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HomeMy WebLinkAboutBybee Stone, Horning Roofing - $3,087,439.20 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 Amounts already paid by CRC to be reimbursed per Equipment and Improvements Installment Purchase Contract Limestone(Bybee Stone) $2,966,839.20; Alternate Clay Tile Rooting(Homing Rooting) S 120,600.00 Total Authorized Disbursement r.}3IQ8MQ39 20;' t, I - `: All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement(Equipment,end Improvements), dated February 23, 2010, by and between The National Bank of Indianapolis and Carmel Theater Development Company, LLC. Dated: 3 Z3/%a CITY OF CARMEL REDEVELOPMENT COMMISSION By: _L��' Les S. Olds Printed: Executive Director Title: Draft Limestone Cladding (Bybee Stone) Up Through December 2009 Total Contract Amounts through application 19 Completed and Stored to date $ 3,131,018.00 Retention held $ 164,178.80 Paid to date $ 2,966,839.20 Amount reimbursed to CRC $ 2,966,839.20 � f, n °rte � Ate Document G702ICi aTM ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: 19 Distribution to: City of Carmel Performing Arts Ctr CRC Cannel fbi PERiOD TO: 12/31/2009 OWNER ❑ One Civic Square Carmel IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 11/30/07 ARCHITECT O Bybee Stone Co Inc Shiel Sexton 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSO Architects Inc ❑ CONTRACT FOR: Performing Art CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and Appiication 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 2' 850,000 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ payment shown herein is now due. 2.Net change by Change Orders $ 415 ,000 CONTRACTOR: I( 3.CONTRACT SUM TO DATE(Line 1±2) $ 3 1265 ,000 By: 1\ _- b L2 _ Date: 12/15/09 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $3, 131 ,018 State of: Indiana 5.RETAINAGE: County of:OW e n a. 1 0 %of Completed Work Subscribed and sworn to before (Column D+E on G703) $1164, 178. 80 me this 15 y f Dec. , }0 b. %of Stored Material Notary Public: (Column F on G703) $ _ My Commissi n expires: 2 / 0 6 Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 164 , 178 . 80 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,966, 839. 20 In accordance with the Contract Documents, based on on-site observations and the data comprising 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 $ 2 , 821 ,407 . 20 accordance with the Cont Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 145,432 .00 AMOUNT CERTIFIED $ /95!'4132-00 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on I • ontinuation Sheet that are changed to conform with the wnount certified) (Line 3 less Line 6) $ 298, 160. 80 CONSTRU .:)∎ AGER: By: "0"---- ��i` Date: 23De-G2(709 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC : ( i� _ _ �' Total changes approved in previous months by Owner $ 415 ,000 $ By: `{ Date: Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 415 ,000 $ named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 415 ,000 the Owner or Contractor under this Contract AIA Document G7021CMan,—1992.Copyright©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIAe 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.This document was created at 11:25:14 MDTOn 08/19/2008 under the terms of license number 26001 issued by the American Institute of Architects,and is not for resale.This document is licensed for one time use only and may not be .r.nr.,durari nrinr in Ile rmmnlofinn ., 0 . .s A DOCu 1 i lent G703 , ® 1 992 Continuation. Sheet MA Document.002,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATIONNO: 19 containing Contractor's signed certification is attached. APPLICATION DATE: Dec.10,2009 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: December 31,2009 Use Column Ion Contracts where variable retairtage for line items may apply, ARCHITECT'S PROJECT NO:"2695-2025 CONTRACTOR: Bybee Stone Co Inc A B C D J E F - G H I WORK COMPLETED MATERIALS TOTAL 'BALANCE PRESENTLY COMPLETED RETAINAGE SCHEDULED FROM PREVIOUS' % TO. ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD (0 AND TO STORED D (0+C) FINISH {IF VARIABLE (D+E) D ORE) (D1-E+17) (C-G) 1 Shop•Drawings 387,000 387,000 0 0 387,000 100% '0.00 34,830.00 2 Raw Material 911,400 911,400 .0 0 91.1,400 100% 0.00 61,525.00 3 Material Storage 0. 0 0 0 0 0% 0.00 0.00 4 Shop Fabrication 1,301,600 1,171,520 91,302 0 1,262,822 97% 38,778.00 52,064.00 5 Material Delivery 100,000 40,000 25,000 0 65,000 65% 35,000:00 100.00 6 Engineering Allowance 150,000 102,246 0 0 102,246 68% 47,754.00 7,329.80 • 7 Change;Order#1 415,000 373,500 29,050 0 402,550 97% 12,450.00 8,330.00 Totals 3,265,000 2,985;666 J45,352 0 . 3,131,018 '13',989..0�A14 8o_ AIA Document G7Q3TM—1992.Copyright m 1963,,1965,.1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA0Documentie protectod'by U.S.Copyright Low and International Trestles.Uhauthorizedraproductlomor distribution of this AtA"'Document,orally portion of it,may,result tn,severe civil and crituinat,pcnaltles,and-wilt be prosecuted-to the maximum extent possible,underthe taw.This document was created at 09:50:20 MDTon`07/17/2008 under the terms of license:number 26001 Issued by the American Institute of Architects,and Is not for resale.This document is licensed forone time use only and may nor be reproduced prior to its completion. PARTIAL WAIVER OF LiEN STATE OF INDIANA) Gty#: SS COUNTY OF MONROE) Escrow#: TO WHOM IT MAY CONCERN: WHEREAS the undersigned has been employed by the City of Carmel, Carmel Redevelopment Commission to furnish Limestone for the premises know as Regional Performing Arts Center of which the City of Carmel is the owner. THE undersigned, for and in consideration of $145,432.00 , and other good and valuable considerations,the receipt whereof is hereby acknowledged,do(es)hereby waive and release any and-all lien Or claim of,or right to, lien, under the statutes of the State of Indiana, relating to mechanics' liens, with respect to arid on said above described premises, and the improvements thereon, and on the material; fixtures, apparatus or machinery furnished arid on the moneys, funds or other considerations due or to become due from the owner, on account of labor services,material, fixtures, apparatus or machinery,hereto furnished to this date by the undersigned for the above described premises, INCLUDING EXTRAS*. Date: Dec. 15; 2009 Company-Name: Bybee Stone Company.Inc Address: / �} 6293 N.Matthews Dr,Ellettsville.IN 47429 Signature and Title: *EXTRAS INCLUDE"BUT ARE N T LiMITED TO CHANGE ORDERS, BOTH ORAL AND WRITTEN,TO THE CONTRACT. CONTRACTOR'S AFFIDAVIT STATE OF INDIANA) SS COUNTY OF MONROE ) THE undersigned, Mary Beth Haas, being duly sworn, deposes and says that he or she is Vice Pres., of Bybee Stone Company, Inc who is the.contractor furnishing Limestone for the building located at Carmel. Indiana owned by the, City of Carmel.Carmel Redevelopment Commission . That the total amount of the contract including,extras is 3;265;000.00 on which he or she has received payment of $2,708,943.20 prior to this payment. That all waivers are true, .correct and.genuine and delivered unconditionally and that there is no claim either legal or equitable to defeat the validity-of said waivers. That the following are the names of all parties who have furnished material or labor,'or both, for said work and all parties having,contracts or ,.sub contracts for specific portions of said work or.for material entering into the construction thereof and the amount due or to become due each,and that the items mentioned:include all labor and material re.itired to com.tete Said work accordin• to clans and NAMES WHAT FOR CONTRACT AMOUNT THiS BALANCE PRICE PAID PAYMENT DUE BYBEE STONE COMPANY;INC LIMESTONE S3,265,000.00 S2,708,943.20 S257,976.00 S 298,080.80 TOTAL LABOR&AIAT'L TO COMPLETE S3,265,000.00 S 2,708;943:20 5257,976.00• S298,080.80 That there are no other contracts for said work outstanding;and that there is nothing due or to become due to any person for material,labor or other work of any kind done or to be done upon or in connection with Said Work other than above stated. -Date:----Dec. 15,2009 Signature: L, TANA Vice President, Subscribed and Sworn to Before Me This 15th Day of December , 2009. Extras included but are not limited to Change Orders, Both oral and written.to the contract. , h011.49-yv Not ry Public Commission Expires: 8/25/2016 F.1 1'22R5/96 Provided by Chicago Title.Insurance Company �a k . TM �;> ;� • Document 70 l a - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER; PROJECT; APPLICATION NO: 218 DIstrlbutlan to: City of Carmel Perl'imnin r Arts Cl• CRC • Carmel TN PERIOD TO: 11/30/09 OWNER 0 . One Civic Square Cannel IN 46032 CONSTRUCTION MANAGER 0 FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 11/30/07 ARCHITECT 0 Bybee Stone Co Inc Shicl Sexton 6..93 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR 0 Ellctbviite IN 47429 VIA ARCHITECT: MELO 0 CSO Architects Inc i 1 CONTRACT FOR: Performing Art CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made fur payment,as shown below,in connection with the Contract• belief the Work covered by this Application 11w Payment hue been completed in accordance with the Continuation Sheet,AIA Document 07D3,is low. cd, Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and ayments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2 , 850 r 000 payment shown herein is now due. p �1i 5;2,Not chango by Change Orders $ CONT CTOR: 3,CONTRACT SUM TO DATE(Line 1 i 2) •• 1- -)65 265 ,000 Ry.. A n. _ >/ t i3:te: 11/09/09 4.TOTAL COMPLETED S STORED TO DATE(Column G on G703) $ 2,985,586 State of: I n d i n is 5.RENNAGE: County of:Ow en a.l 0U %of Completed Work Subscribed and NVVOr9 to before 164 , 178 . 80 (Column 0+E on 0703) $ me this 9 Uyof c) ?om. � N 0 1 b. °j,ofStored Material 'Notary Publi {�jT� ��f (Column F on 0103) $ M Commission expires: 8/2 5/M Total Retalnage(Lines 5a a•5b or Total in Column I of 0103)., :ii 164 , 178 . 00 CERTIFICATE FOR PAYMENT 2 ,821. ,407- 20 In uceordance 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 $ 1, ,7 0 8 r 8 6 3-2 0 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Ccttifcatc) --"--w—.— CERTIFJED. L CURRENT PAYMENT DUE Ell 1 2,„5 zo.00 i AMOUNT CERTIFIED $ _ 9,BALANCE TO FiNiSH,INCLUDING RETAINAGE (Attach explan lion if amount certified differs front the amount applied.Initial all figures on this Application an l on the Co rt inuatiari beet that are changed to conform with the amount certified.) 443 592.80 • (!Line 3 less Line 6) SI ` CONSTRU TI MA •G e My: -.k •_?L., Date:_ lta7 _,.,. CHANGE ORDER SUMMARY A1)i.)ITiON3 ARCHITECT; Total chattgts approved in previous months by Owner $ 415,001 i y Date: Total approved this Month $ This Certificate is not negotiable. The AMOUNT Ct;R r11 l I t) is payable only to the Contractor TOTA - L S $ 3' I 1 tl' named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NRT CHANGES by Change Order -$ - . ..) , I II (he Owner or Contractor under this Contract. AlA I7oeltlttont G7011CMalu—1992.Copyright tt len py The Amodcan Inelllule of Archilecta.All rlghta roeerved,WAIttNING:This A,A`' Document try protoolnd by U.S,Copyright Lew and internailonat Trnotk'o. Unauthorized re/pror)uctton or distribution of this AIA.`Document,or any portion of it,may rosuit In aovoro civil and criminal penalties,anti will ha itrouucuiud to the maximum extoni posalttic nncar urn law.This document was created al I t:15:1•I MDTon atttlht2Utt under the terns of litonso number 2C001 Issued by the American Institute el Architects,mid l.net tot reshla.This document I.liecttowi for etre little utM only:mamas mat an rnnrngnrnd wino-Iq II.rn.»nlnlhn Art i 0 TM L1 pei Document G702/Ma m 1992 Application and Certificate forRayrnent Construction Manager-Adviser Edition TO OWNER: Cl.,‘) '' PROJECT:\ APPLICATION NO: 17 Distribution to: City of Carmel I- Performing-Arts Ctr CRC Cannel'1• PERIOD T0: 10/31/09 OWNER ❑ One Civic Square ,----- Carmel IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: - VIA CONSTRUCTION MANAGER: CONTRACT DATE: 11/30/07 ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR 0 Eliettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSO Architects Inc ❑ CONTRACT FOR: Perfonning Art 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 shown is attached. 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 1.ORIGINAL CONTRACT SUM $ 2,850,000 payment shown herein is now due. 2.Net change by Change Orders $ 415,000 CONT CTOR: 3.CONTRACT SUM TO DATE(Line 1 t 2) $ 3, 265,000 By: i1N_" f,•, k, Date: to '1'S !Ucj 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2,873 ,042 State of: India a 5.RETAINAGE: County of:OW en a. 10%of Completed Work Subscribed and sworn to be oe (Column D+E on 0703) $ 164 , 178 . 80 me this 1r5 di of >- �% ' p ,, b, %of Stored Material Notary Commission,xp 8 2 5 2 0 / ( J (Column F on G703) $ My Commission expires: • Total Retainage(Lines 5a+5b or Total in Column I of 0703).. $ 164 , 178 . 80 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $2 , 7 0 8 ,8 6 3 . 2 0 In accordance with the Contract Documents, based on on-site observations and the data comprising 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 $2, 554 ,075. 20 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 $154 , 788. 00 AMOUNT CERTIFIED $ 'IS/4 -71?)?9 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs fr•om the amount applied Initial all figures on this Application and on the Con inuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 556, 136. 