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HomeMy WebLinkAboutGibralter, Signature - $16,722.10 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 Application 19(Signature) June 2011 $ 1,256.50 Application 14(Gibraltar) June 2011 $ 15,465.60 Total Authorized Disbursement $ 16,722.10 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 National Bank of Indianapolis and Carmel Theater Development Company, LLC. Dated: 7/4 CITY OF CARMEL REDEVELOPMENT COMMISSION By: Les S. Olds Printed: Executive Director Title: 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 Paid by Carmel Theater Development $ 20,627.46 June 2011 Application 14 Amount to be paid by Carmel Theater Development $ 15,465.60 ,tiw~1 ® s� ® ' o O :- ' = 1 :• :— a 92t 2 c r • : •Application and Certiicate'`fo r Payment Construction'Manager-Adviser•Editiotr • „' ROJECT: Cartel City Cntr-P111 Waterproofing&Pa . 'r:14F:`. ° TO.OUVNER Carmel"Theater'Developntent CarnpanF' } ION NO: Distlibtition to ';` - 6 3tilii OWNER ❑ . PERIOD T0:.. .- CONSTRUCTION MANAGER ❑ •FROM CONTRACTOR: Gibraltar Construction Corp VIA CONSTRUCTION MANAGER: CONTRACT DATE:INB/10 . ARCHITECT ❑ 2932 N.Webster Ave. PROJECT NOS: / • • / CONTRACTOR ❑ Indianapolis,IN '46219 • VIA ARCHITECT' FIELD ❑ • Wade Pedeor Design Group,LLC CONTRACT.FOR: g&Topping Slabs CONTRACTOR'S APPLICATION FOR PAYMENT The undcrsinned Contractor certifii 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 t•is A,,ylication for Payment has been completed in accordance with the Contract Documents,,that al..,•{moii is have been paid by the Contractor for Work for which previous Continuation Sheet,AlA Document G703,,is attached. Certificates for Payment ire ss ed and payments received from the Owner, and that current 1;ORIGINAL CONTRACT SUM $1,610,967.40 payment shown rei is / •e- 2:'Net change by Change Orders $ 1'i5'6i8'0o CONTRACTOR:�i� ��'% St ction Corp..;';,r 3.CONTRACT SUM TO DATE(Line l i2) $1,746,395,40 13- Y Date: •►4/ 4.TOTAL COMPLETED&ST,ORED TO DATE(Column G on G703) $1.146;595741--- ' State of-.. „to / .' 5.RETAINAGE: County of :. �'�PL, BRIAN R. MCBRIDE 57 ' a• °I f Cgmpl'e'ted Work ,_ �Y7.7✓''`, G °° 174,659.54 Subscribed ,._• "re'' er ` ancock County ( - iiknp A+Eon 0703) $ s}i'orn,t�o:�b�� o � * RES. of� Cn1 _ me this �` b. .�/ y-:; v►�j My Comm, Exp. 11-29-2017 . (col' ';:96 of stored MOertai Pttblic: : ••.° CQmmiSSi3f) #611$82 No • .. uinn Pori G703) . $ .• . My Commisston;.expires;.. //.- /17 . Total Retainage(Lines 5a+'Sb or Total in Column I of 0703).. ,$.-.. : .., . CERTIFICATE.FOR'PAYMENT 1,57.1,935:86 In accordance with the Contract Documents, based on on=site.observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ this application;.the Coristniction Manager and Architect certify to the Owner that to the best of their (Line*Less Line 5:Total)• knowledge;,information and belief the Work has progressed as indicated,the quality of the Work is in T.LESS PREViOUS CERTIFICATES FOR PAYMENT ,.,:. $ 1.556.470:26 accordance-with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT • (Line 4'from prior`.Certificate) . CER LIMED: • �,o •8..CURRENT PAYMENT.DUE ,. 15;465.60 . 1 $..: AMOUNT CERTIFIED $ L 4CO Uj � r 9:.BALANCE TO FINISH,INCLUDING RETAINAGE y`+y'"` • (Attach explanation amount certified differs from the;amount applied.Initial all figures on this (Line 31ess Lase 6 "'` plication and oil the C lion Sheet to with the ) 174,639 S4 flp ontinua ' Site that are'�iartged *form 't1f he amount cert(Ted ) . .. $ CONSTRU . . :,,;, AD IT70 DED 1 ate. t// x MAN• D BY ►.� !