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Home My WebLink AboutSignature, Smock Fansler - $17,668.45 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 City Center Drive/Range Line Road Streetscape Improvements installment purchase contract Application 13(Smock Fansler) July 2011 $ 16,790.40 Application 18(Signature) July 2011 $ 878.05 Total Authorized Disbursement $ 17,668.45 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 Natio al Bank of Indianapolis and Carmel Theater Development Company, LLC. Dated: 877 h CITY OF CARMEL REDEVELOPMENT COMMISSION By: Les S. Olds Printed: Executive Director Title: P73 Hardscape (Smock Fansler) July 2010 Application 1 Paid by Carmel Theater Development $ 64,998.00 August 2010 Application 2 Paid by Carmel Theater Development $ 77,697.00 September 2010 Application 3 Paid by Carmel Theater Development $166,914.00 October 2010 Application 4 Paid by Carmel Theater Development $309,289.50 November 2010 Application 5 Paid by Carmel Theater Development $238,590.00 December 2010 Application 6 Paid by Carmel Theater Development $ 70,164.00 January 2011 Application 7 Paid by Carmel Theater Development $ 56,929.50 February 2011 Application 8 Paid by Carmel Theater Development $ 65,706.75 March 2011 Application 9 Paid by Carmel Theater Development $ 52,728.75 April 2011 Application 10 Paid by Carmel Theater Development $ 58,639.50 May 2011 Application 11 Paid by Carmel Theater Development $ 25,848.00 June 2011 Application 12 Paid by Carmel Theater Development $ 6,300.00 July 2011 Application 13 Amount to be paid by Carmel Theater Development $ 16,790.40 A1A Type Document Application and Certification for Payment Page 1 of 3 TO(OWNER):CARMEL THEATER DEVELOPMNT CORP PROJECT:CARMEL PARCEL 73 HARDSCAPE APPLICATION NO: 13 DISTRIBUTION 11711 N. PENNSYLVANIA ST. TO: CARMEL, IN 46032 PERIOD TO:7/31/2011 _OWNER _ARCHITECT _CONTRACTOR FROM(CONTRACTOR): Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S 2910 W.Minnesota Street PROJECT NO: Indianapolis, IN 46241 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYM ENT The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the work covered by this application for Payment has been completed in accordance with the Application is made for Payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Type Document is attached. Certificates for Payment were issued and payments received from the owner.and that current payment shown herein is now due. 1.ORIGINAL CONTRACT SUM $ 1,251,450.00 2.Net Change by Change Orders $ 93,656.01 CONTRACTOR: Smock Fansler Corporation 2910 W.Minnesota Street Indianapolis, IN 46241 3.CONTRACT SUM TO DATE (Line 1 +2) $ 1,345.106.01 ! �/�/ f 4.TOTAL COMPLETED AND STORED TO DATE $ 1,345,106.01 By: fit,../f'/74 -->--4517�✓7,�.tAI��a�f,,. Date: 7/4. ! /711 T.M.FANLER i CEO Y 5.RETAINAGE: State of:IN a. %of Completed Work $ 134.510.61 ____10.00 County of: MARION _ b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before me this '2,L l_h Day of , rLf L.'7 20 s1 Total retainage(Line 5a+5b) $ 134,510.61 Notary Public: y, . 'iL:a) L C. ��r Q� 61..t . i�r1 c. J�tf/ My Commission Expires:f 1,-15—r/'I- _^J_ 6.TOTAL EARNED LESS RETAINAGE $ 1,210,595,40 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 less Line 5 Total) 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,based on on-site chserratio re and the data::orn- Line 6 from prior Certificate) $ 1,193,805.00 prising the above application, the Architect certifies to owner that to the bsst of the Architects ( P knowledge,information and belief the Work has progressed as tndlcated,`.hec;u°.1ity of the work 8.CURRENT PAYMENT DUE $ 16,790.40 is in accordance with the Contract Documents. and the Contractor is entitled to peiymcni of she AMOUNT CERTIFIED. I 9.BALANCE TO FINISH,INCLUDING RETAINAGE �� Q�'� (Line 3 less Line 6) $ 134,510.61 AMOUNT CERTIFIED v'��r-'... (Attach explan. (on if,mou e Vied differs from the amount applied. Initial all figures on this CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Application a d on 1/ Co Gnua ion that are changed to conform to the amount certified.) Total changes approved in ARCH ITE• : / ' Z� t/ previous months by Owner 75,000.00 0.00 By: �,/ Date: f Total approved this Month 18,656.01 0.00 This Certificate is not negotiahle. The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance.Payment and acceptance of payment are without prejudice to any TOTALS 93.655.01 0.00 rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order 93.656.01 LW._,.