80 0' CONSTRUCT 0 MANQt. R By: / • .■T(I Date: /0. 3 a. Oe7 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: r' w- it /D� Total changes approved in previous months by Owner $ 415 ,000 $ By: l ; �.� Date: I t' Z Total approved this Month $ 5 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 415,000 $ named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CI•IANGES by Change Order $ 415.,000 the Owner or Contractor under this Contract. AlA Document G702ICMaTM—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.This document was created at 1 1:25:14 MDTon ot/19/2008 under the terms of license number 26001 Issued by the American Institute of Architects,and is not for resale.This document Is licensed for one time use only and may not be -�- AMA n ' i A TM � . oa;.e� n c`n Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: �PROJECT: APPLICATION NO: 16 CRC of Carmel ` .t" erforming Arts Ctr Distribution to: ;'t ,•`\CarmelIT( PERIOD TO: 9/30/2009 One Civic Square % :. 'v` \ OWNER ❑ Carmel IN 46032 �(C? �coa 1 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR;,` Vv '�1,-1 VIA ONSTRUCTION MANAGER: CONTRACT DATE: 11./30/2007 ARCHITECT ❑ Bybee Stone Co Inc S(LQ ) exton 6293 N Matthews Dr '' PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 � VIA ARCHITECT: FIELD ❑ CSO Architects Inc ❑ CONTRACT FOR: Performi g� rt� 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,ALA Document G703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 2 , 850,00 0 payment shown herein is now due. 2.Net change by Change Orders $ 415 ,000 CONTRACTOL' • 3.CONTRACT SUM TO DATE(Line I y 2) $ 3, 265,000 By: Ala _ J vz.i. It_�/,� Date: 9/18/09 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2 , 718 , 254 State of I n d ' a - 5.RETAINAGE: County of:Ow en a. 10 %of Completed Work Subscribed and sworn to before (Column D+E on G703) $ 164 , 178 . 80 me this 18 f of geL, b. %of Stored Material Notary Public. )1...J1.4 (Column F on G703) $ My Commissi nn expires: B 25/2016 r Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 164 , 178 . 80 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $2 , 554 ,075 . 20 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 $2 , 246 , 295 . 20 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 $307,780. 00 AMOUNT CERTIFIED $ .37t 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied initial all fig Tres on this Application and on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 710, 924 . 80 CONSTRUPTIIOJMNfIGER: c By: e Date: ( '7U-(,u0I CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: r j Total changes approved in previous months by Owner $ 415 ,00C $ B 1. , r�•*�Y /Y ��r Date: Total approved this Month $ $ This C. tificate�:not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 415,000$ name, herei suance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 415,000 the 0 •r Contractor under this Contract. AIA Document G702ICMaT°—1992.Copyright m 1992 by The American Institute of Architects.All rights reserved.WARNING:ibis 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.This document was created at 11:25:14 MDTon 08/19/2008 under the terms of license number 26001 issued by the American Institute of Architects,and is not for resale.This document is licensed for one time use only and may not be ron.r.riura.i mint in 7e rmmnlnenn `r` Doc meat G702/C a © 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO,OWNER: PROJECT: APPLICATION NO: 15 Distribution to: City'of Carmel Performing Arts Ctr CRC Carmel INg PERIOD TO 8/31/09 OWNER ❑ One Civic Square Carmel IN 46032 CONSTRUCTION MANAGER O FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 11/30/07 ARCHITECT ❑ Bybee Stone.COlnc Shiel Sexton 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSO'Architects Inc ❑ CONTRACT FOR: Performing Art 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 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM • $ 2 , 850 ,000 payment shown herein is now due. 2.Net change by Change Orders 5 415 ,000 CONTRACTOR: 3,CONTRACT SUM TO DATE(Line 1±2) $ 3 , 265 ,000 By: 1 � � Date: F-- /?-0, 4.TOTAL COMPLETED&STORED TO DATE(Column G on'G703) $ 2 ,410 ,474 .State of: Indiana 5.RETAINAGE: County of OW e n a, 10 %of Completed Work. Subscribed sworn to be Ore o2-0 dcl (Column D+E on G703) $ 164 , 178. 80 me this. 1 � of • b. %of Stored Material NotaryPublic, o e (Column F on 0703) $ My Commissidn expire`r Y2(!)16 ii Total Reteinage(Lines 5a+5b or Total in Column 1 010703).. $ 164, 17 8 . 80 CERTIFICATE FOR PAYMENT 6.70TALEARNED.LESSRFTAINAGE $ 2, 246, 295. 20 In accordance with the Contract Documents, based on on-site observations and the data comprising 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 - $ 2,080 , 175. 20 accordance with the Contract Documents,and'the.Contractor is entitled to payment of the AMOUNT T (Line 6 from prior Certificate) CERTIFIED. ° 8.CURRENT PAYMENT DUE $ 166, 120 . 00 AMOUNT CERTIFIED $ 4&A 0 9.BALANCE TO FINISH,INCLUDING RETAINAGE h t� (Attach'explanation if amount certified differs from the amount applied.Initial all figuths on this Application 'don t •'Continuation Sheet that are_changed to conform with the amount,certified) (Line 3 less Line 6) $ 1 ,018 ,704. 80 CONSTRU TON 'N''ER: r 9.20..2.001 ' By: i _� Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE� : :� ,, Total.changes approved in previous months,by Owner $ 415 ,000$ gy: Date: Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 4.1 5,000$ named herein. Issuance, payment and acceptance of payment are without.prejudice to any rights of NET CHANGES by,Change Order .5 415, 00'0 the Owner or Contractor under this Contract. AIA Document G702(CMa l"-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 roproductlon.or distribution of this Ale Document,or any portion of It may result to severe civil and'criminal penalties,and'Will.be prosecuted to the maximum extent possible tinder the law.This document was created'at 11:25:14 MDTon 08/19/2008 under the terms of license number 26001 issued by the Amertcarnlristitute of Architects,and is not for resale..This document Is licensed for one time use only and may not be �j G p d A TM — 1992 Application and Certificate for Payment Construction Manage�A sr �>;gon TO OWNER: PROJECT: v v APP !CATION NO: 14 Distribution to: City of Carmel Performing Arts Ctr (3 \ l CRC Carmel IN \J) ei,PERIO D TO: 7/31/09 OWNER 0 One Civic Square % Carmel IN 46032 0- CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGE' •0 TRACT DATE: 11/30/07 ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 6A VIA ARCHITECT: FIELD ❑ CSO Architects Inc ❑ CONTRACT FOR: Performing Art 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 2 850, 000 Certificates for Payment were issued and payments received from the Owner, and that current , 1.ORIGINAL CONTRACT SUM $ payment shown herein is now due. 2.Net change by Change Orders s 415 ,000 CoNTRACFOA—_` / � ,�cd J/.ice �`/�r G.� 3,CONTRACT SUM TO DATE(Line 1 t 2) $ 3,265,00° Sy; L� �( Date: 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ ? , 244 , 11311 State of: I n d i a 4 5.RETAINAGE: County of:Owe n a. 10 %of Completed Work 164, 178 .80 Subscribed and sworn tie b:y. : i �j •� (Column D+Eon G703) $ me this /'7 da .f. � �7y1� / y I �, b. %of Stored Material Notary Public: ` / w (� (Column F on G703) $ My Commission expires: 0 2 2U1 6 Total Retainage(Lines Sa+5b or Total in Column I of G703)- $ 164., 17 8. 80 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2 ,080, 175 . 20 In accordance with the Contract Documents,based on on-site observations and the data comprising 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 $ 1 ,999, 255 . 20 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 00 8.CURRENT PAYMENT DUE $ 81 ,000 00 AMOUNT CERTIFIED $ aleceo 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied Initial all figures on this Application a don the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 1 , 18 4,824 . 80 CONSTRU TNN h By: L-�f Date: 1:Zg-z1U`� CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: p Total changes approved in previous months by Owner $415 ,000 $ By: /��' Date: ` Total approved this-Month $ $ This Certifi = negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $415,000 $ named h-, nonce, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $415 ,000 the Owne or Contractor under this Contract. • AIA Document G702/CMaT"—1992.Copyright el 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 AIA° Document,or any portion of It,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible tinder the law.This document was created at 11:25:14 MDTOn moans under the terms of license number 26001 Issued by the American institute of Architects,and is not for resale.This document Is licensed for one lime use only and may not be Document G7O2IC ryl - 1992 Application and Certifies otA meat Construction Manager Adviser Edition TO OWNER: //(� qZ �, " pR ECT: APPLICATION NO: 13 Distribution to: City of Carmel Ct I a 1n Arts Ctr CRC <' .,U\J. n(NV5, U PERIOD TO: June 30 , 2009 OWNER ❑ One armel 1NS46032 �� �� ��� CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: \�y' / I' CONSTRUCTION MANAGER: CONTRACT DATE: 11/3 0/0 7 ARCHITECT ❑ Bybee Stone Co Inc „/ Shiel Sexton 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 6y � VIA ARCHITECT: FIELD ❑ CSO Architects Inc CONTRACT FOR: Performing Art ❑ 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 2, 8 5 0,0 00 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ payment shown herein is now due. 2.Net change by Change Orders $ 415 ,000 CONTRAC 'R: • G 3.CONTRACT SUM TO DATE(Line 1*2) $ 3, 265,000 By: v . r —��.—nr/_ / ,--69'_ Date: 4' '/ —6 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 2 , 163 ,434 State of: I n d i;n A 5.RETAINAGE: County of:Owe n a. 10 %of Completed Work 164 , 178.80 Subscribe¢apd sw m to be /?W.A.. + (5 9, (Column D+E on G703) $ me this y da of i b. %of Stored Material Notary Publi : ' { (Column F on G703) $ My Commis expires: 2 C0 6 �\ Total Retainage(Lines 5a+5b or Total in Column I of 0703).. $ 164 , 17 8. 8 0 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 1 ,9 99, 255. 2 0 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 $ 1,8 2 9,0 9 5. 2 0 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 $ 1n, 1 n, 1 fi n _(p II o AMOUNT CERTIFIED $ 1/12)1 L 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach expla ration if amount certified differs from the amount applied.hzitial all figures on this 1 , 265,744 . 80 Application d o the I ontinuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ p, CONSTRU TI II NM:`�F': Date: •Z(p_ZdQ By: / r`0 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: ''jrl .yip Total changes approved in previous months by Owner $ 415 ,000$ By: �I i �� J Date: 6'G. I ' Total approved this Month $ $ This Certificate is not egotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 415,0 0 0$ named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 415,00 C the Owner or Contractor under this Contract. AIA Document G702JCMaT"—1992.Copyright 61992 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 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.This document was created at 11:25:14 MDTon 08/19/2003 under the terms of license number 26001 Issued by the American Institute of Architects,and is not for resale.This document Is licensed for one time use only and may not be .e....,.�...oa.......i,,a.-.......ion..,. A co S% kid, is I"i AIA Document G7021 `. IaTm ° 1992 o� . ���©�g �,)•,�t Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: 12 ?,y/ Distribution to: City of Carmel Performin ,Arts Ctr 2 0 0 CRC. 5/3 1 Carmel IN- PERIOD TO; / OWNER ❑ One Civic Square Carmel IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: ViA CONSTRUCTION MANAGER: CONTRACT DATE: 11/.30/07 ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSO Architects Inc CONTRACT FOR: Performing Art CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to,the best of the Contractor's knowledge,information and Appiicatian'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 payment, shown is attached. 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 -1.ORIGINAL CONTRACT'SUM $2 , 8 50 ,000 payment shown herein is now due. 2.Net change by Change Orders $ 415,000 CONT-.CTOR: ' f� 3.CONTRACT SUM TO DATE(Line 1 2)- . . $3 ,265,000 By: i, ^_ ` vj>•.►6h,e�+. Date:/�"' U 9 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1 ,9-9 3 ,2 7 4 State.of In d i.%na 5.RETAINAGE: County of:OW e n a. 10 %'of Completed Work Subscribed an sworn to bef e 9 Q (Column D+E on 0703) $1.6 4, 17 8.8 0 me this I Cf day of P' ►a", o,©� b, %of Stored Material Notary Public:, 0)-a--/t._ X›. (Column F on G703) $ My Commission expires: 8/2 5/201.6 Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 1 64, 17 8 .80 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprising 6,TOTAL EARNED.LESS RETAINAGE '$ 1 ,829 ,095 . 20 this.application,the Construction Manager and Architect certify to the-Owner that to the bestof 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 $ 1 , 551 , 793. 