�:� d It l l CHANGE ORDER SUIV Ili1:�AktY' . • ' D NS:.. ' „UCTIQNS ' ARCNRE „111• D ign Group;.L.C° . Total char es �. Previous months by Owner $ ^. .. gM,�►P� f+d...}h P Y. _��, •$ _ 13Y: �:� 'ssW,�.�...,; Date: Total approvedthis"Month" $��� $ it � Y I I j _ This .Tcate nggottable. "•e AIM •° C' "1'IHED is;payable illy fo the Contractor i•-..I... TOTALS ;$ named fi. "ip.'L;fit:''.:,,i payrrienntt and"acceli.•cc'of •aytne• are without prejudice to any rights of NEf CHANGES by Gltedge'Order the Owner : C• tractor under` is Contract. . ' . /� �b // • 4f3Dfir CAUTION You.should sign:an original AlA-Contract Document;;on-•Which this;text'appears in RED:.An.original assures.that changes.will not-he obscured..,. . . , MA Document G702ICMarkl-.1992. . .." ' Copyright �r'1992 by The American Iristihtte of"Architects.Ati Nghts reserved.WARNING:This AIA°�Document is protected by t1.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-penanles,and will be prosecuted to the maximum extent possible under the la*. I Purchasers are permitted to reproduce ten(10)Copies of this document wtieti completed.To report copyrightviolations of ALA Contract Documents,e-mail The American Institute of Architects'legal counsel;copyright@aia.org. n �)� T.S , , , • CONTINUATION SHEET Page 2 of 3 APPLICATION NO. : 14 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 6/30/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 6/30/2011 variable retainage for line items may apply. ARCHITECTS PROJECT NO.: A B C D I E F G H t WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE (D+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 $425.00 $47,500.00 100% - 4,750.00 3 Demobilization $2,000.00 $1,800.00 $200.00, $2,000.00 100% - 200.00 4 Submittals $18,000.00 $18,000.00 $18,000.00 100% - 1,800.00 5 Misc. General Conditions $32,724.40 $32,724.40` t-- $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 10 Trench 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 $742,000.00 $742,000.00 100% - 74,200.00 18 Joint Sealants $200.00" $0.00, $200.00 $200.00 100% - 20.00 19 Plumbing $18,400.00 $18,400.00 $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 v -$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. : 14 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 6/30/2011 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: 6/30/2011 ARCHITECT'S PROJECT NO. : A B C D E F G II I WORK COMPLETED MATERIALS TOTAL BALANCE TO RETAINAGE PRESENTLY COMPLETED AND % ITEM DESCRIPTION OF WORK SCHEDULED VALUE FROM PREVIOUS STORED(NOT IN STORED TO DATE (G!C} (C I H (IF VARIABLE NO. APPLICATION THIS PERIOD (D+E) D OR E) (0+E+F) RATE)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% - 398.80 28 Change Order#7 $4,008.00 $41008.00 $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 $979.00 $1,959.00 100% - 195.90 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 1,675 2,791 100% - 279.10 36 Change Order#15 $1,340 200 1,140 1,340 100% - 134.00 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 6,464 6,464 100% - 646.40 41 Change Order#20 $3:592 - 3,592_ 3.592 100% - 359.20 42 Change Order#21 $5,110 - _ 5,110 5,110_ 100% - 511.00 43 Change Order#22 $3,863 - 3,863 3,863 100% - 386.30 44 45 . 