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HomeMy WebLinkAboutGibralter, Signature - $23,072.71 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 Veteran's Way Improvements installment purchase contract Pay application 18(Signature) May 2011 $ 2,445.25 Pay application 13(Gibraltar) May 2011 $ 20,627.46 Total Authorized Disbursement $ 23,072.71 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: C/ 23 // CITY OF CARMEL REDEVELOPMENT COMMISSION By: Les S. Olds Printed: Executive Director Title: P111 Waterproofing and Paving (Signature Construction) June 2010 Application 7 Paid by Carmel Theater Development $27,350.45 July 2010 Application 8 Paid by Carmel Theater Development $ 9,231.31 August 2010 Application 9 Paid by Carmel Theater Development $15,171.63 September 2010 Application 10 Paid by Carmel Theater Development $10,013.63 October 2010 Application 11 Paid by Carmel Theater Development $14,432.35 November 2010 Application 12 Paid by Carmel Theater Development $26,741.77 December 2010 Application 13 Paid by Carmel Theater Development $10,115.22 January 2011 Application 14 Paid by Carmel Theater Development $ 7,306.66 February 2011 Application 15 Paid by Carmel Theater Development $ 817.55 March 2011 Application 16 Paid by Carmel Theater Development $ 1,162.20 April 2011 Application 17 Paid by Carmel Theater Development $ 1,523.33 May 2011 Application 18 Amount to be paid by Carmel Theater Development $ 2,445.25 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT 6702 PAGE ONE OF 2 PAGES 2 TO OWNER Carmel Theater Development Com PROJECT: Carmel City P111 Waterproofing APPLICATION NO Invoice# 18 I Distribution to: Invoice# 15 Signature costs OWNER Carmel Indiana 46032 ARCHITECT PERIOD TO: 5/23/2011 X CONTRACTOR FROM CONTRACTOR: VIA ARCI-IITECT: Pedcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Carmel,Indiana 46032 CONTRACT FOR: CONTRACT DATE: 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,is 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 payments received from the Owner,and that current payment shown herein is now due. I. ORIGINAL CONTRACT SUM 168,387.53 2. Net change by Change Orders 11,659.90 CONTRACTOR: 3 CONTRACT SUM TO DATE(Line 1±2) $ 180,047.43 / 4 TOTAL COMPLETED&STORED TO $ 180,047.43 / r /" C 2 / By O / Date: J y 5 RETAINAGE Thomas oontz, 'resit ent ,�� a. 0 %of Completed Work $ 0 Suwscnbcd an•sworn to before me this �t/ day of De�e�r»ber— 9 (Column D+Eon G703) ., _. . b. %of Stored Material $ .o,PC'yBe-. LINDA BUCHANAN (Column F on G703) '=`NOTARY. _ Hancock County I otal Icetamage(Lines as+eb or -.,,p,:..SEAL.;es My Commission Expires Total in Column 1 of G703) $ 0 00 ARCHITECT'S CER I IF ICA I E FUR PAYMEN ,.F/' August 20,2011 6. TOTAL EARNED LESS RETAINAGE $ 180,047.43 In accordance with the Contract Documents,based on on-site observations and th"e�"ata " (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7 LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 177,602.18 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8 CURRENT PAYMENT DUE $ 2,445.2D is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 0.00 (Line 3 less Line 6) AMOUNT CERTIFIED .. $ CHANGE ORDER SUMMARY ADD111ONS DEDUC I IONS (Attach explanation(lams ert�fied differs from the amount applied.Initial all figures on this lbtal changes approved Application and ache/anti, nation ' t that are changed to conform with the amount certified.) In previous months by Owner ARCHITECT: Total approved this Month By: 'a-- Date: 5`311 fi TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the contractor namea nerem.issuance,payment ana acceptance of payment are witnout NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT.1992 EDITION.AIA.©1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE,N.W.