOUNT CERTIFIED is payable onl l to the Contractor TOTALS $ $ named herein. ce, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. �`�� AIA Document G702/CMaTM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document,or any portion of it,may result in severe civil and criminal penalties,and will 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. \ 4TA ® Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). - Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). - Column I:This column is normally used only for contracts where variable retainage is.permitted-on:a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form o},,atthe end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa'lorm;. Construction Change Directives:Amounts not in dispute that have been included in Coristructi'ori Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A20fLClbla E.Making Payment s The Owner should make payment directly to the Contractor based on the amount certjfiedy te:.0 nstruction Manager and Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed him contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMaTM—1992.Copyright ©1992 by The American Institute 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 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. VI NoAIA Document G7O3TM - 1992 Continuation Sheet AIA Document G702TM Application and Certification for Payment, APPLICATION NO: 8 containing Contractor's signed certification is attached. APPLICATION DATE: 6/24/2011 In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0: 6/30/2011 ARCHITECT'S PROJECT NO $ - A I3 C D E F G H WORK COMPLETED TOTAL MATERIALS BALANCE Carmel Regional Performing Arts Center COMPLETED o SCHEDULED FROM PREVIOUS PRESENTLY /o TO RETAINAGE ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G—C) FINISH (If variable rote) NO 777 3rd Ave. S.W. (D+E) (Not in D or E.) (O DA+E) (C—G) Bonds $ 5,457.00 $ 5,457.00 $ 5,457.00 100% Materials Platform $ 170,063.00 $ 170,063.00 $ 170,063.00 100°h. Brazillian Cheery Sleeper/Sub Non-Stage General Allowance $ 15,000.00 $ 15,000.00 $ 15,000 00 100% Non-Stage As Built Allowance $ 5,000.00 $ 5,000.00 $ 5,000 00 100% Labor Platform `` $ 30,007.00 $ 30,007.00 $ 30 007.00 100% . Brazillian Cherry Direct Apply Materials Orchestra High $ 100,026.00 $ 100,026.00 $ 100,026.00 100% Materials Orchestra Low $ 100,026.00 $ 100,026.00 • $ 100,026.00 100% Material Box Tier $ 100,026.00 $ 100,026.00 $ 100,026.00 100% Labor Orchestra High $ 24,712.00 $ 24,712.00 $ 24,712.00 100% Labor Orchestra Low $ 24,712.00 $ 24,712.00 $ 24,712.00 100% Labor Box Tier $ 24,712.00 $ 24,712.00 $ 24,712.00 100% Material Donor Amenity $ 54,278.00 $ 54,278.00 $ 54,278.00 100% Labor Donor Amenity $ 20,476.00 $ 20,476.00 $ 20,476.00 100% Stage As Built Allowance $ 5,000.00 $ 5,000.00 $ 5,000.00 100% CO#1 $ (25,000.00; $ (25,000.001 $ (25,000.00) 100% CO#2 0.00 0.00 CO#3 $ 14,963.50 $ 14,963.50 $ 14 963.50 100% CO#4 $ 15,000.00 $ 9,709.38 $ 2,965.00 $ 12;674.38 84% $ 2,325.62 GRAND TOTAL $ 694,458.50 $ 689,167.88 $ 2,965.00 $ - $ 692,132.88 100% $ 2,325.62 $ - CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703T"—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 distribution of this AlA®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. \1°11/1/ ® - Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702T51,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted'above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on MA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D& E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E. Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed—This Period.) Column C. Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done. Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A20I. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative proposes only,and are not intended to reflect actual construction costs. A 13 C D I: E 0 Fl 1 WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED ITEM SCHEDULED FROM PREVIOUS PRESENTLY ^/, TO RETAINAGE DESCRIPTION OF WORK AND STORED NO ( C) FINISH (If variable role) . VALUE APPLICATION TI IS PERIOD STORED TO DATE G (D+£) (An in Do r£) (D+£+F) (C-G) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS 6 MISC.CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703T"–1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute 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 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. 