46 47 48 _ 49 • , 50 , $1.746,595.40 $1,729,411.40 $17,184.00 $0.00 $1,746,595.40 100% $0.00 $174,659.54 ISA Form#1-402 AFFIDAVIT AND WAIVER OF LIEN ❑ FINAL /1 PARTIAL F2 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 Fifteen Thousand Four Hundred Sixty Five and 60/100 Dollars ($15,465.60) ❑ 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 re :ipt of such payment. THERFORE,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 thereo account of LABOR or material or both,furnished by the undersigned thereto, subject to limitations of conditio ex,, eased herein, if any and further certifies that no other party has any claim or right to a lien on account of any wor-„•e •% ed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By Title President WITNESS MY HAND AND NOTORIAL S is '1 s •ay of June,2011. (Notary Public) m It 79 ip MI olaMA Su®COMTPACTORS ASSOCIATION COMPI AATID oS`�vPc/t BRIAN R. MCBRIDE Res. of Hancock County t Aa u..00 wr+toe p•e®uctioA Pwoh My Comm. Exp. 11-29-2017 D l AN Commission # 611862 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 Paid by Carmel Theater Development $ 2,445.25 June 2011 Application 19 Amount to be paid by Carmel Theater Development $ 1,256.50 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER Carmel Theater Development Com PROJECT: Carmel City PI 1 l Waterproofing APPLICATION NO Invoice# 19 1 Distribution to: Invoice# 15 Signature costs OWNER Carmel Indiana 46032 ARCHITECT PERIOD TO: 6/23/201 I X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: 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 12,916.40 CONTRACTOR 3. CONTRACT SUM TO DATE(Line 1±2) $ 181,303.93 /z3b 4 TOTAL COMPLETED&STORED TO 5 181,303.93 By� j Date: 5 RETAINAGE: I homaYS .Koontz,President J w a{, , a. 0 %of Completed Work $ 0 ubscribed a sworn to before me this 0,11 day of, •.<' •-. •' ! -- .- (Column D+E on G703) •,..wfPC;... T LINDA BUCHANAN b. %of Stored Material $ ''NOTAA.•. Hancock County • (Column F on G703) -" - My Commission Expires SEAL � - I ota!Itetamage(Lines.a+ or F'oeM August 20,2011 Total in Column I ofG703) $ 0.00 ARCH!I EU I'S CEK1 IFIGATE I-OK `T-F.77-"''":7--'''' .. 6. TOTAL EARNED LESS RETAINAGE $ 181,303.93 In accordance with the Contract Documents,based on on-site observations and the data (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) $ 180,047.43 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8 CURRENT PAYMENT DUE $ 1,256.50 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 ADD!I IONS DEDUC I IONS (Attach explanation i'• • it certified differs from the amount applied.Initial all figures on this I otal changes approved Application and on h•Con r.n Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECT: t� q„..,,,/, Total approved this Month By: _. �� Date:TOTALS $0.00 $0.00 This Ce ificate is not netotiable. The AMOUNT CERTIFIED is payable only he contractor namea rem Issuance,payment ano acceptance of payment are wit NET CHANGES by Change Order $0.00 prejudice t. I '_hts 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 0401 -Certificati.• • 'ocument's Authenticity from the Licensee. ,�� (7%i ��Q v SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 19 6/23/11 Carmel City Pill Waterproofing - Gibraltar Carmel, Indiana Total Work RETAINAGE I 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 68,760.82 628.25 0.00 68,132.57 68,760.82 100% 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 87,007.20 628.25 0.00 86,378.95 87,007.20 100% 0.00 181,303.93 1,256.50 0.00 180,047.43 181,303.93 100% 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 one thousand two hundred fifty-six dollars and fifty cents ($1,256.50) 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 TomassE/Koontz, President Subscribed and sworn to before me this: d.,,..,..(.. ...7 3 aod Notary Public: , 20.. . .*, LINDA BUCHANAN "OT e Hancock County . sEAL 4; My Commission Expires .'' ;4 August 20,2011