20 accordance with the Contract Documents,and the,"Contractor is entitled to payment of the AMOUNT;Ref7------ (Line.6 from prior Certificate) CRIED'8.8.CURRENT PAYMENT DUE i,$ 277 , 3 0.2 AMOUNT CERTIFIED - $ Z7 4 g v 9,BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial'all figures on this . Application and on the Co tinuation Sheet that are changed to conform amount certified) (Line 3 less Line 6) $ 1 ,435 ,904 .80 CONSTRUCT IN'M G By: (1(,1 _- - Date: L . ZOC,- CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT T: �-i �/� Total changes approved in previous months by Owner $415 ,000 $ By: /� _�� Date: W .i. Total approved this Month $ ,.,e his Certifi ie is t negotiable. The AMOUNT CERTIFIED is payable on y to the Contractor TOTALS $4 1 J ,UUU $ named her rn..Issttir ce, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $415 ,0 0 0 Ole Owne or r. ttiis.Contract. • AlA Document G7021CMe"-1992.Copyright 0 1892.by The American Institute of Architects.All rights reserved.WARNING:This,AIA°'Document ls•protected by U.S.Copyright Liman('International Treaties, Unauthorized reproduction or distribution of this AIA°Document,or any portion of it,may,rssuit in severe civil and crhninnl penaltiesaand will be prosecuted to tho'maximum extent possible under the law,This document was creeted'GM I:25:14'MDTen 08/19/2008 under the terms of license nijmber'26001 issued by the American institute of Archltects,and'.is not for resale.This document is licensed for one time use only and may not be 0 \ilii s ik, • -44.A1{ Document G 702IC ��r am — 1992 Application and Certificate for Payment Construction +r1angger Adviser Edition , TO OWNER: PROJECT: '= -_::-`j C '1 APPLICATION NO: 11 Distribution to: CittyC f Carmel Performing Arts Ctr• Carmel IN i PERIOD T0: 4/30/09 OWNER ❑ One'Civic Square -2:.1 - i Carmel IN 46032 ;:; 1'i CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: ' CONTRACT DATE: 11/30/07 ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton CONTRACTOR ❑ 6293 N Matthews Dr = j PROJECT NOS:2695-2025 Ellettsville IN 47429 VIA ARCHITECT: ; J FIELD ❑ CSO Architects Inc i . ' -_y / ❑ • CONTRACT FOR: Performing Art `--:� .:. .r , 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,for aymemeas shown b is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous 2, 850,000 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ payment shown.herein is now due. 2,Net change by Change Orders $ 415 ,000 CONT CTOR' ,u: ` -- ' 4/17/09 3.CONTRACT SUM TO DATE(Line 1 A:2) $ 3, 265,000 By: c� Date: • 4.TOTAL COMPLETED&.STORED TO DATE(Column G on G703) $ 1 , 715 ,972 State of: Ind i na 5.RETAINAGE: County of Owen a. 10 %of Completed Work Subscribed and s o'1 before (Column D+Eon G703) $ 164 , 178 . 80 me this 17th /of' Ap i l, 0. b. %of Stored Material Notary Publi 0 (Column F on 0703) $ My Commission expires: 8/25/ 016 Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 16 4, 17 8. 8 o CERTIFICATE FOR PAYMENT In accordance with the Contract Documents;based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE • $ 1 ,551 ,793 . 2 0 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 an belief th Work has progressed as indicated,the quality Of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1 , 4 77,609.20 accordance with.the Con' at Doc.' e ,and the Contractor is entitled to payment of the AMOUN1 (Line 6.from prior Certificate) CERTIFIED. 'fig N4 4 ■\ ',.r osvf 8.CURRENT PAYMENT DUE $ 7 4, 184 .00 AMOUNT CERTIFIED b\*. t`1�� M.. ' $111,1172A 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation i anoun' er f•d,di„ffersfrorn the amount applied.Initial all fgures on this Application an on the:Co,ljnuationSheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 1 , 713 , 206 . 80 CONSTRUCTIO MA .G At By: / LA.. it,..i Date: S , [- G40�1 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITE• i ' /'"— , ( ` Total changes approved in previous months by Owner $ 415 ,0 0 $ By: Date: '-1 •-s co'01 Total approved this Month S $ Tit'• Certif ate_is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 415 ,00 $ . n., ed , ein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES,by Change Order $ 415,0 0 0 _ e.0 • er or Contractor under this Contract. • AIA Document G7021CMaT"'–9992.Copyright C1 1992 by The American Institute ofArchitects.All rights resoryed.WARNING:This Al Document Is,protected by U.S.Copyright Law and international Trestles. Unauthorized reproduction or distribution of this AIA0 Document,or any portton.of lt,may result In severe chili and criminal penalties,and will'bo•prosecuted to the maximum extent possible under the livi.This document was created at 11:25:14 MDTbe 08/19/2008 under the terms of license number 28001 Issued by the American institute of Architects,.and is nol for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. • Y3 e Application and Certificate for Payment Construction Manager Ad iiser Edition TO OWNER: PROJECT: --,- ' '\' APPLICATION NO: 10 Distribution to: City of f Cannel Cannel Arts Ctr `,"c. '"0 CRC One Civic Square IINN \�� �' r4`,,:, \,�' PERIOD T0: 03/31/09 OWNER ❑ Cannel IN 46032 tV� n CONSTRUCTION MANAGER ❑ \1 \doh`' -..,==-' FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: - CONTRACT DATE: 11/3 0/07 ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton ,,w 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 VIA ARCHITECT: 31 FIELD ❑ CSO Architects Inc ❑ CONTRACT FOR: Performing Art 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 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM s2 , 850 ,000 payment shown herein is now due. 2.Net change by Change Orders $ 415 ,000 CONT CTOR: ;_-=`:--.. 3.CONTRACT SUM TO DATE(Line 1-±-2) $3, 2 6 5,0 0 0 By: �`�JC X � Date: 3/19/09 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $1 , 6 4 1 ,7 8 8 State of I n d i n a 5.RETAINAGE: County of Owen a. 10 %of Completed Work Subscribed and sworn to before • 164, 178 . 80 ,: of March A9 „ (Column D+Eon G703) $ me this 19 \A" pt , b. %of Stored Material Notary Publi. , (Column F on G703) S My Commissiplexpirl� J�4U/L 5 01 6 Total Retainage(Lines 5a+5b or Total in Column I of 0703).. t 164 , 178 . 80 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 1,477 ,609. 20 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 $ 11368 ,999. 00 accordance with the Contr Documents,and the Contractor is entitled to : I nt of the • a4.4 (Line 6 from prior Certificate) CERTIFIED. e:.r, w 8.CURRENT PAYMENT DUE I$ 108 ,610. 2 d AMOUNT CERTIFIED `� $ ,:" 9.BALANCE TO FINISH,INCLUDING RETAINAGE i/ L., (Attach explana '. if an t certified differs from the amount applied.Initial all figures on this �� Application •t• ,n : ont nuatian Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) S 1 ,787 , 390. 80 CONSTRU 40. •AN ER r t.— By: il�'_/a Gif`_ Date: 5.Z -.2oo ci CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC : �� ) ie Total changes approved in previous months by Owner $ 415,000s By, : 4 a Date: �•151I ,4 Total approved this Month S $ This C. "ficate i of negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 415,000$ name�'herein. ,!uance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 4] 5,000 the %caner o, ontractor under this Contract. • AIA Document G702fCMar"-.1992.Copyright' 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 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.This document was created at 11:25:14 MDTon OBI192008 under the terms of license number 26001 Issued by the American Institute of Architects,and Is not for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. RI L' i o TM Docu m eat G7O2IC a. © 1 992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: 9 Distribution to:. City f Carmel Carmel rtning Arts Ctr ' Tfl PERIOD TO: .February.28,2009 OWNER ❑ One Civic Square Carmel-IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: rVIA CONSTRUCTION MANAGER: - ' CONTRACT DATE: 11130/07 ARCHITECT ❑ Bybee Stone Caine. Shiel•Sexton 6293•N-Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSC Architects Inc ❑ CONTRACT FOR: Performing Art CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payulent,as shown below,in connection with the Contract. belief the Work'covered by this Applicatiou.for Payment has been completed in accordance with the Continuation Sheet,AIA.Do eat,as G703,is attached. 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 1.ORIGINAL CONTRACT SUM $2,850,000 payment shown herein'is now due. • 2.Net change by Change Orders $ 415 ,000 PONT CTOR: 3.CONTRACT SUM TO DATE(Line 1*2) $3, 7.Fi"`1 ,0o0 BY: �� � 0--'------ Date: 2/19/2009 4.,TOTAL COMPLETED&.STORED TO DATE(Column G;on 0703) $1 , 52 1 , 1 10 State of: I'n d i n a 5.RETAINAGE: County of:Owen 0,1 0 %of Completed Work Subscribed and ssdo to before (Column D+E on G703) $ 152 , 111 me this 19th d S f Februar b. %of Stored Material Notary Public: ,� ��� . (Column F on G703) $ My CommiSsi expires: . /w 1 n 1/4'./ Total Retainage(Lines 5a+5b or Total in Column I of G7o3).. $ 1 5•') , 1 1 1 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on--on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE • $1. , 368'.,99 9 this application,the Construction Manager and Architect.certify to the Owner that to the best Of their (Line 4Less Line.S Total) knowledge,information and belief the Work,*progressed as indicated;the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT S. ' 2 9 8 ` 7 9 9 accordance with the Contract Documents,and'the Contractor is entitled to payment of the AMOUNT (Line 6.from prior Certificate) CERTIFIED. Gre 8.CURRENT PAYMENT DUE $ '7 Q 7 On I AMOUNT CERTIFIED $ i1a, 9.BALANCE TOFINISH,INCLUDING RETAINAGE �/ (Attach explanatibn.if amount certified:diiffers from the amount applied Initial all figures on this �ci Application and on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 1 , 896,001 .00 It CONSTRUCT a,. ER: By: _ --...0e Date: I75/09 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: 7 p Total changes approved in previous months by Owner $41 ,00 0.. $ By: Date: ,.-2.'t-01 Total approved this Month $ $ This Certifica,.is no 1 ':,otiable. The AMO I T CERTIFIED is payable only to the Contractor TOTALS $415,000 $ named her-''. lssuanc payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Chan a Order $ the Owl: or eont1, or under this Contract. y g 415 ,.000 AIA DocumentG702/CMni°—1992..Copyrlght 01992 by The American Institute of Architects.Ail rights reserved,WARNING:This Ale document Is protected by U.S.Copyright Lawand International Treaties: Unauthorizod,reproductlon or distribution ethic AlAe Document,or,any portion of ii,may result tn.eovere civil and criminnt.ponalties,and will be prosecuted to the maximum extent possible Under the law.This document was created at 11:25:14 MDTon 02/19/2008 under the terms of license number 20001 Issued by the American Institute of Architects,and is ndt for resale.This document is licensed for onetime use only and may not be ATAV i e ` TM Application and Certificate for Payment Constructiory,*l l . di tion TO OWNER: PROJECT: %v �©� 1. 'PLICATION NO: 8 Distribution to City CRC of Carmel Performing Arts Ctr D One Civic Square W P'� c Q P -10D TO:January 1,2009 OWNER ❑ Carmel IN 46032 \\\ \\ CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANA,ER: CONTRACT DATE: January 31,2009' ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton 6293 N Matthews Dr 6y PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSO Architects Inc ❑ CONTRACT FOR: Performing Art 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 Paymenthas been completed in accordance with the Continuation Sheet,AIA Document 0703,is attached. 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 1.ORIGINAL CONTRACT SUM $2 , 8 5 0,0 00 payment shown'herein is now due. 2.Net change by Change Orders $ 415 ,000 CONT-,CTOR: . 3.CONTRACT SUM TO DATE(Line 1±2) 53 ,265,0 00 BY: iti■_: _APJ,: -Li-40 Date: 1/19/09 4,TOTAL COMPLETED&STORED TO DATE(Column G on G703) $l. , 443, 110 State of: I nd i. a 5.RETAINAGE: County of. Mon r•e a. 10 %of Completed Work Subscribed and swf to before (Column D+E on G703) 5 144 , 31.1 . 00 me this 19th r12; of Janua , . 079 b. %of Stored Material Notary Publi / 1 I . (Column F on G703) 5 My Commission expires: 0 .• li Total Retainage(Lines 5a+5b or Total in Column I of G703),. 5 144 , 311 . 0 0 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 1 , 7 9 R,7 99 .110 this application,the Construction Manager and Architect certify to the Owner that to the'bestof 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" $ 1 , 193, 3 8 2 .00 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 I$ 1 n 5,4 1 7 AMOUNT CERTIFIED $ '165,11 gle- 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from'the amount applied.Initial all figures.on this Application and on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 1 ,966 , 201 .00 0 CONSTRUCTION MANAGER: BY —.K.11,.... Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: / 7 Total changes approved in previous months by Owner $415 ,000 5 BY: l ,f�� d ir` �' ,r'=-.��-...-�.i��,__�..-.-�,,, Date: Total approved this Month $ $ r This Certifica i ,;.:.