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. Director of Redevelopment/ 1/1(6 Cf°5- elv1, „.,.. -a, - • SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 I I I 1 I I Invoice # 18 5/23/11 Carmel City P111 Waterproofing - Gibraltar Carmel, Indiana 1 Total Work RETAINAGE 1 BALANCE Scheduled Completed WITHHELD PREVIOUS TOTAL COMPLETED TO DESCRIPTION Value This period THIS PERIOD APPLICATIONS TO DATE I % FINISH Pre-Construction Services: Project Management 3,117.15 0.00 0.00 3,117.15 3,117.15 100% 0.00 Site Supervision 4,173.64 0.00 0.00 4,173.64 4,173.64 100% 0.00 General Conditions: GIBRALTAR Testing and Inspecting 2,500.00 0.00 0.00 2,500.00 2,500.00 100% 0.00 Project Management 758.46 0.00 0.00 758.46 758.46 100% 0.00 Site Supervision 68,132.57 0.00 0.00 68,132.57 68,132.57 100% 0.00 Site Safety Director 3,811.31 0.00 0.00 3,811.31 3,811.31 100% 0.00 Design Drawings 4,184.47 0.00 0.00 4,184.47 4,184.47 100% 0.00 Temporary Electric 0.00 0.00 0.00 0.00 0.00 0% 0.00 Office Supplies 770.97 0.00 0.00 770.97 770.97 100% 0.00 Tools and Equipment 1,618.12 0.00 0.00 1,618.12 1,618.12 100% 0.00 Field Engineering and Surveying 4,601.79 0.00 0.00 4,601.79 4,601.79 100% 0.00 Construction Management Fee 86,378.95 2,445.25 0.00 83,933.70 86,378.95 100% 0.00 180,047.43 2,445.25 0.00 177,602.18 180,047.43 100% 0.00 CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and /or labor as follows: Construction Management Services for a project known as Carmel City Center P111, located at Carmel, Indiana and owned by the Carmel Theatre Development Company and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of two thousand four hundred forty-five dollars and twenty-five cents ($2,445.25) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, finished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC • /Thomas Koontz, President Subscribed and sworn to before me this: n'lA y ay god Notary Public: ‹..,..e,, '' LINDA BUCHANAN :NOTARY. : Hancock County s. SEAL My Commission Expires '."O,, ? August 20,2011 P111 Waterproofing and Paving (Gibraltar) May 2010 Application 2 Paid by Carmel Theater Development $331,812.00 June 2010 Application 3 Paid by Carmel Theater Development $188,748.00 July 2010 Application 4 Paid by Carmel Theater Development $ 57,970.80 August 2010 Application 5 Paid by Carmel Theater Development $ 98,261.10 September 2010 Application 6 Paid by Carmel Theater Development $174,561.30 October 2010 Application 7 Paid by Carmel Theater Development $223,782.30 November 2010 Application 8 Paid by Carmel Theater Development $331,778.70 December 2010 Application 9 Paid by Carmel Theater Development $ 50,627.70 February 2011 Application 10 Paid by Carmel Theater Development $ 14,715.90 March 2011 Application 11 Paid by Carmel Theater Development $ 7,847.10 April 2011 Application 12 Paid by Carmel Theater Development $ 55,737.90 May 2011 Application 13 Amount to be paid by Carmel Theater Development $ 20,627.46 el 22 0 • . . . -, . -Document G--. 7-02tCH-Mi"- - 1992 Application and:Certificatefot-Payment Construction Manager-Adviser Edition TO OWNER •:CarrneiTiseater,134i6PMent CompanYPRCLIECT:' Carmel City Cntr-P111 Waterproofing&pa(feltiggION NO ,:ii:,,:i!•,,,F Distribution to PERIOD TO -.•''''•0t4q111- ._ .: , 17 OWNER 0 "-:'''.:'-'":-:- !- •-,..-„, ' CONSTRUCTION MANAGER 0 FROM CONTRACTOR: -Gibraltar Construction Corp VIA CONSTRUCTION MANAGER: CONTRACT DATE:ins/10 ARCHITECT El 2932 N.Webster Ave. . • PROJECT NOS - 1 i CONTRACTOR 0 Indianapolis,IN 46219 VIA ARCHITECT. FIELD 0 - Pedoor Design Group,LLC - CONTRACT'FOR: Waterproofing&Topping Slabs • •. 0 . . . . .. CONTRACTOR'S APPLICATION FOR PAYMENT . The undersigned Contrattor certif-s that to the best of the Contractor's knowledge,information and belief the Work covered by this ' .plication for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. / Contract Documents,tha .-; ann.unts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703;is attached. i Certificates for Payme , er-,issued and payments received from the Owner, and that current „:,.. , 1.ORIGINAL CONTRACT SUM _,_.i. ,, $1610,967.40 payment shown herein*raw 0 e. 1.23,06.,.og Gibra.,r .