<2.e4,---k..7__. 94-1-ill , —is AIA Type Document ' Application and Certification for Payment Page 3 of 3 TO(OWNER):CARMEL THEATER DEVELOPMNT CORP PROJECT:CARMEL PARCEL 73 HARDSCAPE APPLICATION NO: 13 DISTRIBUTION 11711 N.PENNSYLVANIA ST. TO: CARMEL,IN 46032 PERIOD TO:7/3 112 01 1 _OWNER _ARCHITECT _CONTRACTOR FROM(CONTRACTOR): Smock Fansler Corporation VIA(ARCHITECT): • ARCHITECT'S 2910 W.Minnesota Street PROJECT NO: Indianapolis,IN 46241 CONTRACT FOR: CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE 22 CHANGE ORDER#8 6,825.00 6,825.00 0.00 0.00 6,825.00 100.00 0.00 682.50 23 Veneer Falswork for Pavers at 3,500.00 0.00 3.500.00 0.00 3,500.00 100.00 0.00 350.00 entry 24 Topsoil and Irrigation for NE 12,430.00 0.00 12,430.00 0.00 12,430.00 100.00 0.00 1,243.00 Planter 25 Bond Increase 2,726.01 0.00 2,726.01 .0.00 2,726.01 100.00 0.00 272.61 REPORT TOTALS $1,345,106.01 $1,326,450.00 $18,656.01 $0.00 $1,345,106.01 100.00 $0.00 $134,510.61 • • AFFIDAVIT AND WAIVER OF LIEN [ ) Final IX] Partial [X] Payment to Follow State of Indiana County of Marion T.M. Fansler, being duly sworn states that he is the CEO of SMOCK FANSLER CORP. having contracted with: Carmel Theater Development Corp. to furnish certain labor, materials, and/or services as follows: Misc. Construction for a project known as: SFC 410-052 Cannel Parcel 73 Hardscape located at Carmel,IN and does hereby state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the owner the sum of: ($16,790.40) Sixteen Thousand Seven Hundred Ninety Dollars and 40/100 [ j receipt of which is hereby acknowledged;or [X) 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 sun? 0160.00). ( ) receipt of which is hereby acknowledged; or [ ) the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon on account of Labor, Materials, and/or Services, furnished by the undersigned thereto, subject to limitations or conditions expressed herein. if any; and further certifies that no other party has any claim or right to a lien on account of any work performed, materials, or services furnished to the undersigned for said project, and within the scope of this affidavit and waiver. SMOCK FANSLER CORP. By �� L—Title CEO .11. M. Fansler WITNESS MY HAND AND NOTARIAL SEAL. this 21"' day of July, 2011. --/-tom/ ICJ C /? 'C..t-� Glenda C. Hill Notary Public My commission expires November 15, 2014 Residing in Marion County P73 Streetscape (Signature Construction) April 2010 Application 4 Paid by Carmel Theater Development $ 7,382.79 May 2010 Application 5 Paid by Carmel Theater Development $ 2,998.20 June 2010 Application 6 Paid by Carmel Theater Development $ 8,685.83 July 2010 Application 7 Paid by Carmel Theater Development $ 5,795.38 August 2010 Application 8 Paid by Carmel Theater Development $ 12,324.93 September 2010 Application 9 Paid by Carmel Theater Development $ 9,302 86 October 2010 Application 10 Paid by Carmel Theater Development.1_1750.11 November 2010 Application 11 Paid by Carmel Theater Development 5:12,155 ) December 2010 Application 12 Paid by Carmel Theater Development $ 4,185.75 January 2011 Application 13 Paid by Carmel Theater Development $ 3,381.34 February 2011 Application 14 Paid by Carmel Theater Development $ 6,737.31 March 2011 Application 15 Paid by Carmel Theater Development $ 7,360.79 April 2011 Application 16 Paid by Carmel Theater Development $ 3,324.75 May 2011 Application 17 Paid by Carmel Theater Development $ 1,840.75 July 2011 Application 18 Amount to be paid by Carmel Theater Development $ 878 05 • APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENTG702 PAGE ONE OF 2 PAGES 2 TO OWNER Carmel Theater Development Corp PROJECT: Carmel Parcel 73 APPLICATION NO Invoice ' p Distribution to: Carmel Indiana 46032 Streetscape Signature costs OWNER ARCHITECT PERIOD TO: 7/21/2011 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 ofthe 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 $ 134,510.60 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1 ±2) $ 134,510.60 4. TOTAL COMPLETED&STORED TO $ 117,494.60 By: Date: 9/L // 5. RETAINAGE: '' om . oontz,President f a. 0 %of Completed Work $ 0 Subsc ibed and vom to before me this day of J 4,249 Sr -f 'arP�•-• LINDA BUCHANAN (Column D+12 on G703) ;_°:.. eff;.: b. %of Stored Material $ _ •NOTARY ; Hancock County (Column F on G703) ,N9.oE L ` My Commission Expires Total Retainage(Lines 5a+5b or ` August 20,2011 Total in Column 1 of 0703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 117,494.60 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) $ 116,616.55 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 878.05 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 17,016.00 (Line 3 less Line 6) AMOUNT CERTIFIED $ ES78.05 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanat• ' amount certified differs from the amount applied.Initial all figures on this Total changes approved Application. d ont e Continuation Sheet that are changed to conform with the amount certified.) 1 0 in previous months by Owner ARCHI"I• T: Total approved this Month 13y: '(.�✓ �---� Date: fft.liff TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the contractor named herein.Issuance,payment and acceptance of payment are without NE"I'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 0401 -Certification of Documents Authenticity from the Licensee. . 7,25 •-• ••• • • SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 19 7/21/11 Parcel 73 Streetscape Carmel, Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO Committed NO. WORK VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH Cost Pre-Construction Services 0.00 4,481.93 0.00 0.00 4,481.93 0% (4,481.93) 4,481.93 General Requirements: 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 Testing and Inspecting 2,500.00 1,052.89 0.00 0.00 1,052.89 42% 1,447.11 1,052.89 Site Supervision 53,005.30 44,204.48 0.00 0.00 44,204.48 83% 8,800.82 44,204.48 Construction Management 2,500.00 0.00 0.00 0.00 0.00 0% 2,500.00 0.00 Site Safety Director 500.00 500.00 0.00 0.00 500.00 100% 0.00 500.00 Design Drawings 3,000.00 0.00 0.00 0.00 0.00 0% 3,000.00 0.00 Temporary Electric 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 Temporary Lighting 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 Office Supplies 250.00 0.00 0.00 0.00 0.00 0% 250.00 0.00 Temporary Fire Protection 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 Temporary Water 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 Tools and Equipment 1,000.00 0.00 0.00 0.00 0.00 0% 1,000.00 0.00 Projection Signage 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 Field Eng. and Surveying 2,500.00 0.00 0.00 0.00 0.00 0% 2,500.00 0.00 Health and Safety 0.00 0.00 0.00 0.00 0.00 0% 0.00 0.00 Waste Disposal 2,000.00 0.00 0.00 0.00 0.00 0% 2,000.00 0.00 Construction Management Fee 67,255.30 66,377.25 878.05 0.00 67,255.30 100% (0.00) 67,255.30 134,510.60 116,616.55 878.05 0.00 117,494.60 87% 17,016.00 117,494.60 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 Parcel 73 Streetscape, located at Carmel, Indiana and owned by the Carmel Theater Development Corporation and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of eight hundred severty-eight dollars and five cents ($878.05) 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, furnished 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 Tho s E. Kd' tz, President Su cribed and sworn to before me this: ,91 J u/� Zo</ Notary Public: ,7‹. 64--41- • • LINDA BUCHANAN Hancock County �av. 5EA :,. My Commission Expires August 20,2011