-: negotta�le, The AMOUNT CERTIFIED is payable o ly to the Contractor TOTALS $415 ,000 $ named herei issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES b Change.Order the Owner or ontractor under this Contract: Y $4:15,'000 AIA Document G702/CMa"+-1992.Copyright,0 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 resultin severe civil and criminal penalties;and viilbho.prosocided:to the maximum extent possible under the law.This document was created at 11;25:14 MDTon O8t19/2008 under the terms of license number 26001 Issued by the American Institute of Architects,and is not for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. == - iv U ocument 7O2ICi aTM = 1992 Application and Certificate-for Payment Construction Manager-Adviser Edition • TO OWNER: ,, 9 ,. PROJECT: APPLICATION NO:7 Distribution to:, City of Carmel / ; t Performing Arts Ctr CRC " Carmel IT PERIOD TO: December 1,2008 OWNER ❑ One Civic Square 'r'' �C' \R ' Carmel IN 46032 /��j' ti • • CONSTRUCTION MANAGER ,❑ FROM C Q�G CONSTRUCTION MANAGER: CONTRACT DATE: December 30,2008 ARCHITECT ❑ Bybee Stone Co I nc Shiel Sexton 6293 N Matthews Dr. PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville"IN 47429 • VIA ARCHITECT: FIELD ❑ CSO Architects Inc • ❑ CONTRACT FOR: Performing'' 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 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 2, 850,000 payment shown herein is now due. 2.Net change by Change Orders $ 415 ,000 CONT CTOR: 3.CONTRACT SUM TO DATE(Line 1±2) 5 3 ,265 ,000 By: �.2 Date:12/18/0 8 4.TOTAL &STORED TO DATE(Column G on G703) $ 1 , 3 2 5 ,9 8 0, State of: I n d i na 5.RETAINAGE: County of: Monroe a. 10 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 132, 598 me this 18 ay of Dec•gigh4 b. %of Stored Material Notary Public 4 I L (Column F on G703) $ My Commission-e c�, Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 132,598 CERTIFICATE FOR PAYMENT C.,, 6,TOTAL EARNED LESS RETAINAGE $ 1 , 19 3,3$2 In accordance with the Contract Documents;based on on-site observations and the data comprising this application,•the.Construction Manager and,Architect-certify to the Owner that to the best of their (Line.4 LessLine 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 $ 1 , 140,408 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 5 52 ,974 _ AMOUNT CERTIFIED $ 5 a%'__LA_ 9.BALANCE TO FINISH,INCLUDING RETAINAGE �LiDG' (Attach explanation if amount certified differs from'the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified) . (Line 3 less Line 6) $ 2,0 71 ,618 0.0 CONSTRUCTION MANAGER: By: 3-"L i--- Date: j2/v2(eg CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: j t•Total changes approved in previous months by Owner $ 415 ,000,$ M � " @a . Total approved this Month $ $ / This Certi .;: 'IS not ne otla.le. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 415,000$ named, Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change"Order $. 415 ,000 the 0 or Contractor under this Contract. 14 . AIA'Document G7021CMarM—1992.Copyright®1992 by The American.institute of Architects.All rights reserved.WARNING:This AlAe Document is protected by U.S.Copyright Law and International Trestles. Unauthorized reproduction or distribution of this Ale Document,or any portion of It,may restrain severe civil and criminal penalties,and will bo prosecuted to the maximum extent possible under the law.This document was created at 1 1:25:14 MDTon 08(1920.08 under the terms of license number 26001 Issued by the American Institute of Architects,and Is not for resale.This document is licensed for one use only and may not be reproduced oriorto its completion. mw ii e • ao (((��� \1 Document s_.i7®2/CMa — 1992 Application and Certificate fsk. yment Construction Manager-Adviser Edition TO OWNER: } P JECT: APPLICATION NO: 6 Distribution to: City of Carmel ;„.,),, Per rmtng Arts Ctr CRC xr e..% ''---• Carmel Ca el IN PERIOD TO: November I,2008 OWNER 0. One is Square �S: e,. CONSTRUCTION MANAGER 0 CarmelIN 46032 ✓ , FROM CONTRACTOR: IA'NSTRUCTION MANAGER: CONTRACT DATE: November 30,2008 ARCHITECT 0 Bybee Stone Co Inc Shiel Sexton 6293 N_Matthews Dr -.:.-. PROJECT NOS:2695-2025 CONTRACTOR Ellettsville IN 47429 t`,{ ViA ARCHITECT: FIELD C CSO Architects Inc, • CONTRACT.FOR: PerformingArt E CONTRACTOR'S APPLICATION.FOR PAYMENT The undersigned Contractorcertifies 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 Doctunents,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 1.ORIGINAL CONTRACT SUM 52,850 ,000 payment shown herein is now due. 2.Net change by Change Orders $ 415 ,000 CONT CTOR: } 3.CONTRACT SUM TO DATE(Line 1 f 2) 53 ,265 ,000 By: �. L' ia-� Date: 1 k ( c !CA" 4,TOTAL COMPLETED&STORED TO DATE(Column G on 0703) $1 , 2 6 7 , 12 0 State of: f21/ 5.RETAINAGE: County of: The y a. 10 %of Completed Work Subscribed and sworn to before a�Q(^2 (Column D+E on G703) $ 126 ,712. me this f g y of t -72 u—zL U b. %of Stored Material Notary Public. !''` 4 a) / m � "' �(O (Column F on.G703) $ My Comissio r p Total Retainage(Lines 5a+5b or Total in Column I o€0703).. $ 126 , 712 .00 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based.on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 1 , 140 ,408 .00 this'application,the.Canstruction:Manager and Architect certify to the Owner that to the best of their (Line 4Less 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 $ 800,6 4 6 • 3 0 accordance with the'Contract'Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CE FIED. 7 8,CURRENT PAYMENT DUE 1 5 3 39,761 . --,0 MOUNT CERTIFIED $ 3391.7‘t 9.BALANCE TO FINISH,INCLUDING RETAINAGE ,(Attach explanation if amount certified differs from the amount applied.Initial all f figures.on this Application and an_the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less.Line 6) $ 2, 12 4,5 9 2 .00 CONSTRU 0 MANAGER: IlY' 4 . .- ,, Date: 1 2. • O, M M CHANGE ORDER SUARY ADDITIONS ., DEDUCTIONS ' ARCHITECT: .,--- ' i Total changes approved in previous months,by Owner $41.5 ,000 $ ' g PP P Y By: t,-J` � "�J"`�.'. Date: 4)(4 /�` Total.approved this Month $ $ This Ce 'c 'r n-.• Sable. T e-AMOUNT CERTIFIED is payable..nly'to the Contractor TOTALS $415 ,0005 name_/erein,..Y suance, payment and acceptance of payment arc without prejudice,to any rights of NET CHANGES by Change.Order $415 ,0 0 0 the 5 4 e,:-'Contractor under this Contract. AIA Document G702/CMah-1992.Copyright ®1992 by The American institute of Architects,Alt rights reserved,WARNING:This AIA°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 romilt in severe civil and Criminal pennitiearand will bo'prosecuted to`the maxtinuin extent possible under Um law:This document was created of t 1:25:14 MDTan 08/19(2006 under the terms of ltcense number 26001 Issued by the American Institute cif Architects,and is not for resale.This document is licensed for one time use only and may not be reproduced prior to Its completion. �`I .ts f TM Document 7 2/C a — 1992. Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION.NO:.5 Distribution to: City of Carmel Performing Arts Ctr CRC Carmel TN PERIOD T0: October 1,2008 OWNER ❑ • One Civic Square Cannel IN 46032 CONSTRUCTION MANAGER ❑ • FROM CONTRACTOR: VIA CONSTRUCTION:MANAGER: CONTRACT DATE: October 31,2008 ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton 6293 N Matthews Dr PROJECT NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSO Architects Inc CONTRACT FOR: Performing Art 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 6703,is attached. 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 1.ORIGINAL CONTRACT-SUM 5 2 , 850 ,00 0 payment shown herein is now due. 2.Net change by Change Orders 5 415,000 CONTRACTOR: ,. 3,CONTRACT SUM TO DATE(Line 1±2) 5 "I , 7 6 c O 0 0 By: ' 11�_ ",A s_ _ Date: 10/17/08 4.TOTAL.COMPLETED&STORED TO DATE(Column G on G703) 5 8891, 607 State of _/ 5.RETAINAGE: County of. a. %of Completed Work Subscribed p sweat to befC 'v" (Column D+Eon 0703) $ 88 , 960 . 70 me this of CC/ ��la b. %of Stored Material Notary Publi • (Column F on G703) S. - My Commis ' n piresi r-- Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ 8 8,.960. 70 CERTIFICATE FOR PAYMENT ' 800, 646.3 0 646.30 In accordance with the Contract Documents, based on on-site observations d the data comprising 6.TOTAL EARNED LESS RETAINAGE $ _ this raid s application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line S Total) knowledge,information and belief the Work has progressed as-indicated,the,quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 533 , 814. 30 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 , $ 2.6 6 ,8 3 2. 0 0, AMOUNT CERTIFIED $ 2.(0(a 6 S3 L v 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation-if amount certified dyers from.the amount applied.lnitial.all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 2,464, 353 . 70 CONSTRUCT •■ M,NAGER: _ Date: 0 '2 ?, By: ► 1� CHANGE ORDER.SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: ' r, Total changes approved'in previous months'Uy Owner $ 415 ,00C $ By: 4 1I,t � i--~"' Date: I try ' 'J U Total approved this Month $ $ This Certificate is$tot negotiable. The AMOUNT CERTIFIED is payable on y to the Contractor TOTALS ^$ 415,000 named herein. Issuance, payment,and acceptance of payment are without prejudice to any rights,of NET CHANGES by Change Order $ 415 ,000 the Owner or Contractor under this Contract. AIA Document G702/CMa'4-1992.Copyright 0 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA°7 Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Alit'Document,or any portion of it,may result In severe civil and criminal ponaltlss1 and,will be prosecuted to the maximum extent pouxlbta:under the Jaw.This document was created art 1:25:11 MUTon,09119/2008 under the terms of license number 26001 Issued by the American Institute of Architects,end Is-not for resale.This document is licensed for one time use only and may not be m =........!. ii. a , Document G7®2/c a ® 1992 • Application and Certificate for Payment Construction'Manager-Adviser Edition' TO OWNER: PROJECT: APPLICATION NO: 4 ' Distribution to: City of Carmel Performing Arts Ctr CRC Carmet.IlV PERIOD TO: September I,2 OWNER ❑ One Civic Square P 008 Carmel N 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGE �\c,;5 CONTRACT DATE: September 30,2008 ARCHITECT ❑ • Bybee Stone Co Inc Shiel Sexton ,- 6293 N Matthews Dr , • a 7 .PROJECT.NOS:2695-2025 CONTRACTOR ❑ Ellettsville IN 47429 :.% VIA ARCHITECT: \'- ..<,.? FIELD ❑ CSC)Architects Inc - CONTRACT FOR: Performing Art ,. ❑ • CONTRACTOR'S APPLICATION FOR PAYMENT 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 far Work for which previous Continuation Sheet,AIA Document G 703,is attached' Certificates for Payment were issued and payments.received from the Owner, and that current 1.ORIGINAL CONTRACT'SUM $ 2 ,850, 0.00 payment shown herein is now:due. 2.Net change-by Change Orders $ 415 , 0'00 CONT-,CT•R:; 1 T , Q-0 3,CONTRACT SUM TO DATE(Line I t 2) $ 3, 265,000 By: , . t Date: l� 4.TOTAL COMPLETED&STORED TO DATE(Column 0 on 0703) $ 5.93 , 127 State oft '.J *a_Act... 1 5.RETAINAGE; County of: la,ts){;L.., a. 10%of Completed Work Subscribed and sworn-to before (Column D+Eon G703) ,$ 59, 312-.7 0 me this I 3 „day of o t . C)O rd. b. '%of Stored Material Notary Pub ' • (Column,F on 0703) $ My Com"mi ton expire !`^' / Total Retainage(Lines 5a+5b or Total in Column Lof G703).. $ 5-9 ,.312 .70 CERTIFICATE FOR'PAYM T In accordance with the Contract Documents, based on on-site-observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 53 3,8 1.4. 30 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 $ 427 .'4 34 .00 accordance With the Contract Documents,and the Contractor is•entitled to payment of the AMOUNT (Line 6.from prior Certificate) CE TIFIED. a 8.CURRENT PAYMENT DUE $ 10 6 , 3'8 0 .t0 CUNT CERTIFIED; $ (9`5.C3 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if a,nourit certified differs from the amount applied.Initial all figures on this v Application and On the Continuation Sheet that are changed to conform with the amount certified) l�-- (Line 3 less Line 6) $.2,7 3.1 , 18 5.7 0 CONSTRUCT • MANAGER: 7 By: - '�� Date: .2._ •6 CHANGE ORDER SUMMARY ADDITIONS: ' DEDUCTIONS ARCHITECT: Total changes approvedin previous months.by Owner SI 15 ,000 $ By:, �_� Date: I r t Og Total approved this Month $4 1 5 ,0 00 $ This Certificate'•s not net. table. The AMOUNT CERTIFIED is payable.onl to the Contractor TOTALS $ $ named herein ssuance .ayment.and acceptance of payment are withotit prejudice to any rights-of NET CHANGES.by-Change-Order $115 . 000 the Owner or Contra T sr under this Contract. AlA Document G7021CMa T"—1992.Copyright 42 1992 by The American Instltute'of Architects.All rights reserved.WARNING:This AlA"Document ls,protocted by U.S.Copyright Law and International Treaties. . 'Unauthorized robroduction or.distrlbutioh of this AIA©Document,or any portion of it-may result iii severe civil and crlminal.penaltios,and valll'ha,pmsecuted to the mmdmurn extent possible under the levy.This document was created at 11:25:14 MDTon 08/19/2008 under the.lerms of llcense number 26001 Issued by the-American Institute of Architects,and Is notfor resale;This document is licensed for one time use only and maynot be reproduced prior to its completion. TM < ;� Document G 7O2IC R r i a — 1 992 Application and Certificate for Payment Construction Manager Adviser Edition TO OWNER: PROJECT: APPLICATION NO:3 Distribution to: City tyC Performing�f Carmel ,Arts Cur One Civic Square •W PERIOD TO:August 1,2008 OWNER ❑ Cannel IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: August 31 ,.2008 ARCHITECT ❑ Bybee Stone Co Inc Shiel Sexton 6293 N Matthews Dr .PROJECT NOS:2695-2025 CONTRACTOR 0 Ellettsville IN 47429 VIA ARCHITECT: FIELD ❑ CSO.Arcbitects Inc CONTRACT FOR:Performing Art 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,at shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the ContinuationSheet,.AIA Document G703,is attached. 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 I.ORIGINAL CONTRACT SUM $ 2,8 5 0 ,0 0 0 payment shown herein is now due. . 