* struction Corp 2.Net change by Change Orders -, -'-:' ,' . - $ - - CONTRACTOR: i if 3.CONTRACT SUM TO DATE(Linci4-,2.),1 . .” • - 1,734-,(130:40 - - $ -... By ,/ PAL - ''' . '. '- T'...'! fh - Date: ......‹.73„-A/ • _. -, - -..:.::, t_. 4.TOTAL COOLETED&STORED 40 DATE(Column G on G703) -• $ , ' ' -, State oE. • / ',VW, :.,1,-'4.;:=-I__':-•1.-:-. ',Pt'Pf-, BRIAN R. MCBRiDE e, , 5.FiETAiNAd : ,,..,,, -=:' . . . County of /-A-...r.Pe-r.?;,----i .7 , - ries. of Hancock County .. -- . - a. . 7,ut Completed feted Work 7 172,941.14 Subscribed and sworn ..-. _,. p5, 9 - ...,c=7 ..x„.10o4 My Comm Exp 11-29-2017 (colio a+E on G70V $ me ihis5 daYef 1):/ Commission #611862 - b. s=r-!:':!;%-of Stored Material . Notary Public: '''''''''''' ''. - 4111■ - _... - My Commission.eipire§;. //".- -14,- .47' (Column F on G703) $:. . . .. . . - - - • . Total Retainage(Lines 5a+5b or Total 0Columill of 0703).. $...; . • CERTIFICATE FOR T PAYMEN -- 1,556,470.26 .In accordance with the Contract Documents, based on on-site observations and the.data comprising B.TOTAL EARNED-LESS'RETAINAGE - ,. - - - $ . tins apPlication,the Construction Manager and Architect certify to the Owner that to the best of their (Line 41.4ss Line 5TOtill) knowledge:,information and belief the Work has progressed as indicated,the quality of the Work is in • .80 7.LESS PREVIOUS cERTIFicgas_fori PAYMENT • - ' - $ ' '1 535 842 accordance with the Contract Document's,and the Contractor is entitled to payment of the AMOUNT (Line 6 frompricit Certificate) .- -'--- -- •'• • . CER'11FiED &CURRENT PAYMENT DUE $ 20 AMOUNT cet-nk ED _,. . $ ZAL#9,7, t .. . (Attach explanation if amount certified differs from the amount Initial all figures on this 9:BALANCE TO FINISH,INCLUDING RETAINAGE:':: - • - : = in,560:14 - Application-and on the continuation Sheet that areChangedto conform with the amount certified) . (Line 3:Jess Line 6) - .. .' ' ',i„. ,- : $• -: CONSTRUCTION'.,• .• ER:A. • , ,, ::" '', :;- - • -L=.: .:..--0,.,-.i- . By ••_....-IT.--z.-• ..- .:!,- .''''' - Date: (-A)r/i s . . CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS . .: . . . ARCHITECT: •,..- -:-.017111- . . r LLC D:- .6944,10, Total changestipito:4.editipieVions months by Owner ..$:./ 5,•2:›44...;.3 $ - By: • % 'AOC-MORAIllt - - Date: 11, Total apptOedithis'IVIOnth- - I.. .$ ..-7.- ... $ -.. -' . . This Oettifica. isb4,11egotiable: e AMO 11 5, RTIFIED is payable illy the Contractor . . - :: '*i4j:;-,,,:!!.,'.*'''' ..: :. _. . • -- TOTALS $/.2A',■044.? $. . named•••-:. -in. sSnarick:Payment and acce•* .I. o pay ate without preudiceo any rights of the Own or sntiactedunder•thiS Contract. NET CHANGES by Change Order : -:: '- $/...: . ste.7 . - • th -OZ. 613frq .. _ . . CAUTION:You should sign an original AIA.,Coritract Document on which this text appears in RED.An,original assures that changes will not be obscured. AIA Document D702/Citlem-1892 Copyright-.01092 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by US.Copyright Law and International Treaties. t/ Unauthorized reproduction or-distribution of this Ale Document,oranY 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 cornpleted.To report copyright-violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@ala.org. 0 Director of Redevelopment/1/2(6 0 Fo s- '• TT CONTINUATION SHEET Page2of3 APPLICATION NO.: 13 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 5/30/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 5/30/2011 variable retainage for line items may apply. ARCHITECTS PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO IF VA NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE ABLE (0+E) DORE) (D+E+F) (C-G) RATE) 1 Allowance $25,000.00 $25,000.00 $25,000.00 100% - 2,500.00 2 Supervision $47,500.00 $47,075.00 $47,075.00 99% 425.00 4,707.50 3 Demobilization $2,000.00 $1,000.00 $800.00 $1,800.00 90% 200.00 180.00 4 Submittals $18,000.00 $18,000.00 $18,000.00 100% - 1,800.00 5 Misc.General Conditions $32,724.40 $31,905.00 $819.40 $32,724.40 100% 3,272.44 - 6 Excavation at North