8320 Brookville Road since 1894 Suite M TELEPONE: (317)357-3562 Indianapolis, IN 46239 CINCINNATI FLOOR FAX: (317)357-5338 COMPANY AFFIDAVIT AND PARTIAL WAIVER OF MECHANIC'S LIEN I, Zack Maricle , being first duly sworn, state that I am the Contract Manager of Cincinnati Floor Company (hereafter referred to as the"Company") and am familiar with the following facts stated herein: 1. The undersigned, in consideration of, and upon receipt of payment in the sum of $ 2,965.00 does hereby waive, release and relinquish any and all liens and claims for liens for labor or work performed and/or material furnished through the 30 day of JUNE, 2011 to the construction project commonly known as Carmel Regional Performing Arts Center located at 777 3rd Ave. S.W. Carmel, In 46032 (hereinafter the"Project"). 2. All laborers, material men, and subcontractors or the Company have been paid for all sums which were due for work, labor and/or material machinery provided by said parties for the Project and for which the Company has received payment. 3. The Company represents that it is not aware of any Mechanic's lien having been filed by or presently threatened to be filed against the Project by any party having performed work and labor for the Company and/or furnished material, machinery, equipment, and fuel to the Company for the project. 4. This waiver excludes retainage withheld and any change order work not yet billed. Zack Maricle Contract Manager BY: kv,,\Arvv.A.,4 k11, STATE OF INDIANA COUNTY OF MARION Sworn to and subscribed in my presence this 24 day of JUNE, 2011 .PEGGY L.at3UE 1 My Commission Expires: NOT PUBIJC STATE-OF INDIANA : My CnmrnI stun Expires-July 4,2•^:' * AIA Document G702/CMaTM - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TOO NERR� PROJECT: APPLICATION NO: at in�ti�tt- g Distribution to: �ne Civic Square Carmel Regional Performing Arts Center SW, 30, 2011 Carmel, In 46032 777 3rd Ave. S.W. PERIOD TO: OWNER ❑ CFC JOB# IW443 CONSTRUCTION MANAGER ❑ FRONNONTRAC.TOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: March 23, 2009 ARCHITECT ❑ Incinnatl oor Company, Inc p�p'�E�T S: 2695 CONTRACTOR ❑ 8320 Brookville Rd, Suite M CFC 1NVOt2EN 36760 Indianapolis IN 46239 VIA ARCHITECT: CSO DATE OF INV: 6/24/2011 FIELD ❑ CONTRACT FOR: Brazillian Cherry Sleeper/Subfloor SALESMAN: KAP El - CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. 689,495.00 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 4,963.50 payment shown herein is now due. ' 2.Net change by Change Orders $ 694,458.50 CONTRACTOR: Cincinnati Floor Co, Inc.: 3.CONTRACT SUM TO DATE(Line 1 ±;2) $ By: _(p� [��^ Date: 692,132.88 — �° C/24/20,-1 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ State of: IN Zack Maricle, Contract Manager . 5.RETAINAGE: County of: MARION PEGGY Lal lE I) a. %of Completed Work Subscribr214and sworn to befcloNE, 2011 NOTARY PUBLIC.,, (Column D+Eon G703) $ me this day of x SEAT `¢ ( ) /�,. Y � �J" 9TATEsOF INDIANA f. G b. %of Stored Material Notary Public:P,�/" I Rry Castvu►tEasion ivxl7ires Jufy,4;,..1.015 (Column F on G703) $ My Commission e,pi e . Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ CERTIFICATE FOR PAYMENT 692,132.88 In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) 682132.88 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 10,000.00 ,/: 8.CURRENT PAYMENT DUE $ AMOUNT CERTIFIED ...... $ 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation ' mount certified differs from e amo int,applied. Initial all figures on this 2,325.62 Application and on ontinus ion Sheet y at ar Chang-t to conform with the a )unt cm ifled.) (Line 3 less Line 6) $ CONST v CTION BY: 1 ,*� _ 1-L ,■.A 0 Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHI Total changes approved in previous months by Owner $ $ By: Date: I / Total approved this Month $ $ This Certificat• :' not .>_ottable. The AMOUNT CERTIFIED is payable on to the Contractor TOTALS $ $ named here'.... ssua ,• ', payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owne, or C '.- ctor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. ln� AIA Document G702/CMaTM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. D`11 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 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. t-t:LTIAIA Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated-into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule offialues each time a Change Order is added to the Project,this is not normally done.Usually:Change Orders are listed separately,either on their own G703 forrngorrat the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa fojm Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 inA201/CMa. E.Making Payment ' The Owner should make payment directly to the Contractor based on the amount certified hyithe;Construction Manager and Architect oniAl'A Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed:form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMaTM-1992.Copyright ©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 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. ! AIA Document G7O3TM - 1992 Continuation Sheet AIA Document 0702TM,Application and Certification for Payment, APPLICATION NO: BC.A':N«ki . 