2.Net change by Change.Orders; $ CONT-.CTOR: 3,CONTRACT SUM TO DATE(Line L 2) 5 2 ,8 5.0, 00 0 By: ds Date: 8 19/08 4.TOTAL COMPLETED:&STORED TO DATE.(Column G on G703) $ 4 7 4,9 2 7. State of 7 cl-i o t;''.-'•' 5,RETAINAGE: County of: E� ,yL, _ L MYERS a. 10%of Completed Work Subscribed and swot to before '?Or`:I.t I UBUC STATE F INDIANA (Column D t Eon 0703) $ 47,,4 9 3 me this 19 r/ o f Aug O 8 MEN b. %of Stored Material Notary Public: .i -ta�ti.e U ,� , ly aiY CON MISSION EXP.AUC.25,20 ' (Column F on 0703) $ My Commissio t expires: 8/25/08 Total Retainage(Lines-5a+5b or Total in Column I of 0703).. $ 4 7 ,4 9 3 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on.on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE - $ . 427 ,434 this application,the Construction Manager and Architect certify to-the Owner Mat to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality oldie Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT 5 3.0 2.,960 accordance with the Contract Documents,and the Contractor is entitled to payment:of the AMOUNT (Line 6 from prior Certificate) t.. ERTIFJED. J(,� t,� 8.CURRENT-PAYMENT DUE !$ 124,,474S-4 AMOUNT CERTIFIED' $ I Z "1 q ' ` 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs jront.the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified) (Line 3 less Line 6) $ 2,4 2.2 ,5 6 6 CONSTRUCT NAGER: ` By: Date: glzg oa CHANGE ORDER SUMMARY ADDITIONS ` DEDUCTIONS ARCHITECT: (��p(1f((( ,�/[� Total changes approved in previous months by Owner $ $ By: Date: z-( `y0 CJ Total approved this Month $ • .$ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ • $ named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANOES by Change Order. $ the Owner or Contractor under this Contract. . t., ALA document G702iCMai"—1992.Copyright 0 1992 by The American Institute of Architects.All rights reserved,WARNING:.. his.AlA"Document Is protected by U.S.Copyright Law and Intertrntinnat T- - Unauthortzed reproduction nrdistribution of this Ate document;or any portion of tt;may resutt>in severe•civil and criminal penalties,and will be propecutnrt+>,t.�- document was created at 11:25:14 bfDTon 08!1912008 under the terms of license number.26001 issued by the American Institute of errt't,-, - -- reproduced prior to Its completion. • tog = cu '021992 . L71.117 Application and Certificate for Payment „, •TO OWNER: PROJECT: / Fy �`� `. APPLICATION NO:2 Distribution to: City of:Carmel Reg Performing Arts Ctr ,•,/ l� /PERIOD TO:Jul 31,2008 Carmel Redevelopment Corn Carmel IN J •ti. July OWNER ❑ One Civic Square a ' Carmel IN 46032 .,; `� j,:� CONTRACT FOR: Reg Performing Art ARCHITECT ❑ FROM CONTRACTOR: ViA ARCHITECT: / CONTRACT DATE: November 30,2007 CONTRACTOR ❑ Bybee Stone Co Inc CSO Architects Inc y P 0 Box 968 PROJECT NOS: 2695-2025 Bloomington IN 47402 J -.41! FIELD ❑ - OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet,AIA Document 0703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 2, 8 5 0,00 0 that current payment shown herein is now due. 2.Net change by Change Orders $ CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1±2) $ 2 , 850,000 By: Date: 7-19-08 4.TOTAL COMPLETED•&STORED TO DATE(Column G on G703) $ 336 , 622 • Suite of: Indiana 5.RETAINAGE: County of: Owen a. %of Completed Work Subscribed and sworn to before (Column D+Eon G703) 5 33,662 me this 19 da of July, 2 0 0 ^ h. %of Stored Material �t ,./i (ColumnF on G703) S Notary.Public: `�•d71 • My Commission expires:8—2 5—0 8 Total Retainage(Lines 5a r 5b or Total in Column I of G703) $ 33 , 662 6.TOTAL EARNED LESS RETAINAGE $ 302 , 960 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 Less Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 188,660 this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, information,and belief the Work has progressed as indicated, the quality of the, Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of U e 8.CURRENT PAYMENT DUE $ 1 14 , 30 0 AviQUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ 11113t20—'-'' (Line 3 less Line 6) $ 2, 547, 040 (Attach explanation if arnountcertified differs from the amount applied.Initial all fgures on this Application and,.'' . t!,Continuation Sheet that are changed to conform with the animal certified.) , r . CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: . t,i} • i ' — -°' Total changes approved in previous months by Owner$ $ By: V ' ` ,,t.-* Date: 3 i Total approved this Month • $ $ This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to he Contractor TOTALS S $ named herein.Issuance,payment and acceptance of payment are without prejudice to any rights of S the Owner,or Contractor under this Contract NET CHANGES by Change Order AIA Document G702T'—1992.Copyright 0 1953,'1963,1965,1971,.1978,1983 and 199214 The American institute of Architects.All r(phts reserved.WARNING:Thta AMA0 Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAC Document,or any portion of it,may result In severe civil and criminal ponaltias,.and will be prosecuted to the maximum extant possible under the,law:This document was created at 09;50:20 MDTon 0711713005 under the terms of license number 26001 issued by the American institute of Architects,and is not for resale.This document is licensed for one time use only and may not be reproduced prior to its completion. Draft Alternate Clay Tile Roofing (Horning Roofing) Up Through January 2010 Partial Contract Amounts through application 8 Completed and Stored to date $ 134,000.00 Retention held(based on 10%retention) $ 13,400.00 Paid to date $ 120,600.00 Paid by Carmel Theater Development Company $ 120,600.00 • 4.4914% Document G7O210 w/ a ° 1992. JAN 2120'10 Application and'Certificate for•Payment Construction Manager-Adviser Edition By- TO OWNER: pvPROJECT: , .i'ee/ '74 ' APPLICATION NO: g Distribution to: Carmle/� �%fix �g ;or) -�(��frn PERIOD TO: /-45--/v OWNER ❑ 644'6fel e„ "e.' irk CP' CONSTRUCTION MANAGER ❑ ca.Vhne/, t Al ybo3z �Drh i CONTRACTOR: a�ih VIA CONSTRUCTION MANAGER: PROJEC CT NOS: / CONTRACTOR ❑ dbe Salo/0A./ .2(o g0„a7LblerP-isle-i=rgPhee., VIA ARCHITECT: FIELD ❑ 7,r-)41A 6-, A1 li/(. 2 IF es 6 ❑ CO RACT FOR: 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. Certificates for ayment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $4.3 blo,iol.66 payment show erein is ow due. 2.Net change by Change Orders $ / .136 CONTRACT 3.CONTRACT SUM TO DATE(Line I ±2) $/ ZQ.6O By: 1L� Date: /—/.--I C.) 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $'7 93 Qdo.OO State of. ZI�C/iet.n 6., 5.RETAINAGE: County of:oar/so() a. f6 %of Completed Work Subscribed and sworn to before (Column D+E on 0703) $ 79540.66 me this /5 day of jGc4c rc 2 D/b b. 919 of Stored Material Notary Public: (Column F on 0703) $ 6. DO My Commission expires: d a-e 2-// Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ -7q soo. vd CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based o.n on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $7/J``,5_06. La 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 $ 6,75-b&).•6o 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 $ </.6,5113•Q.0 AMOUNT CERTIFIED $ IA Sad. 00 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach.explanation if amount certified.differs front the amount applied.Initial all figures on this Application old on-the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ /, 6101 qP0.46 CONSTRUC ON AN ••ER: By: ' Date: i.2,f-LO(0 ADDITIONS DEDUCTIONS R ii't"lr �'� CHANGE ORDER SUMMARY ARCHITE' ��t� E� � Total changes approved in previous months by Owner $t f/q yQO t� $"/y3Q.Qb By: rC4 . • Date: O .0-f-, QOiO Total approved this Month $. $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS ry/lj 05.40 $ /Y30-06 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ �/7, q7.-og the Owner.or Contractor under this Contract. CAUTION:You should.sign an original AIA'Cbntract Document;:on which this text appears in RED.An originat:assures that changes will not be obscured:, AIA Document G7021CMarM—1992.Copyright ©1992 by The American Institute of Architects.Ail rights reserved.WARNING:This Aie Document is protected by U.S.:Copyright Law and International Treaties. Unauthorized reproduction,or,distribution of this AIAe Document„or any,portion of it,may result,in severe civil and criminal penalties;and will be prosecuted to the maximum extent possible under.tho,mw.. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AlA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. - CONTINUATION SHEET AIA DOCUMENT G703 Page 1 of 1 - Application No: II- Application Date: 12/18/2009 JOB NAME CARMEL-R PAC CONSTRUCTION . Period To: 01/01/2010 HORNING JOB# 8-2408 Architect's Project No: A B C D E F G H I Work Completed Materials Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to,Date (G/C) Item# Description of Work Scheduled Value (D+E) This Period (Not in 0 or E) (D+E+F) 1 Roofing Labor $107,140.00 $47,430.00 $47,430.00 $59,710.00. $4,743.00 2 Roofing Material $166,980:00 $166,980.00 $166,980.00. $0.00 $16,698.00 3 Nailbase Material $105,300.00 $105,300.00 $105,300.00 $0.00 $10,530.00 4 Nailbase:Labor $38,1.80.00 $34,540.00 $34,540:00 $3,640.00 $3,454.00 5 Sheet Metal Labor $57,350.00 $20,070.00 $10,000.00 $30,070.00 $27,280.00 $3,007.00 6 Sheet Metal Material $146,390.00 '$90,000.00 $10,000.00 $100,000.00 $46,390.00 $10,000:00 7 Tile Dome Material .$112,000.00. $112,000.00 $112,000.00 $0.00 $11,200.00 8 Tile Dome Labor $39,800.00 $0.00 $0.00 $39,800.00 $0.00 9 Tile Balance Material $168,000.00 $41,000.00 $41,000.00 $127,000:00 $4,100.00. 10 Tile Balance'Labor $59,700.00 $0.00 _ $0.00 $59,700.00 $0:00 11 Paver:Material $56;700.00 $0:00 $0.00 $56,700.00 $0.00 12 Paver Labor $18;900.00 $0.00 $0.00 $18,900.00 $0.00 13 Bond $15;010.00 $15,010.00 $15;010.00 $0.00 $1,501.00 14 Subcontractor $250,000.00 $2,100.00 $2;100.00 , $247;900.00 $210:00 15 Submittals $5,000.00 $5,000.00 $5,000.00 $0.00 $500.00 16 Safety/Start-up $7;500:00 $3,000.00 _ $3,000:00 $4,500.00 $300.00 17 Clean-up/Closeout $7,500.00 $0.00 $0.00 $7,500.00 $0.00 18 Change Order#1 ($1;430.00) ($1.;430.00) ($1,430.00) $0.00 ($143.00) 19 Change Order#2 $419,400.00 ; $109,000.00 .$25,000.00. $134,000.00 $285,400:00 $13;400.00 20 Allowance $5,000.00 $0.00 $0.00 $5,000.00 $0:00 $1,784,420.00 _ $750,000:00 $45,000.00 $0:00 $795,000.00 $989,420.00 $79,500.00 HORNING ROOFING & SHEET METAL CO, LLC AFFIDAVIT AND WAIVER OF LIEN INVOICE# 8 STATE:INDIANA FINAL PARTIAL PAYMENT TO FOLLOW COUNTY OF: MARION _RON PHELPS II_Being duly sworn that he is the President of_Horning Roofing&Sheet Metal Company,LLC contract with Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: As Per Contract for a project known as as: Carmel Regional Performing Arts Center located in: Carmel and owned by and does hereby further state • on behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) That there.is due from the contractor the sum of: DOLLARS p: S a 6, 563- 00 receipt of which is hereby acknowledged or the payment of which has been promised as the sole consideration of the 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 there is due from the contractor the sum of: DOLLARS: receipt of which is hereby acknowledged or the payment of which has been promised as the sole consideration of the affidavit and Final Waiver of Lien which is 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 or material or both,furnished by the undersigned thereto,subject to limitations.or conditions'expressed herein,in any,and further certified that no other party has any claim or right to lien on account of any work performed or material fur ished:to undersigned for said project and within the scope of this affidavit and wavier. _ � szHorning R ofn &She et Metal Co.,LLC By: Vr g President Ron Phelps II WITNESS MY HAND•AND NOTARIAL SEAL THIS: /—(9"- 40/0 MY COMMISSION EXPIRES:02=02-11 COUNTY OF RESIDENCE: Morgan �� � NOTARY Kevin L.Moore • IA Document G7021CMa 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER:Cativi 6� PROJECT: fbc al 2 f"I APPLICATION NO: Distribution to: Com�� `1"."' �Gn�� t n 9J PERIOD TO: ZS—Al-09 OWNER ❑❑ Oil nu , 0 � /pr,,�Q) CONSTRUCTION MANAGER ells-mat � Pt V.��� T�-�r FROM CONTRACTOR. VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ I'R5 Y ?0 1(240n, _ ,,hhh �'l%�1 8i2� ti PROJECT NOS:626 9 I CONTRACTOR ❑ '/D y�' VIA ARCHITECT: FIELD ❑ i 0 sj`,11s> U /� CONTRACT •••, CSO ❑ 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 amountsve been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment wet.- 'ss • and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $/8,66,0,&0.09 payment shown herein is nots•■e 2.Net change by Change Orders $ 7 * t.0:CONTRACT'°: • Q 3,CONTRACT SUM TO DATE(Line 1 t 2) $i ,i i'•may: ' le 4./ , Date: ��"11 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ .• 9 .••State of:•' s II S 5.RETAINAGE: County of:Mt5 a. /Q %of Completed Work Subscribed and sworn to I efore ^ (Column D+Eon G703) $ 2t a 00 me this id day of ).'6. , .;�i ` ji)9 b. �Yo of Stored Material Notary Public: i ey,,,, Q (Column F on G703) $ 0 0 My Commission expires: 0, -02-i/ Total Retainage(Lines 5a+513 or Total in Column I of 0703).. $ 9S,cro Q9 CERTIFICATE FOR PAYMENT n,,./ In accordance with the Contract Documents,based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE SO931�..CO this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) (� ,/ n knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $616 p ry o 09 accordance,with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. ,�✓ /y� 8.CURRENT PAYMENT DUE ��` l[i� A j' w �.