Ramp $4,643.00 $4,643.00 $4,643.00 100% - 464.30 7 Storm Casting Materials $79,000.00 $79,000.00 $79,000.00 100% - 7,900.00 8 Storm Casting Labor $11,000.00 $11,000.00 $11,000.00 100% - 1,100.00 9 Trench Drain Material $59,000.00 $59,000.00 $59,000.00 100% - 5,900.00 10HTrench Drain Labor $15,000.00 $15,000.00 $15,000.00 100% - 1,500.00 .,11 Demolition Labor $35,000.00 $35,000.00 $35,000.00_ 100% - 3,500.00 12 Topping Slabs&Curbs Material $170,000.00 $170,000.00_ $170,000.00 100% - 17,000.00 13 Topping Slabs&Curbs Labor $164,900.00 $164,900.00 $164,900.00 100% - 16,490.00 14 Rebar Material $15,000.00 $15,000.00 $15,000.00 100% - 1,500.00 15 Masonry $3,000.00 $3,000.00 $3,000.00 100% - 300.00 16 Metal Fabrications $1,200.00 $1,200.00 $1,200.00 100% - 120,00 17 Waterproofing&Exp. Joints $742,000.00 $723,260.00 $18,740.00 $742,000.00 100% - 74,200.00_ 18 Joint Sealants $200.00 $0.00 $0.00 0% 200.00 - 19 Plumbing $18,400.00 $17,480.00 $920.00 $18,400.00 100% - 1,840.00 20 Electrical $1,800.00 $1,800.00 $1,800.00 100% - 180.00 21 Alternate#7 $184,000.00 $184,000.00 $184,000.00 100% - 18,400.00 22 Change Order#1 -$18,400.00 -$18,400.00 -$18,400.00 100% - (1,840.00) 23 Change Order#2 $5,182.00 $5,182.00 $5,182.00 100% - 518.20 24 Change Order#3 $3,252.00 $3,252.00 $3,252.00 100% - 325.20 25 Change Order#4 $26,871.00 $26,871.00. - $26,871.00 100% - 2,687.10 CONTINUATION SHEET Page 3 of 3 APPLICATION NO.: 13 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 5/30/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 5/30/2011 ARCHITECTS PROJECT NO.: A , B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) (C-G) RATE) (D+E) DORE) (D+E+F) 26 Change Order#5 $7,200.00 $7,200.00 $7,200.00 100% - 720.00_ 27 Change Order#6 $3,986.00 $3,986.00 $3,986.00 100% - 398.60 28 Change Order#7 $4,008.00 $4,008.00 $4,008.00 100% - 400.80 29 Change Order#8 $14,921.00 $14,921.00 $14,921.00 100% - 1,492.10 30 Change Order#9 $8,529.00 $8,529.00 $8,529.00 100% - 852.90 31 Change Order#10 $12,192.00 $12,192.00 $12,192.00 100% - 1,219.20 32 Change Order#11 $1,959.00 $980.00 $980.00 50% 979.00 98.00 33 Change Order#12 $2,265.00 $2,265.00 $2,265.00 100% - 226.50 34 Change Order#13 $8,441.00 $8,441.00 $8,441.00 100% - 844.10 35 Change Order#14 $2,791 1,116 1,116 40% 1,675 111.60 36 Change Order#15 $1,340 2001 200 15% 1,140 20.00 37 Change Order#16 $8,042 8,042 8,042 100% - 804.20 38 Change Order#17 $2,205 2,205 2,205 100% - 220.50 39 Change Order#18 $3,415^ 3,415 3,415 100% - 341.50 40 Change Order#19 $6,464 6,140 324 6,464 100% - 646.40 41 - - 42 43 - , . 45 - 46 47 ` - 49 50 $1,734,030.40 $1,706,492.00 $22,919.40 $0.00 $1,729,411.40 100% $825.00 $172,941.14 ISA Form#1-402 «r, AFFIDAVIT AND WAIVER OF LIEN AitsrtaatwArNifk ❑ FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion,SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Carmel City Cntr-P111 Waterproofing and Paving Components and owned by Carmel Theater Development Company. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of Twenty Thousand Six Hundred Twenty Seven and 46/100------- Dollars ($20,627.46) ❑ receipt of which is hereby acknowledged;or ® the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER)that the final balance due from the Owner is the sum of Dollars ( ❑ receipt of which is hereby acknowledged;or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE,the undersigned waives and releases unto th= owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereo account of LABOR or material or both,furnished by the undersigned thereto,subject to limitations of condition exp :ssed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work,r erfo ed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By 1� ` Title President 1/211 WITNESS MY HAND AND NOTORIAL SE d e ay of May, 2011. (Notary Public) 0..r¢" (14, BRIAN R. MCBRIDE Q t,7, IbOl&NA SusCOeTRAC7oAS A$SOCIATUON INCCAIKAATEO * * Res. of Hancock County Uvu,RO*•Retl Aap,ed„nwn s,en,e„ae My Comm. Exp. 11-29-2017 ” - I ON Commission#611862