9 containing Contractor's signed certification is attached. APPLICATION DATE: 6/24/2011 / In tabulations below,amounts are stated to the nearest dollar. 6/30/2011 Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0: ARCHITECT'S PROJECT NO $ A B C D E F G H I WORK COMPLETED TOTAL Carmel Regional Performing Arts Center MATERIALS BALANCE SCHEDULED FROM PREVIOUS COMPLETED ITEM DESCRIPTION OF WORK PRESENTLY % TO RETAINAGE VALUE APPLICATION THIS PERIOD STORED AND STORED NO 777 3rd Ave. S.W. TO DATE (G-C) FINISH (If variable rote) (D+E) (Not inDorE) (D+E+F) (C c) Bonds $ 5,457.00 $ 5,457.0C $ 5,457.00 100% Materials Platform $ 170,063.00 $ 170,063.00 $ 170,063.00 100% Brazillian Cheery Sleeper/Sub Non-Stage General Allowance $ 15,000.00 $ 15,000.00 $ 15,000.00 100% Non-Stage As Built Allowance $ 5,000.00 $ 5,000.00 $ 5,000 00 100% • Labor Platform $ 30,007.00 $ 30,007.0C $ 30007.00 100% Brazillian Cherry Direct Apply Materials Orchestra High $ 100,026.00 $ 100,026.00 $ 100,026.00 100% Materials Orchestra Low $ 100,026.00 $ 100,026.0C $ 100,026.00 100% Material Box Tier $ 100,026.00 $ 100,026.00 $ 100,026.00 100% Labor Orchestra High $ 24,712.00 $ 24,712.0C $ 24,712.00 100% Labor Orchestra Low $ 24,712.00 $ 24,712.00 $ 24,712.00 1000/0 Labor Box Tier $ 24,712.00 $ 24,712.0C $ 24,712.00 1000/0 Material Donor Amenity $ 54,278.00 $ 54,278.0C $ 54,278.00 100% Labor Donor Amenity $ 20,476.00 $ 20,476.0C $ 20,476.00 100% Stage As Built Allowance . $ 5,000.00 $ 5,000.0C $ 5,000.00 100% CO#1 $ (25,000.00) $ (25,000.0C) $ (25,000 00)" 100% CO#2 0.00 0.00 CO#3 $ 14,963.50 $ 14,963.5C $ 14,963.50 100% CO#4 $ 15,000.00 $ 12,674.38 $ 12,674.38 84% $ 2,325.62 $ 694,458.50 $ 692,132.88 $ - $ - $ 692,132.88 100% $ 2,325.62 $ - GRAND TOTAL • CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703"'—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 distribution of this AlA®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. ADocument G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702TM,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A20I TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local ALA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on ALA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D. Enter in this column the amount of completed Work covered by the previous application(columns D& E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application, including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed—This Period.) Column G.Enter here the total of columns D, E and F.Calculate the percentage completed by dividing column G by column C. • Column H. Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done. Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A20I. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect actual construction costs. A B C D Ii F O 11 I WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED ITEM SCHEDULED FROM PREVIOUS PRESENTLY % TO RETAINAGE NO. DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G=C) FINISH (If variable rare) +E) (\S,S,Do'El TO DATE (D+E+F) (C—G) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5.000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS ■MISC.CONC. 5.000 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20000 7 PAVING,LOWER DRIVE 20,000 0 0 0 20,000 8 PAVERS 1, 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WO 5,000 0 RKS 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703TM–1992.Copyright©1963,1965,1966,1967,1970, 1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING: This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale 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. 8320 Brookville Road since 1894 Suite M TELEPONE: (317)357-3562 Indianapolis, IN 46239 CINCINNATI FLOOR FAX: (317)357-5338 COMPANY AFFIDAVIT AND PARTIAL WAIVER OF MECHANIC'S LIEN I, Zack Maricle , being first duly sworn, state that I am the Contract Manager of Cincinnati Floor Company (hereafter referred to as the"Company") and am familiar with the following facts stated herein: 1. The undersigned, in consideration of, and upon receipt of payment in the sum of $ 10,000.00 does hereby waive, release and relinquish any and all liens and claims for liens for labor or work performed and/or material furnished through the 30 day of JUNE, 2011 to the construction project commonly known as Carmel Regional Performing Arts Center located at 777 3rd Ave. S.W. Carmel, In 46032 (hereinafter the "Project"). 