� �If AMOUNT CERTIFIED $ ��}} 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial ml figures on this Application and or -ntinuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $Ij /09 •5/„7,p- GYM CONSTRU 6 . . AGER: By: /Edge' ,,.:,,A0.9' Date: 3YL 26169 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC t CT: tt , 7 _ ( w Total changes approved in previous months by Owner/�/�/,�,,, $ % o Date: /I, 0 UCJ b pP P y `7'J 9 7U;•tQ) $�7 .0 By: Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable onl to the Contractor TOTALS• t 9 ya9,co $/Y •a' named herein.Issuance, payment and.acceptance of payment are without prejudice to any rights of / the Owner or Contractor under this Contract. NET CHANGES by Change Order $ CAUTION:'You should sigri:aii original AIA'Contract,Document;on Arithich this.text,appears.in'RED.An original assures that_changes•will not be:obscured.' AIA Document G7021CMauf—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law arid International Treaties. Unauthorized reproduction oi_distribution:of this'AfAID Document,or.any portion 61 it,may result in severe civil,end criminal`penalties,and.witi be prosecuted to the`;maximuin 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. CONTINUATION SHEET AIA DOCUMENT G703 Page 1 of 1 -- Application No: 7 Application Date: 11/24/2009 JOB NAME CARMEL-R PAC CONSTRUCTION Period To: 12/01/2009 HORNING JOB # 8-2408 Architect's Project No: A B C D E F G H 1 Work Completed Materials Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to Date (G/C) Item# Description of Work Scheduled Value (D+E) This Period (Not in D or E) (D+E+F) 1 Roofing Labor $107,140.00 $47,430.00 $47,430.00 $59,710.00 $4,743:00 2 Roofing Material $166,980.00 $166,980.00 $166,980.00 $0.00 $16,698.00 _ 3 Nailbase Material $.105;300.00 $105,300.00 $105,300.00 $0.00 $10,530.00 4 .Nailbase labor $38,180.00 $30,540.00 $4,000.00 $34,540.00 $3;640.00 $3,454.00 5 Sheet Metal Labor $57,350.00 $11;470.00 $8,600.00 $20,070.00 $37,280.00 $2,007.00 6 Sheet Metal Material $146,390.00 $30,000.00 $60,000.00. $90,000.00 $56,390:00 $9,000.00 7 Tile Dome Material $112,000.00 $112,000.00 $112,000.00 $0.00 $11,200:00 8 Tile Dome Labor $39;800.00 $0.00 $0.00 $39,800.00 $0.00 9 Tile.Balance Material $168;000.00 $41,000.00 . $41,000:00 $127,000.00 $4,100:00 . 10 Tile Balance Labor $59,700.00 $0.00 $0.00 $59,700:00 $0.00 11 Paver Material $56,:700.00 $0.00 $0.00 $56,700.00 $0.00 12 Paver Labor $18,900.00 $0.00 $0.00 $18,900.00 $0:00 13 Bond $15,010:00 $15,010.00 $15,010.00 $0.00 $1,501.00 14 Subcontractor $250,000.00. $2,.100:00 $2,100.00. $247,900.00. $210:00 15 Submittals $5,000:00 $5,000.00 $5,000.00 $0.00_ $500.00 16 Safety/Start-up $7,500.00 $3,000.00 $3,000.00 $4,500.00 $300.00 17 Clean-up/Closeout $7,500.00 $0.00 $0.00 $7,500.00 $0:00. 18 Change Order#1 ($1,430.00) $0.00 ($1,430.00) ($1,430.00) $0.00 ($143.00) 19 Change•O•der#2 $419,400.00 $84,000:00 $25,000.00 $109,000.00 $310,400.00 $10,900.00 20 Allowance 15.,000.00 $0.00 $0.00 $5,000.00 $0.00. $1,784,420.00 $653,830.00 $96,170.00 $0.00 $750,000.00 $1,034,420.00 $75,000.00 lication:and:Cer..t ficate:::for Pa. .ment.Constructio :;Mann SPA ...:... . !� i? ..... . ...�.. . : . • ;.:r:::TO:OWNER:::da.': . ..,PROJECT:::- *; • �pCICATION,,NO::>..s., :::::;'.;.:;::;:<:: :::::':::':;.: ::.:.:,.;::;::''';::..':. ':.Dlstributian lo: :. •;:: t s ►- �; - .:`:OD Ta ": .: :. .: .:.; ::.'.:::•_.•• : : :.': :.,OWNER: 1.,: il: (,D; ... ��. CONSTRUCTION.MANAGER::C•l•..FROM:CON TRACTOR... • :,..'.: ... VIA CONSTR CTION:MANA t •NTRACT:DATE::'::.•••` •:.:.::;•': ARCHITECT ,.0 : ... : ..:. . {°01.11. f b.' j{1 t f . ,f s:• PROJECT NOS.' 1 •1 . ; CONTRACTOR C VIAf ARCHITECT: ;.::• CONTRACY.FOR ci: .: . . t .: .. . CaNTRIICTO.R:S:APPLiGA�"10.N••FD.R:PAYMi*NT':.:. '::' :.: . .t1n�[G,�,,,itcd:Cpntructor:c�rklliia:tlnli:ao:►hc best.of:the:C>oru.raiarit'y.knrawlcrigc,"lnfnrinati+,rta�r�J:::::',;':: • .:: ' : ' tuliel'thc:Wt?7a:'cavct'cda7y�t[liti:.A�[alicatiuln for,.I'avnt�ltl:lrut;hccn;cctm letcd in.accpr�l4x t;illi the>:.. ,'• ..........; Apl?Ilr tutn:;rn:rnutic:for ptynent,•as s[tuivit.tacluw;:in cnni)ectlo. .WilliL&Cun[sact,.:>::. :.•:'..••' • :•c .•.' . .• . .ntrito.:., t,nn?t:nt3 that a!['.anl.1un14:[uivc bci;n 41 :.yahc:'t't'tntlat_!tu tor,.,QC..f0 r... iich:hrcvipun.:..'.: ., t.trntuuIutLOI:Shct,Ally;D u..tirncnL G703...i.:4 ta..hral:' .. :..., '... .•• ,;:. . ..•.,..; ,.1 r. ;tract'':fife :&Urrunt... I v it�ur�f;iut ; p•:+nllYnt.F;isrtct wi'4Ct1::.l.rurn,.th4::.OWllp, , (,.�it I Ltitr- l r t o r. k I.. .. i QRIGiNAL C4N3RACT:SUM:' "'S :::• w(;k`;j!ayrncnt ltu.wr...(lct�ili •w du ..: C n :.. ...•-. •I:: NT C 0 : ':... 2.Nat than a b ha e,4rdars...,. . ,. � Y 9 � / . Q� (,fit) RA �' R, 3 CONTRACT SUM:TO.DATE ti.rnc I±2l.. .: t '',,,,,..1 f .,.. •,gyp'. r,t 1 4:TOTAL COMPLETED&STORED;TO DATE(Cr,lumn'G on,G"JU3.). . $ 3):(0Swt-ot: • lC'a k : .;•:',::>. .S RETAINAGE;. r r :. �pun�.:nt:.. :....'. !�� Jr,tt(..r411mp1ctGd 4lt>tl.. ..•. : ,.: :.. : Sukiscrtltcd and SKnrti t.c.rlici-orc,� '...,.. ...: ":::.:::..:.. . . . n n!r U3 ..,.. . . . .: .. :niM this' : ..''."dtlu of:` •'.G,' •a...: r ,........ . .i'a.ni.�trrrcd iV,ta►ctial. . ... .. ..., ''.;:' .....:.:.::..:.:....::''..:': Nu�•Y ........! - ... . . . .. •• .. "...... .. •. .. ... .�•:r..:,:... .,..`;,..." .(rlrl usstun CX IcCS; .� .....:,.{,.Cnlyntn.l..on .. ,... ,.. .. . . ... .. . 5r My C tr P e)2.....0. : T .. F PAY.•• • "Ct)hlL RetaitrtiKc(hlttCS•.rtil+`5b •vt'TOtpi ul:t:,-nlurtln.l •G1'Ca703},. ...:b ��7 t,�::'�::,;: .... ::':: %l:arwr. c .:with thL CC)it.rlict..l)ocumcnts;I ci d'r,n:c7n.sitt:obstructions anrl:tht;.ilFltrtcurnpn'tnf, . :,.rye 6.TOTAL EARNED.LESS•RETAINAGE '1'7.:wt•�: :tier;a{?Ililuttitm:',t c Construction Mitrtul;cr and:Architect•ecrtCl:y.tra:thc•Ovt'ncr ttiatta.the I7e4t:r,Ctheir i t ,[',y,l :•: . :`:....': ;:••.:-......::::'•... Icnowlas(l e.:inlir.r t uon and beiiert.he•Wirrk:ha>• ro+tcrted.ac ilulwalei,l.ttic.quality.of'tlte.We rk'i';.im'• ::':', (Ltr a,�.L+�s.I,tnc S. W 7. ... ;:,:': • 6 ., r r s P. b . ,[�V accordaur;G'with tlic.Contrt)ct'Docun Gsu. and iltc,Gontractar.is entit.led.In. u mcnt o1 tht AMOUNT •..7:L.-.. PREVIOUS GER7t�1CA TES.FOR PAYMENT..,„„_,„,...;..'.;.,.:�...-...;:;: . ::.. ... .. , .. .., .. ..:p'y .. ... :..::.....:....:•G t na►.�r..r c..,3ii tcatc .-....: .: . . ,. :.., :,'tLtnc t 7 .. Cl~R.t 11^.l R,[). .;• ... 8.CU RREN T:PAYM ENT DU E I, AM OUNT CERTIFIED,' , •. . •,...:-.. .;:, ..•:.. . ::'. •.... . tfturJ rrx?lrrurrtrt iraunrlul.r:e'>7r r•rti crfout.th :ur�irrt r a r , c t e'11 j r'*ua r s•.o 'tiris •': ;.:: : ... .; . 9. A.ANC .fO.FINISF,.INCLU SNG.BETA[NACE..•.. •. 9 0 Irc urrnn nr d o r t r J l r C r ua rior Sheet rt rt u rr c. 0- e i(1 a ron o Y i:i itlt the' amount•` 4.4.:::60....::.......'- . . . ;' .° ::r : ` . .:': ;: :° ; .. .: $..• = .,: ::<CONSTRU TI N MA r: v;;>. .' . . ;.:::.::.., , ;`:.', ... . .[Z .` DDI.I IONS.. ..DDEDLUCTIONf.,.. :;..:: C [iANGE C31ti)t [i SUMMARY.''. CFIiTE T:;°,;:: C•:. ::..::.:•Tuttll t:httngcr;aplu'uur:d in.previauc nulutll;;.by Owner• '$1/,//• M .I r :oat u Mn Lrltal ruvLtl tins lth:. g,... �.:.•r .:.•..... :'�� '''�' IR � .�•:.. ...... r„•.. .. .. ... ':.','.TtllS.:CCrtltlC:ttc.. _...ni11,.ncyr:rtitlt}t4,''rhe.:AMt;)[,1NT'C1 rR171”.1k:.13::.I,i:i[rt6'tll?lU't?nly la;tllC"C;49t1U'aCll]r'"•. .. 'named,hen:iu::E'nU4nce �a llcnr::nd.ae optdnc : it•,. n rnuttl::t[rc,:.witlok: tre udtCc:to ltn ri•hta of .-. :..s .the' 7wncr: r:C�ntract�r.under this Contract, ' : N B T C[I NI(1 L:h by Chan eardGr •..,°:.. . .... • .. . $:::. . [ • G;:::....:r:.,.. . .. :•::'.... :::•:...,.....,.:::...:..:••••••••:::......: .,... ° .. . :CAUTtON You tthoutd sign an original/Mk Contract Document,on:whtch this ttsnt appears to RED:An original assurer that changes wilt•not bo'obccu'rcd. • ' ...,_ ...,, AlA Document.G7021GItiar"'—'1092::Copyright 010t 2 by.The:American'ti atilulri of Archhects.All:rinhta reserved.'WARNING:'7hLgAJAm'Document la pratectcd by'U,S.:Copyrtght.Law and International Treaties, ~.•'' ' ..Unauthort:.ed roproductian.or distribution'of this AIA�`:Document,orany portion❑hlt,,mny result in severo.civitand crindnai penalties,and wilt.be prosecuted to thetnaxltnum extent paeaibte under the law. :.' Purchrteer.t Inc pertlilltud.to reproduce ten(10)copies'ot.tills.duuumont when.completed.,To report eopyA([ht.vielstluri.ai AIA Gents+rt,Oocumcrtts;.a-mntl.The'Am»ricnn:InstttUle:01 Archllecee.leuei counsel'.Cp aynehugata.efe. CONTINUATION SHEET AIA DOCUMENT G703 Page 1 of 1 - Application No: 20 Application Date: 10/27/2009 JOB NAME CARMEL-R PAC CONSTRUCTION Period To: 11/01/2009 HORNING JOB# 8-2408 Architect's Project No: A B C D E F G H Work Completed Materials Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to Date (G/C) Item# Description of Work Scheduled Value (D+E) This Period (Not in 0 or E) (D+E+F) 1 Roofing Labor $107,140.00 $47,430.00 $47,430.00 $59,710.00 $4,743.00 2 Roofing Material $166,980.00 $88,000.00 $78,980.00 $166,980.00 $0.00 $16,698.00 3 Nailbase Material $105,300.00 $105,300.00 $105,300.00 $0.00 $10,530.00 4 Nailbase Labor $38,180.00 $30,540.00 $30,540.00 $7,640.00 $3,054.00 III Sheet Metal Labor $57,350.00 $0.00 $11,470.00 11111.1111111 $11,470.00 $45,880.00 $1,147.00 6 EMEMEEME $146,390.00 $30,000.00 .11.111. $30,000.00 $116,390.00 $3,000.00 1111111111 Tile Dome Material $112,000.00 $41,000.00 $71,000.00 $112,000.00 $0.00 $11,200.00 8 Tile Dome Labor .. $0.00 N $0.00 $39,800.00 $0.00 9 Tile Balance Material $168 000.00 $41,000.00 11111.1.1111111111111111111 $41,000.00 $127,000.00 $4,100.00 10 Tile Balance Labor $59,700.00 $0.00 IIIIIIIIMHIINIIIIIIII $0.00 $59,700.00 $0.00 11 Paver Material $56,700.00 $0.00 IIIMMMIIIIEIE $0.00 $56,700.00 $0.00 Paver labor $18,900.00 $0,00 11111111111111 $0.00 $18,900.00 $0.00 INNEMIN Bond $15,010.00 $15,010.00 111111111111111111111111111111111 $15,010.00 $0.00 $1,501.00 14 Subcontractor $250,000.00 $2,100.00 1111.11.11.1111111111111111 $2,100.00 $247,900.00 $210.00 111110111111Submittals $5,000.00 $5,000.00 11111111111111.111111.111 $5,000,00 $0.00 $500.00 16 �'ratlt ' " $7,500.00 $3,000.00 $3,000.00 $4,500.00 $300.00 17 Clean-up/Closeout $7,500.00 $0.00 11.1111111111111111111111111 $0.00 $7,500.00 $0.00 18 Change Order#1 ($1,430.00) $0.001111111111111111111 $0.00 ($1,430.00 $0.00 19 Change Order#2 $419,400.00 $84,000.00 IIIIIIIIIIIIMOIIIIIIIIIIIIII $84,000.00 $335,400.00 $8,400.00 20 Allowance $5,000.00 $0.00 IIIIIIIIIIIII $0.00 $5,000.00 $0,00 IIIIIIIIIIMIIEMIEIIIIIMIMII IMIIMMIMINIIOIIIIIMIIIIIIIIIIIIIIII $1,784,420.00 $492,380.00 $161,450.00 $0.00 $653,830.00 $1,130,590.00 $65,383.00 .\94 7 11‘‘ TA Document G702/C M l ° 1992 r-. Application and Certificate for Payment Construction Manager-Adviser Edition _.�,� , �� TO OWNER: Cartrnel Bede talo e. - PROJECT:'�re 74. APPLICATION NO: 6- 1 •'-'� °'='' COWS fl - 'l't --t)\ f` ,� Distribution to: OY1e r�� uCt re, e�-+DnLt �r2�rvYt'rin� PERIOD TO: 9 00-Oq �ti?�� OWNER ❑ cP tcwe(.i Tifl Lilo 632. 1/4 Co CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: "� ARCHITECT ❑ lAo k3rv,Z oa�1Y■ 51 I1 Sf yC�0h PROJECT NOS: o7(y ! / CONTRACTOR ❑ k3ua E.vlierprUe CArk74)/tee_ 'TrndP(S 1Sk 11 t'e21$ VIA ARCHITECT:CSti ^'..I FIELD ❑ CONTRACT FOR: ❑ 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 shown is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for P ment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM S 3L & Lin 0o payment shown h ein is now due. 2.Net change by Change Orders $ Li/7,97O.66 CONTRACTO 3.CONTRACT SUM TO DATE(Line 1 +1) $/,7 't y2D,co By: nil, Date: l —�O—U 9' 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ V'9_2 app, ob State of: natzne. /�� ■ 5.RETAINAGE: County of:fat ri or? a. /0 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 6/9,a 3P:a� me this O day of eg 0e - 0.2 b. %of Stored Material Notary Public: ri, i��' (Column F on G703) $ 0. aet My Commission expires: o2-� -.2O f/ Total Retainage(Lines 5a"+5b or Total in Column I of G703)., $ ii/, 2. co CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $y�3 /1/2 . or) In accordance with the Contract Documents, based on on-site observations and the data comprising 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 s3 416I 7'-42.. be) accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. S.CURRENT PAYMENT DUE $ "J 7/400./QO. O d AMOUNT CERTIFIED $ X77 </QO. OO 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application td on the ours Sheet that are charged to conform with the amount certified.) (Line 3 less Line 6) $ /,31 1,27P 06 CONSTRUCT N A¢ By: :r. Date: i 0, 3 0./} I G} CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT i. � 1 , f., Total changes approved in previous months by Owner s1 if yD0,Ob$ I,L/3O. 66 By: �f I jJ i ;I Date: t ', 2,�l Total approved this Month $ $ This Certi 'care is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ named herein. Issuance,•.payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ i.i//7 170. 6-41, the Owner or Contractor under this Contract. J CAUTION::You-should.sign an original AIA Contract,Document,.on`which this text appears in•RE!).An original assures that changes will not be obscured. AIA,Document G702/CMa"A—1992.Copyright.©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe Document Is protected by,U.S.Copyright Law and international Treaties.