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Home My WebLink AboutGibralter, Signature - $13,450 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 15(Gibraltar) July 2011 $ 12,105.00 Application 20(Signature) July 2011 $ 1,345.00 Total Authorized Disbursement $ 13,450.00 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 National Bank of Indianapolis and Carmel Theater Development Company, LLC. Dated: W/// // CITY OF CARMEL REDEVELOPMENT COMMISSION B Y: ' 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 Paid by Carmel Theater Development $ 15,465.60 July 2011 Application 15 Amount to be paid by Carmel Theater Development $ 12,105.00 •alt!_.. rtd Document G7 2f - ."..._a ® 1 992 •Application and Certificate-for Payment Construction.Manager Adviser Edition _ TO=OWNER: Carmel Theater,`Da lopment Company. PROJECT: Carmel City Cntr-Pill Waterproofing&PARkra Af ION NO _ -_,15 ;_;= Distribution to . PERIOD TO:: :`-.7/,31'/1`1 OWNER ❑ .. CONSTRUCTION MANAGER D. FROM CONTRACTOR: Gibraltar Construction Corp VIA CONSTRUCTION'MANAGER: CONTRACT DATE:1118110 ARCHITECT ❑ 2932 N.Webster Ave. PROJECT NOS: / I - CONTRACTOR ❑ Indianapolis,IN 46219 VIA ARCHITECT' FIELD ❑ Pedcor Design Group,LLC CONTRACT FOR: Waterproofing&Topping Slabs • • • ❑ • CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certi I es 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 •pplication for Payment has been completed in accordance with the Contract Documents,that at , . tots have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment sued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM S 1,610,967.40 payment shown ei s ne•-`1d t - __ 2.Net change by Change Orders -° $ CONTRACTOR:�lebrraol�ar �n i coon Corp . - p / 1,160,045.40 _; _ Date: �/1 (/ 3.CONTRACT SUM TO DATE 'n l-DAT• $ 13y. //t v. 8 STOREfl_ 4.TOTAL COMPLETED .. E(Column G on G703) $ State of: • %��1 - - `_-_ =�F `� �' r0. County of.J i .- ' _ # (..,...from AN h'1C8 �^ BRf R RIDE 5.RETAINAGE: _:•;,. _ :: ty RA` a. of;Ci iii leted Work =°` ,..r Hancock _,„., _ . P 176.004.54 Subscribed and s�. •to ef: "4000- .► *M C Ci{COUfi(Coi.i ii.)+Eon G703) . $ me this /9 __day f �� y omm 11-29-201 7 b. - '6%of Stored Material Notary • I i.10TmISS10O # 6 f• ) .' . ' $ My Commission expires:,'/ '7 7 '�+r- (Coltmm F on G703 0 62 _ Total Retainage(Lines 5a+5b or Total in Column I of G703). $•: . CERTIFICATE FOR PAYM ENT - 1,584,040.86 In-accordance with-the Contract Doctiiinerits;based on an.site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ .. this application,the Construction-Mali gar-and Architect.certify to the Owner that to the best Of their (I ine 4 Less Line 5 Total): knowledge;information and belief the:Work_has progressed as indicated,the quality of the Work is in 1,571,935.86 accordance with the Contract Documents,and the Contractor is entitled to p a t of the AMOUNT 7.LESS PREVIOUS CERTIFICATES FORPAYMEN7 $: P Y� (Line 6 from prior certificate) • CERTIFIED. _r_ • •12,1-05.00 8.CURRENT PAYMENT DUE • _- I$ AMOUNT CERTIFIED . .. $ - I 1-07 . (Attach explanation if amount certified dif`ers from the_.amtiuia'1 applied Initial dll figures on this 176,004.54 Application and'on the Continuation Sheet that are rliaed'to conform.with the amount certified.) (Line 3 less Line 6) $ GONSTRUC1ION AG ,• — = -- Byt ,.� Date: . ^4-3111 . (/ CHANGE ORDER S vlli4Y 4DDTIINS DEpYTC pNS ACIET: - •�• • • '�l€ /� I0 Total-changes_agg'nkve'iii previous montttis by Owner $ $ ` 1 1 _ ��e�'^D:-• $Y� 1! � Date: . 4 2�— � . ')total apprithd liis'Montil $;,f y ? .$ This Certificate is; egotiable. t AMOUNT CERTIFIED is pa .tie my t the Contractor v, _ ce .TO"IAIS; $� $. .. �paym,�au_,acceptan of payment o:t�rejiidice .any rights o naiiied tierdin. Issu are , .. to of I`fET C EiANGES by Change'Or lei $�i j1- : rite Owner<or Contiactoi:.iin,er Contract • . - CAUTION:You should sfgn_.an orlginaLAIA ContractDoctjmegtJ;on_wh,Ich this-text appeats In.RED.;An;original assures:that-changes'104 not be.obscuted:,, . _ il-1992 �I ht®'-t>,.4i d:h . erica.;.",,. :fe ....u... : eser d - ._. A!A Document G7021CYa �opyr g - 992`by Tfie Artieii�NI§titufe.oiAichifecfs:MdNgtils reserved.WARNING:This AIA.Documem`Ispiottcted by U.S.CopSttiglif,I:gvr.and'litternetlonal Treaties. Unauthorized reproduction or distribullon of•thle A1A°Document,or at y.portion of.it,may reault`In.severe civil criminal penalties,-and will,*prosecuted to the maximum<extent possible:under the law. Purchasers are permitted to reproduce ten t101_cobies of this document wheh completed.To report copyright violations of AIA Contract Documents;e-malrThe American Institute of Architects'legal counsel;copyright@aia.org. du • • CONTINUATION SHEET Page 2 of 3 . APPLICATION NO.: 15 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 7/31/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 7/31/2011 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 RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G i 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 $47,500.00 $47,500.00 100% - 4,750.00 3 Demobilization $2,000.00 $2,000.00 $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 $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%1 - 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 $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 -$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.: 