2. All laborers, material men, and subcontractors or the Company have been paid for all sums which were due for work, labor and/or material machinery provided by said parties for the Project and for which the Company has received payment. 3. The Company represents that it is not aware of any Mechanic's lien having been filed by or presently threatened to be filed against the Project by any party having performed work and labor for the Company and/or furnished material, machinery, equipment, and fuel to the Company for the project. 4. This waiver excludes retainage withheld and any change order work not yet billed. Zack Maricle Contract Manager, B : • ► \. ,. STATE OF INDIANA COUNTY OF MARION Sworn to and subscribed in my presence this 24 day of JUNE, 2011 PEGGY..LflRUE 4 MUTAf7Y PUf3L1G My Commission Expires: :,.. RY,P ``� G, IOW 87A io E INDIANA " a RIv Crs�fiinissicin r�it�July�,?.!f 4!* OWNER CONSENT OF SURETY ARCHITECT TO FINAL PAYMENT CONTRACTOR Conforms with the American Institute of SURETY Architects,AIA Document G707 OTI-IER C f0 OWNER: City of Carmel ARCHITECT'S PROJECT NO.: (Name and address) #1 Civic Square Carmel, IN 46032 CONTRACT FOR: Construction PROJECT: Carmel Performing Arts Center CONTRACT DATED: (Name and address) March 23, 2009 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Invert name and addre.v.c of Surety) Great American Insurance Company 301 E.4th Street Cincinnati, OH 45202 SURETY, on bond of (lncert n,nne and oddre,v.c n/(.011/1710,0 Cincinnati Floor Company, Inc. 8320 Brookville Road, Suite M Indianapolis, IN 46239 .CONTRACTOR. hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Invert name and address ofOwner) City of Carmel #1 Civic Square Carmel, IN 46032 OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF.the Surety has hereunto set its hand on this date: June 24, 2011 (hecerl in writing the manth fallmved Sc'the numeric elate and year.) Great American Insurance Company (Surety) Attest: (Signana-e of oil prized represeniaure) Mary Beth Milling, Attorney-In-Fact (Primed!nine cInd rifle) S-2134/GE 10/01 XDP S1029AB(2/11) GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET ° CINCINNATI, OHIO 45202 ° 513-369-5000 ° FAX 513-723-2740 The number of persons authorized by this power of attorney is not more titan FIVE No.0 20125 POWER OFAl-FORNEY KNOW ALLNIEN BY•fHl SE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY.a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name.place and stead to execute on behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power MARK NELSON STELLA ADAMS ALL OF ALL RANDAL T.NOAH BEVERLY J.WAKER CINCINNATI,OHIO S75,000,000. MARY BETH MILLING This Power ofAttorney revokes:ill previous powers issued on behalf of the attorney(s)-in-last named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to he signed and attested by its appropriate officers and its corporate seal hereunto affixed this 1ST day of FEBRUARY 2011 . Attest GREAT AMERICAN II NSURANCECOM PAN Y �p`eh 115U"NCF e Ouid Akt, ..... STATE E OI 01-110.COUNTY OF IIAIMILI ON-ss: DAVID C.KITCHIN(877-377-2405) On this 1ST day of FEBRUARY . 2011 , before me personally appeared DAVID C. KITCI-IIN, to me known, being duly sworn, deposes and says that he resides in Cincinnati. Ohio, that he is a Divisional Senior Vice president of the Bond Division of Great American insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company:that the seal affixed to the said instrument is such corporate seal:that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. KAREN L.GROSHEIM NOTARY PUBLIC,STATE OF OHIO , / ,1 Alf�' ��fm -- MY COMMISSION EXPIRES 02-20-16 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: /hat the Divisional President,the.several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal:lssislatu Vice Presidents.or any one of them,be and hereby is authorized,from time to time, to appoint one or more Attorneys-in-Fact to execute on behalf of the Company as surety any and all bonds,undertakings and contracts of suretyship.or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority:and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company-may be affixed by facsimile to am-power of attorney or certificate of either given for the e.vecution of any bond. undertaking,contract of sure suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal oldie Company. to he valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION 1,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of tune 9,2008 have not been revoked and are now in full force and effect. Signed and scaled this n' day of JUNE . 2_ 0( . o-4'.15U.NCF // 3 • 102'JAC` J71)