- Unauthoiized reproduction or distribution of this;Ale Document,or any portion of it,may result in severe civil and criminal penaltles,.and will be prosecuted to the maximum.extent possible under the.lew. Purchasers are{iermittedto 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. CONTINUATION SHEET AIA DOCUMENT G703 Page 1 of 1 Application No: ,3"" Application Date: 09/29/2009 JOB NAME CARMEL-R PAC CONSTRUCTION Period To: 10/01/2009 HORNING.JOB# 8-2408 Architect's Project No: A B C D E F G H 1 Work Completed Materials Total Balance Retainage From Previous Presently Completed &. to Finish Application Stored Stored to Date (G/C) Item# Description of Work Scheduled Value (D+E) This Period (Not in D or E) (D+E+F) 1 Roofing Labor $107,140.00 $27',430:00 $20,000.00 $47,430.00. $59,710.00 .$4,743.00 2 Roofing Material $166,980.00 $22;000.00 $66,000.00 $88,000.00 $78,980.00 $8,800.00 3 Nailbase Material ,$105,300.00 $105,300.00 $105;300.00 $0:00 $10,530.00 4 Nailbase Labor $38,180.00 $30,540:00 $30,540.00 $7,640.00 $3,054.00 5 Sheet Metal Labor $57,350.00 $0.00 $0:00 $57,350.00 $0.00 6 Sheet Metal Material $146,390.00 $30,000.00 $30,000.00 $116,390:00 .$3,000.00 7 Tile Dome Material $112,000.00 $41,000.00 $41,000:00 $71,000.00 $4,100.00 8 Tile Dome Labor $39,800:00 $0.00 $0.00 $39,800.00 $0.00 9 Tile Balance Material $168,000:00 $41,000.00 $41,000:00 $127,000.00 $4,100:00 10 Tile Balance Labor $59;700.00' $0:00 $0.00 $59,700.00 $0.00 11 Paver Material $56,700.00 $0.00 $0.00 $56,700.00 $0.00 12 Paver Labor $18,900.00 $0.00 $0.00. $18,900:00 $0.00 13 Bond $15,010.00 $15,010.00 $15,010.00 $0.00 $1,501.00 14 Subcontractor $250,000.00 $2,100.00. $2,1.00.00 $247,900.00 $21'0.00 15 Submittals $5,000.00 $5,000.00 $5,000:00 $0:00. $500:00 16 Safety/Start-up $7,500.00 $3,000.00 $3,000.00 $4,500.00 $300.00 17 Clean-up/Closeout $7,500.00 $0.00 $0.00 $7,500.00 $0.00 18 Change Order#1 ($1,430.00) $0:00 $0.00 ($1,430.00) $0'.00 19 Change Order#2' $419,400.00 $84,000.00 $84,000.00 $335,400.00 $8,400.00 20 Allowance $5,000.00 $0.00 $0.00 $5,000.00 $0:00 $1,784,420.00 $406,380.00 $86,000.00' $0.00 $492,380.00 $1,292,040.00 $49,238.00 . . IA. °e•i��a A / Document G702/C'MaTM — 1992 Application and Certificate for Payment Construction h!.. pp y onstri error Manager-Adviser Edition hz,-. � , TO OWNER:Ccavnej`►�edea( l PROJECT: tel r_7 f} APPLICATION NO: °� d Distribution to: eDVIVA. �9-:IDI la i—Pre-brvrI ris� ►'- `ti Ore C,Yde S L&-m PERIOD T0: ol�S—d OWNER ❑ call let/Z� �.L4 2. (7:44;) CONSTRUCTION MANAGER ❑• FROM CONTRACTOR: rte,,, VIA CONSTRUCTION MANAGER:Pigi `�E. -I/• CONTRACT DATE: /4,,. - ... ``� l ARCHITECT ❑ k VtIO DOC;� 0 , PROJECT NOS: ,,., W' o 4b eh oisC..vGtrIP�ac� i CONTRACTOR ❑ T€t I, iv\ LI192f� VIA ARCHITECT: �O tr;' FIELD ❑ CONTRACT FOR: ❑ CONTRACTOR'S•APPLICATION FOR PAYMENT TI �j���� tifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. be `'S��/• Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. C . +,, counts have been paid by the Contractor for Work for which previous !� C: G IJ4t 4 issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM Si,3/g fro,'�S�1)66 p: tie. 2.Net change by Change Orders $ `1/7, 77O.D6 0 ' lV 3.CONTRACT.SUM TO DATE(Line 1 ±2) $47/S411/241,66 B �, Date: /p. A O 9 4.TOTAL COMPLETED&STORED TO DATE(Column G on 0703) $9,06 3$(0.?S S 5.RETAINAGE: C a. /d %of Completed Work / S • (Column D+Eon 0703) $ Alb 10 j�, n J"t9>l�e,/r�cberry� b: O .%of Stored Material Notary-ruum---- ---.• '" 4iL--.✓ 91"4"."'� (Column F on G703) $ O. 0 a My Commission expires: 9_ -e?0// Total Retainage(Lines 5a+5b or Total in Column I of G703). $. 2/21 ( •hO CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $3 this application,the Construction Manager.and Architect certify to the Owner that to the best of their (Line 4-Less Line 5 Total) /� knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT sv�t J, 7 1-/,.bb accordance with the Contract Documents,and the Contractor is entitled to payment of'the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE I$ 7„R,o 00- Chin AMOUNT CERTIFIED $ 7o?., eco. 66 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.initial alfrgures on this • Application a/d on the Continuation Street that are changed to conform with the amount certified.) (Line 3 less Line 6) $I,.�/T/ 71 Ds CONSTRUCTION MA AGER: By: !d,i U-- I 'jam/. Date: c i i•2.1,U-4 CHANGE ORDER SUMMARY . ADDITIONS DEDUCTIONS T ARCHITECT: `.\! p i Total changes approved in previous months by Owner $409).0 j 4 . �v By: `t" Date: °_l1° f Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ named herein. Issuance,•payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change,Order $ .//7 q o ez 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/CMaTa-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 distributlonof this Ale Document;or any portion of it,may result in,severe'ciiiil rind criminal penalties;and will be'prosecuted.to the,maximum'exterit'possibte'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. CONTINUATION SHEET AIA DOCUMENT G703 Page 1 of 1 Application No: 2Y Application Date: 08/24/2009 JOB NAME CARMEL-R:PAC CONSTRUCTION Period To: 09/01/2009 HORNING JOB# 8-2408 Architect's Project No: A B C D E F G H I Work Completed Materials- Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to Date (G/C) Item# Description of Work Scheduled Value ,(D+E) This Period (Not.in D or E) (D+E+F) ,.1 Roofing Labor $107,140.00 $27,430.00 $27,430.00 $79,710.00 $2,743.00 2 Roofing Material $166,980.00 $22,000.00 $22,000.00 $144,980.00 $2,200.00 3 Nailbase Material $105,300.00 $105,300.00 '$105,300.00 $0.00 $10,530.00 4 Nailbase Labor '$38,180.00 $30,540.00 $30,540.00 $7,640.00 $3,054.00 5 Sheet Metal Labor $57,350.00 $0.00 $0.00 $57,350,00 $0:00 6 Sheet Metal Material $146,390.00 $30,000.00 $30,000.00. $116,390.00 $3,000.00 7 Tile Dome Material '$112,000.00 $41,000.00 $41,000.00 $71,000.00. $4,100.00 8 Tile Dome Labor $39,800.00 $0.00 $0.00 $39,800.00, $0.00 9 Tile Balance Material $168,000.00 '$41,000.00 $41,000.0.0 $127,000.00 $4,100.00 10 Tile Balance Labor $59,700.00 $0.00 $0.00 $59,700.00 $0.00 11 Paver Material '$56,700.00 $0.00 $0.00 $56,700.00 $0.00 12 Paver'.Labor $18,900.00 $0.00 $0.00 $18,900.00, $0.00' 13 Bond $15,010.00 $15,010.00 $15,010.00 $0.00 $1,501.00 14 Subcontractor $250,000.00 $2,100.00 $2,100.00 $247,900.00 $210.00 15 Submittals $5,000.00 ' $5,000.00 $5,000.00 $0.00' $500.00 16 Safety/Start=up $7,500.00 $3,000.00 $3,000.00 $4,500.00 $300.00 17 Clean-up/Closeout $7,500.00 $0.00 $0.00 $7,500.00 $0.00 _ 18 Change Order#1 ($1,430.00) $0.00 $0.00 _ ($1,430.00)_ $0.00 19 Change Order#2 $419,400.00 $4,000.00 $80,000.00 $84,000.00. $335,400.00 $8,400.00 20 Allowance $5,000.00 $0.00 $0.00 $5,000.00 $0.00 $1,784,420.00 $326,380.00 $80,000.00 $0.00 $406,380.00 $1,378,040.00 $40,638.00 TM ftAIA _..../0V' �U IJ llet G7C=amI t:/�a ❑ 992 Application and Certificate for. Payment Construction Manager-Adviser Edition ,r.,, TO OWNER: l PROJECT: . Yce I '1 A APPLICATION NO: _ •` Distribution to: Vl� ��vi C.. s x, 10 `"` ;Qty nil() (r'i-5 �'ERIOD TO: -/5-fs. 0g ‹-% < ,, OWNER ❑ n�; ��YIQ l T-N b N4 b3Z � � `M :CONSTRUCT N MANAGER ❑ CA FROM�0 RACTORR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: <�;, v ARCHITECT ❑ '(V11 ns, KOLY9v-■ ‘rlL°1 \ £4101el PROJECT NOS: o .°9057 ,, �". 1 CONTRACTOR ❑ �'°' 1 rt f I VIA ARCHITECT: ` FIELD ❑ CNTACT FOR: 4 LI al1 est. \ ❑ 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 / Certificates'` �C rtificates for yment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ (p I& ayment shown I rein is w due. 2.Net change by Change Orders $ . / 6000NTRACT //� 3.,CONTRACT SUM TO DATE(Line I t 2) 1 /,to By: /917? Date: 6 (9-"d 4.TOTAL COMPLETED&STORED TO DATE(Column G on 0703) :',..R 4P S8-D.OD State of: - #'.4 5.RETAINAGE: County of: iytad.✓ a. /0 %of Completed Work Subscribed and sworn to before (Column D+Eon G703) $ 5 inc 21(0 this i q day of L w _ v b. %of Stored Material Notary Public: (Column F on G703) $ j}• 't� My Commission expires: ,2 ,. ,. a0// Total Rctainagc(Lines 5a+5b or Total in Column I of 0703). .$3. ,636r rt•60 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE q '7. 2,ob In accordance with the Contract Documents, based on on-site observations and the data comprising 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.LE SS PREVIOUS CERTIFICATES FOR PAYMENT �glek, /2. 65 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 $ 7, 2DO rio AMOUNT CERTIFIED $ 7 c)OO. 00 9.BALANCE TO FINISH,INCLUDING RETAINAGE • t t (Attach explanation if amount certified differs from the amount applied.Initial�all figures on this / �^ tP Application td on dt Continuation Sheet that are charted to conform with the amount certified.) (Line 3 less Line 6) $ L C� 7t7. 1 CONSTR CT ON '14 N : �} By: �� . Date: •�I1.Zd0/ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT' 1 1t try-ft A Total changes approved in previous months by Owner $y/q yea 1 4" b.6 By: r' 418 --'''— ' Date: 6, 'ZCI Total approved this Month $ $ This Certifica is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ $ named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ ' '/7 q7o, d the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on,which this text-appears in RED.An,orlgirial assures that changes twill hot be obscured. AIA Document G702/CMaTM—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.yt/ARNI&d This Ale Document is protected by U.S.Copyright taw and International Treaties. Unauthorized reproduction or distribution of lhis'AlA®Document,Or any portion of it,,may result in•severe civil'and criminal penalties,and.witl be prosecuted to iho'maximum extent possible under the law. Purchasers are permitted to reproduce len(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,coovriohttmala.ora. CONTINUATION SHEET AIA DOCUMENT"G703 Pagel of 1 Application No: 16 Application Date: 06/11/2009 JOB NAME CARMEL-R PAC CONSTRUCTION Period To: 06/15/2009 HORNING JOB# 8-2408 Architect's.Project No: A B C D E F G H I Work Completed Materials Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to Date (G/C) item# Description of Work Scheduled Value (D4-E) This Period (Not in D,or E) (D+E+F) 1 Roofing Labor $107,140.00 $21,430.00 -$6,000.00 $27,430.00 $79;710.00 $2,743.00 2 Roofin• Material $166,980.00 $22,000.00 $22,000.00 $144,980.00 $2,200.00 3 Nailbase Material $105,300:00 $105;300:00 $105,300.00 $0.00 $10,530.00 4 Nailbase Labor $38,180.00 $30,540.00. $30;540.00 $7,640.00 $3,054:00 5 Sheet Metal Labor $57,350.00 $0.00, $0:00, $57,350.00 $000 6 Sheet Metal Material, $146,390.00 $30,000.00 .$30,000.00 $116,390.00 $3,000.00 7 Tile Dome Material $112,000.00 '$41,000.00 '$41,000.00 $71,000.00, $4,100.00 8 Tile Dome Labor $39,800.00. $0.00. $0.00 $39,800.00 $0.00 9' Tile Balance Material $168,000.00 $41,000.00 $41,000.00 $127,000.00 $4,100.00. 10 Tile Balance Labor $59,700.00 $0.00 $0.00 $59,700.00 $0.00 11 Paver Material $56,700.00 $0.00 $0.00 $56,700.00 $0.00. 12 Paver Labor $18,900.00 $0.00 $0.00 .$18,900.00 $0.00 13 Bond $15,010.00 $15;010.00 $15;010:00 $0.00 .$1,501.00 14 Subcontractor $250,000.00. $2,100.00 $2,100.00 $247,900.00 $210.00 15 Submittals $5,000:00 $3,000.00 $2,000.00 $5,000.00 $0.00 $500.00 16 Safety/Start-up $7,500.00 $3,000:00 $3,000:00 $4,500.00 $300.00 17 Clean-up/Closeout '$7,500.00 $0:00 $0.00' .$7,500.00 $0.00 18 Change Order#1 ($1,430:00) $0:00 .$0:00 ($1,430.00) $0.00 19 Change Order#2 $419,400.00 $4,000.00 $4,000.00 $415,400.00 $400.00 20 Allowance. $5;000.00 $0.00 $0:00 $5,000.00 $0.00 $1,784,420.00' $318,380.00 $8,000.00 $0.00 $326,380.00 $1,458,040.00 $32,638.00 W.A. m, .. Docn cn a rit 7o2iC a 1992 r.ioae Application and Certificate for Payment Construction Manager-Adviser Edition <, : ) C ' ,� >( �� :� ``� ' Distribution to: TO OW R: PROJECT: APPLICATION NO: r\, °( t•1Y't(�I 11Prr °) (1J11'1fil+�h d easia tt � o�-m►flo� Axis PERIOD TO: (5-/S-„, , `� "" ' �// OWNER ❑ On civic aquas '�,,. -k. CO NSTRUCTION MANAGER ❑ ca 1, sit) `V6032 �� CONTRACT DATE: ! ARCHITECT ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: a) `�, lido I tjn itl °Y "Alf " �,. PROJECT NOS: a 9 > /I CONTRACTOR ❑ 'Z3 '� "�'.}%h 1, VIA ARCHITECT: Q ?� FIELD ❑ iarepoli%)so ' 6.218 0 CONTRACT FOR: 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-0703.meat.as shown is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Pay nt were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT-SUM $4 4,564 it. .00 payment shown he r is now due. 2.Net change.by Change Orders $ 4/7 9?. C) CONTRACTOR: 3.CONTRACT SUM TO DATE(Line 1 ±2) V 70 ..1 .dD By: i' _ ,,/ ' Date: `�'/� -6 4.TOTAL COMPLETED STORED TO DATE(Column G on G703) S' Q, State of:m-ti,ar 5.RETAINAGE: County of:, mart 4...), ,a, a. /O %of Completed Work // Subscribed and sworn to befo (Column D+Eon 0703) $Z/ yze, Ob me this a day of /et^//206y? b. go of Stored Material Notary Public: (Column F on 0703) $ , 06 My Commission expires:.0z—(j,Z—/1 Total Retainage(Lines 5a+5b or Total in Column I of 0703). $a/ O a 6 CERTIFICATE FOR PAYMENT " -�(61,5772/ In accordance with:the Contract Documents,based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE mC ,r this application,the Construction Manager and Architect certify to the Owner that to-the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work'has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT 9 7D6,jp accordance with the Contract Documents,and the Contractor-is entitled to payment of the AMOUNT (Line 6 from prior Certificate) J CERTIFIED. / / / 8.CURRENT PAYMENT DUE •$ eOl g tl0,d� AMOUNT CERTIFIED $ 27f��jj 3 6, do V 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation.if amount certified differs from the amount applied.Initial airfigQureess on this p� p� Application anion the.Continuation Sheer that are changed to'conform with the amount certified.) (Line 3 less Line 6) $ I i/9 711 /e • do CONSTRUC 'IN M ,r• J I By: i ;I l Date: --. a7. 