15 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 7/31/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts PERIOD TO: 7/31/2011 where variable retainage for line Items may apply. ARCHITECTS PROJECT NO. : A B C D I E F G - H 1 WORK COMPLETED IvtATERIALS TOTAL PRESENTLY COMPLETED AND BALANCE TO RETAINAGE NAM DESCRIPTION OF WORK SCHEDULED VALUE FROM AP ICAON PREVIOUS THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE (D+E) D OR E) (D+E+F) (C-G) 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% - 398.60 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 I 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 $1,959.00 $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 , 2,791 2,791 100% - 279.10 36 Change Order#15 $1,340_ 1,340 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 ChangeOrder#21 $5,110 5,110 5,110 100% - 511.00 43 Change Order#22 $3,863 3,863 3,863 100% - 386.30 44 Change Order#23 $11,839 - 11,839 11,839 100% - 1,183.90 45 Chan a Order#24 $1,611 - 1,611 1,611 100% - 161.10 46 _ . 47 . 48 - 49 50 - $1,760,045.40 $1,746,595.40 $13,450.00 $0.00 $1,760,045.40 100% $0.00 $176,004.54 f ISA Form#1-402 . 5,.., . 1) it 1, ,. ,,, v.v,,,. . AFFIDAVIT AND WAIVER OF LIEN ❑ 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 Twelve Thousand One Hundred Five and No/100 Dollars ($12,105.00) ❑ 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 •ole consideration for this Affidavit and Final Waiver ii of Lien which shall become effective upon recei• •f such payment. THERFORE,the undersigned waives and releases unto the ■0 er of said premises, any and all lien or claim whatsoever on the above-described property and improvements ther:•n count of LABOR or material or both,furnished by the undersigned thereto, subject to limitations of conditions . pry sed herein, if any;and further certifies that no other party has any claim or right to a lien on account of any work •; rfor ed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By Al Title President Jr 1 WITNESS MY HAND AND NOTORIAL SEAL, y s 18th of July, 2011. .►Y," :,,s,tarsi' BRIAN R. MCBRIDE 2 Res. of Hancock County t O 197, INpIAMA SUBCONTRACTORS ASSOCIATION iwCORKORATEC My Comm. E . 11-29-2017 Unaulnagea RalsOdsc er+haNOrtetl o AN Commission # 611862 Re. "an 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 Cannel 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 Cannel 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 Paid by Carmel Theater Development $ 1,256.50 July 2011 Application 20 Amount to be paid by Carmel Theater Development $ 1,345.00 - APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENTG702 PAGE ONE OF 2 PAGES2 TO OWNER Cannel Theater Development Comb PROJECT: Carmel City PI 1 l Waterproofing APPLICATION NO Invoice 4 20 Distribution to: Invoice 4 15 Signature costs OWNER Carmel Indiana 46032 ARCHITECT PERIOD TO: 7/25/201 1 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 14,261.40 CON'T'RACTOR: 3. CONTRACT SUM TO DATE(Line 1 ±2) $ 182,648.93 4. TOTAL COMPLETED&STORED TO $ 182,648.93 By: r -- - �- Date: 74/iii 5. RETAINAGE: Thomas 'oontz,President .34 >el f a. 0 %of Completed Work $ 0 Subs ribed an sworn to before me this o' day of ,,,,, (Column D+E on G703) 'a,.1's••, LINDA BUC .•a Hancock County �.•' b. %of Stored Material $ NO.ARV' ' (Column F on G703 a,Nq sEAI :. My Commission Expires ( ) �. August 20,2011 — �:tE.F iNO�: Total Retainage(Lines 5a+5b or ---- –— _ Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 182,648.93 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) $ 181,303.93 the quality of the Work is in accordance with the Contract Documents,and the Contractor ^I I 8. CURRENT PAYMENT DUE $ 1,345.00 is entitled to payment of the AMOUNT CERTIFIED. (1� 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 0.00 ��– (Line 3 less Line 6) AMOUNT CERTIFIED $ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Total changes approved Application and int he Continua ion Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECT: `. 1 Total approved this Month By: d)1: ‘11L ' Date: ..Z Z� I\ TOTALS $0.00 $0.00 This Cer, ficate is not negotiable. The AMOUNT CERTIFIED is payable only to e contracto .amed h em. Issuance,payment and acceptance of payment are without 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 01992 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. /, 44 ea 10 SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 20 7/25/11 Carmel City P111 Waterproofing - Gibraltar Carmel, Indiana I Total Work RETAINAGE_ I BALANCE Scheduled Completed WITHHELD _ PREVIOUS TOTAL COMPLETED TO DESCRIPTION Value This period THIS PERIOD APPLICATIONS TO DATE 1 % 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 69,433.32 672.50 0.00 68,760.82 69,433.32 100% 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 87,679.70 672.50 0.00 87,007.20 87,679.70 100% 0.00 182,648.93 1,345.00 0.00 181,303.93 182,648.93 100% 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 three hundred forty-five dollars and zero cents ($1,345.00) 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 Thom s E. tz, President Subscribed and sworn to before me this: 'U/y• a S , w 1/ Notary Public: (FP‘ ,g -/..„- :, LINDA BUCHANAN �:pPV P(ie.. '. `.'-- Hancock County ...NOTAPV .' :. S �.._; My Commission Expires •: .6;Kc,; August 20,2011