2_o0I CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT "1.r L Total changes approved in previous-months by Owner $9/?rpp,66 j� yi3).w By: Date: "G • b Total approved this Month i g $ This Certifi to not negotiable. The AMOUNT CER LIMED-is payable-only to the Contractor TOTALS $ $ named h •in ssuance,,:payment and acceptance of-payment:are without prejudice to any rights of NET CHANGES by Change Order $ ,4//7 97Q^ 1)a the Ow er Contractor,under this Contract. CAUTION:.You should sign an original/MA Contract,D'ocument,on which this text appears in RED;An original assures that changes will not be obscured. A1A Document 0702VCMaTU—1992.Copyrlght'CD 1992 by The American Institute of:Architects.AU rights reserved.WARNING,This Ate Document is protected by U.S..Copyright Low and International Treaties. Unauthorized reproduction or distribution of this AIAR Document,or any portion of it;may.result in severe clvil'and erinilnal penalties,and will be prosecuted to the maximum extent possible under the law. " Purchasers are permitted to reproduce ten ti nt r nn;aG nt tnlrrinri imam,.,tip ,M a , T^--^-�---•- • ^ —' CONTINUATION SHEET AlA DOCUMENT G703 Page 1 of 1 Application No: 15 Application Date: 05/07/2009 JOB NAME CARMEL-R PAC CONSTRUCTION Period To: 05/15/2009 HORNING JOB# 8-2408 Architect's Project No: A B C D E F G H I Work Completed Materials Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to Date (G/C) item# Description of Work Scheduled Value (D+E This Period (Not in D or E) (D+E+F) • 1 Roofing Labor $107,140:00 $21,430.00 $21,430.00 $85,710.00 $2,143.00 2 Roofin. Material $166,980.00 $22,000.00 $22,000.00 $144,980.00 $2,200.00 3 Nailbase Material $105,300.00 $105,300.00 $105,300:00 $0.00 $10,530.00 4 Nailbase Labor $38,180.00 $7,600.00 $22,940.00 $30,540.00 $7,640.00 $3,054.00 5 Sheet Metal Labor $57,350.00 $0.00 $0.00 $57,350.00 $0.00 6 Sheet Metal Material $146,390.00 $30,000.00 $30,000.00 $116,390.00 $3,000.00 7 Tile Dome Material $112,000.00 $30,000.00 $11,000.00 $41,000.00 $71,000.00 $4,100.00 8 Tile Dome Labor $39,800.00 $0.00 $0.00 $39,800.00 $0.00 9 Tile Balance Material $168,000.00 $30,000.00 $11,000.00 $41,000.00 $127,000.00 $4,100.00 10 Tile Balance Labor $59,700:00 $0.00 $0.00 $59,700.00 $0.00 11 Paver Material $56,700.00 $0.00 $0.00 $56,700.00 $0.00 12 Paver Labor $18,900.00 $0.00 $0.00 $18,900.00 $0.00 13 Bond $15,010.00 $15,010.00 $15,010.00 $0.00 $1,501.00 14 Subcontractor $250,000.00 $0.00 $2,100.00 $2,100.00 $247,900.00 $210.00 15 Submittals $5,000.00 $2,000.00 $1,000.00 $3,000.00 $2,000.00 $300.00 16 Safety/Start-up $7,500.00 $3,000.00 $3,000.00 $4,500:00 $300.00 17 Clean-up/Closeout $7,500.00 $0.00 $0.00 $7,500.00 $0.00 18 Change Order#1 ($1,430.00) $0.00 $0.00 ($1,430.00) $0.00 19 Change Order#2 $419,400.00 $0.00 $4,000.00 $4,000.00 $415,400.00 $400.00 20 Allowance $5,000.00 $0.00 11111== $0.00 $5,000.00 $0.00 $1,784,420.00 $266,340.00 $52,040.00 $0.00 $318,380.00 $1,466,040.00 $31,838.00 • ;`���t�iJ ®,'V T1d tl i iA } i 1 1,.._.:,,,,... �j�0-....-.r lt I.�. '� ''A°pplicatiq i.and'.Cerfificafe for'-•Paymena Construction:Manager=Adviser Edition :::,.r;y a;� �,1 ��• •;TO O.WN R . . k,.. PROJECT: a r � APPLICATION NO: ./8� r. ' "'try // Distribution to: lTl :� rz „,, ClYliaa `-' '• y n.,�,, � ,���—p OWNER ❑ NU//"n��'�O (�,`' /1 f�� l _ ►G001.1-�L t(3.i.il lzuly -.ERIODT0: •-'1�•.,/J';Y,�` •---, . 3�( mai .f: i.04. • "•'`' e. p UCTION'MANAGEft ❑ROM:CONTRACTOR: VIA CONSTRUCTION MANAGER:apel 8 . CONTRACT:DATE: ARCHITECT ❑ 1°6i1'Trn.• , `gt.Ii: 'r . PROJECT NOS: .961 I CONTRACTOR ❑ VIA ARCHITECT: • C30 FIELD ❑ .ricl�an Its,:Sint) 96; 8, CO CT:FOR:'. ❑ CON?RACTOR'SAPPLIGATIQN FOR.PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge,information and ayment,.as shown.below,in connection with the Contract. belief the Work covered by this.Application for Payment has been.'completed,in accordance with the Application is,made for p Continuation'Sheet,.AIA_Document G703;is attached. Contract-Documents,.that all amounts have been paid by the Contractor for Work for which previous Certificates:for Payment were, *.sued, . • payments received from the Owner, and that current 1:ORIGINAL.CONTRACTSUM $ r }paymenit shown herein is . ••e. 2 Net.change by Change.Orders -��:�; , „ $ '' _ .CONTRACTOR' �,r;:. : �. f 9-15'—.49� 3.-CONTRACT.SUMTO'DATE(Line:l t�2�* '"••" $4 V. ),9/0•00By: _ t.4F ; Date: •4i TOTAL COMPLETED B.STORED:TQDATE(Column G on 0703) 3, State of 21,,c 81>i� t..,'. t• ' S:;RETAINAGE: ,z-:. ;,y .- County.of:.:,n16rta\—. -a. /0 .,%of Completed}Work Subscribed'an •sworn to before'•',i> ' ( D^ r ) .) ro,4 r' Caluinn ,±.fi oti'G703 3 me.fliis % day.of:: ('1,�� 9 b: ,i%iof Stored Material Notary_Public: :•�.f.::. .. (Coliiitiii'F on G703), $ . My Commission.expiies::Q2, -'' j. Total Retainage(Lines 5a+5bor Total.in Column Iof0703).. $' j,ff69,.-00 CERTIFICATE FOR PAYMENT n :In accordance-with.the Contract Documents; based on on-site observations and.the data comprising ' 6.TOTAL EARNED LESS RETAINAGE $ 7) VW' 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 die Work has progressed as indicated,.the quality of the Work is in •7..LESS.PREVIOUS•CERTIFICATES.FOR:PAYMENT $ O'�.'• Oa accordance with the Contract Documents;.and•the Contractor is entitled to payment of the AMOUNT - CERTIFIED. (Line S-from prior•Certificate) . . ,,! B:CURRENT.PAYMENT-DUE • $ % Ps, t 100•••(AMOUNT:CERTIFIED $ .Z39; a co �' 9.BALANCE TO FINISH;INCLUDING.RETAINAGE. �= '(Attcicli esplanatiorr,'if arnounr.certifted differsfrorn rite amotutt applied.Initial all figures:on this • <••�' ~' /�/�/ A licatiowt ttd an the ontinuation Sheet that are cftan ed tocon conform with the amount certified.) a_ ` pP S. f.. J J q (Line 3 less Line 6) ..4,;:„\,,f'' ` �' $•)t ?y //7. .. CONSTRUE ON:''r'N•c . 3. � '4. .. By: t. , • .. Date: � L Zan 1• CHANGE'ORDER SUMMARY3:, .'-'' ADDITIONS • DEDUCTIONS. ARCHIT : 4 Total than es.a roved,tit ieJious months.b Owner 3. $' B Date: ✓1 •01 g pP. I?- y Y �� .Total=a roved.tlits;Month $ �' 'able:''- pp �f/.Q' j. 'Jb. l! � •( This Certif ate negotiable:'The AMOUNT CERTIFIED is payable only to the.Contractor ,,i:F""..^', TOTALS ° $ $ named h chi: ssuance pay'••inent and•acceptan ce of payment are without prejudice to any rights of ' ' " th'e Ow er• Contra -this Contract,. NET CHANGES'by Change Order `$ :97-?, 9�0.C6 . CAUTION:You•shoutd sign an original..A1A Contract Document,:on which this-text appears in RED.Anoriginal.assures that changes will not be obscured. AIA Document —1992rCopyright:©1992'by.The American Iiistitute ofArchitects.All lights reserved•.WARNING:'This AIAe Document'is,proteatod by U.B.Copyright,Law and internattonat Treaties. Unauthorized reproduction or distributiOn 01 this AIA Document,or any,portion of'it may resultfin•severe.civil and'criminal:penalties,.and.viitt be prosecuted:to the.maximum extent possible under.the law. Purchasers are permitted to reprodiice.ten Ott)copies of this document�when corirpiated.To'repoh copyright violations at'AIA Cottuacl•Documents,.a-mail The American institute of Architects'legal counsel,copyright@aia.org. 1-v34 1 MUM i Iur aritt► AIA DOCUMENT G703 Page 1 of 1 Application No: / Application Date: 04/1012009 JOB NAME CARMEL-R PAC CONSTRUCTION Period To: 04/15/2009 HORNING JOB# 8-2408 Architect's.Project No: A . B C D E F G H I Work Completed Materials Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to Date (G/C) Item# Description of Work Scheduled Value (D+E) This Period (Not in D or E)_ (D+E+F) 1 Roofing Labor $107;140.00 $0.00_ $21,430.00 $21,430.00 $85,710.00 $2,143.00 2 Roofing Material $166,980.00 $0.00 $22,000.00 $22,000.00 $144,980.00 $2,200.00 3 Nailbase Material $105,300.00 $0.00 $105,300.00 $105;300,00 $0.00 $10,530.00 4 Nailbase Labor $38,180.00 $0.00 $7,600.00 $7,600.00 $30,580.00 $760.00 5 Sheet Metal Labor $57,350.00 $0.00 $0.00 $57,350.00 $0.00 6 Sheet Metal Material $146,390.00 $0.00 $30,000.00 $30,000.00 $116,390.00 $3;000:00 7 Tile Dome Material $112,000.00 $0.00 $30,000.00 $30,000.00 $82,000.00 $3,000.00 8 Tile Dome Labor $39,800.00 $0.00 $0.00 $39,800.00 $0.00 9 Tile Balance Material $168,000.00 $0.00 $30,000.00 $30,000.00 $138,000.00 $3,000.00 10 Tile Balance Labor $59,700.00 $0.00 $0.00 $59,700.00 $0.00 11 Paver Material $56,700.00_ $0.00 $0.00 $56,700.00 $0.00 12 Paver Labor $18,900.00 - $0.00 $0.00 $18,900.00 $0.00 13 Bond $15,010.00 - $0.00 $15,010.00 $15,010.00 $0.00 $1,501.00 14 Subcontractor $250,000.00 $0.00 $0.00 $250,000.00 $0.00 15 Submittals $5,000.00' $0.00 $2,000.00 $2,000.00 $3,000.00 $200.00 16 Safety/Start-up $7,500.00 $0.00 $3,000.00 $3,000.00 $4,500.00 $300.00 17 Clean-up/Closeout $7,500.00 $0.00 $0.00 $7;500.00 $0.00 18 Change Order#1 ($1,430.00) $0.00 $0.00 ($1,430.00) $0.00 19 Change Order#2 $419,400.00 $0.00 _ $0.00 $419,400.00 $0.00 20 Allowance $5,000.00 $0.00 $0.00 $5,000.00 $0.00 $1,784,420.00 $0.00 $266,340.00 _ $0.00 $266,340.00 $1,51,8,080.00_ $26,634.00 SL Subcontract Billing Report For Work Invoiced From 12/01/07 to 12/31/07 ---^ Subcontract 2695<3025 2U25 Limestone Mat.and.Fab. Job: 2695' Carmel -RPAC Cosntruction Vendor: 8865 BYBEE STONE COMPANY . ";' ' ` � '�' �`!�� l. `. _ _ ` �i�'�� �..� � tqiNh6d be� Units UM Uhit/C6mt Amount Uni��% Amount Units/% Amount 1unmoumosmne Mat.and --- L� — — — 2,850,000.00 7.3e'p6 209'622.00 7a5% 209,622.00 Fab. Total Contract Items 2.850000rm 2ue�uoum 209;622.00 ` . Subcontract Totals: 2,860,000.00 209.822.00 zoA'0000n Total Billings; 209,622.00 209,*22.00 Unpaid Retai : 20,962.20 20;9e2.20 oiwcount§: 0.00 V.00 Net Billings: 188,659.80 188.659.80 • 98 SSC-CMa Projects Page 5 12/20/07 09:25:40 am SLSubBillingReportsot APPLICATION AND CERTIFICATE FOR.PAYfi�l/ENT AIR DOCUMENT G702 PAGE 1 OF.2 c.. TO OWNER: Ci by of Carmel PROJECT: Re ithoal Per- arming APPLICATION NO I . Carmel Redevelopment Cotiiini i gA+tn Arts Center PERIODTO;. 2/1-31/2007 . One divic:taluare. Carmel IN 4bu32 Job NO.2695-2025 • c- , - Inc L.,-, FROM CONTRACTOR Bybee Stone Co Inc VIA ARCHITECT: CSO Architects AticHITECT'S.PROJECT NO: - ° P 0 Box 968`� Bloomington IN 47402 CONTRACT DATE: 11/30/07 CONTRACTOR'S APPLICATION FOR PAYMENT ' Change Orders'Approved in Application is made far payment,as shown below.in connection with the Contract. Previous months by Owner ADDITIONS ,DEDUCTIONS Continuation sheet,AtA Document G7123.is attached TOTAL 1. ORIGINAL CONTRACT SUM $ 2,©50,000.00 • . • , 2. NET CHANGE BY CHANGE ORDERS Approved.thls'month 3: CONTRACT SUM TO DATE(LINE 1&2) 2,850:,000.00 Numbei' ,Data Approved 4.TOTAL COMPLETED&STORED.TO DATE 2 n❑ u 00 • S. RETAINAGE a. T.of completed work_ TOTAL b.10 %of stored material 2O 962.00 ›- Total retafnage , \s Net Change by Change Orders B..TOTAL EARNED LESS RETAINAGE o ILine 4 less Line 5Tihtaf} 188,660.00 aj U The undersigned Contractor certifies.that to the best of the Contractor's Knowledge. • 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT S r.'' 'CQ'A information and belief the Work covered by the Application For Payment has been corn- Line 6 from prior Certificate). .00 ;0 ��' ` a") o plated in accordance with the Contract Documents,that all amounts have been paid by g CIJRREf4T.PAYIvtENT DUE 188,660.00 4\A ��+\+ the Contrctor for Work For whichpretiious Certificates'for Payment Were.Issued and g, BALANCE TO FINISH,PLUS RETAINAGE_ $ 2,661,340.00 payments received from the.Owner,and that currant payment shown herein is now (Line 3 tens Line 61 m_ due„ m C RACTOR' State.oh_'..�- �'�-� County ch: �r� -�—' By. hate: 12/1.4/07 Subscribed and sworn % yr:for; me the a... r /02—/7—01 Q Protect Manager . Notary Public \.4• 1 , &t �. 2.11-A My Commission E pfr©s: --© I • AMOUNT CERTIFIED o. AMOUNT • In accordance with the Contract Documents,based on on'site observations and the data (Attach explanation if amount certified differs from the amount applied far•) comprising the above application,the Architect certifies tothe•Owner that to the best of ARCHITE ,;- the Architect's knowledge,information and belief the Work-has progressed as Inhcated, BY:• Date: t?IV 01.4 v the quality of the Work is in accordance with the ContractiJocuments,and tho This Cer'!cat, -not negotiable-The AMOUNT CERTIFIED is payable.only to the Contractor is entitled to payment of the AMOUNT CERTIFIED: Contra to arned herein.Issuance,payment and acceptance of payment are without prejud e to any rights of the Owner or Contractor under this Contract: AMnocUMENr G702 APPIICAt ION AND CERTIFICATE FOR PAYMENT MAY 1983.EOkTIDN AIA©BEGS THE AMC-IIICAN INSrtTtrfE OF ARCHITECT&1735 NEW YORK AVENUE.N.4V-WASHINGTON O.C.Zoace APPLICATION AND CERTIFICATE FOR PAYMENT I Cont. Sheet for AIA Document G702 Page 2 of 2 PROJECT NAME: Regional Performing Arts Center APPLICATION# 1 City of Carmel Indiana DATE 12/14/2007 PERIOD 12/1-3112007 Description of Work Original Revised Previous Work in Place Stored Total Completed Percent Balance Retainage Value Value Applications_ this month Materials &stored Complete to Finish Shop Drawings 387,000 0 0 0 of 0 387,000 0 Raw Material 911,400 0 0 209,622 209,622 1 7 680,816 20,962 Material Storage 0, 0 0 0 0 0 0 0 Shop Fabrication 1,301,600 0 0 0 0I 0 1,301,600 0 Material Delivery 100,000 0 0 0 of 0 100,000 0 Engineering Allowance 150,000 0 0— 0 of 0 150,000 0 Totals 1 2,850,000 0 0' 01 209,622 209,622 7 2,619,416 20,962