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Bunting Graphics - $37,562
Regions Bank hereby is instructed to make a disbursement of Loan Proceeds from the Borrower Loan Account to (or for the account of) Borrower in: (a) the amount of the "Total Authorized Disbursement" line in the "Amount of Authorized Disbursement" column below; and (b) accordance with the terms and conditions of the Agreement, the other Loan Documents, and the Disbursement Instructions. Purpose of Authorized Disbursement Amount of Authorized Disbursement Amount to be paid by Carmel Theater Development Company as per the PAC Signage installment purchase contract Application 4(Bunting Graphics) September 2011 $ 37,562.00 Total Authorized Disbursement $ 37,562.00 All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (Equipment and Improvements), dated July 22, 2010, by and between Regions ank and Carmel Theater Development Company, LLC. Dated: / 7 /( CITY OF CARMEL REDEVELOPMENT COMMISSION By: Les S. Olds Printed: Executive Director Title: It is acknowledged and agreed by the parties that CRC has reserved the right to require, as a condition of authorizing disbursement of Loan Proceeds from the Borrower Loan Account to (or for the account of) Borrower: (a) completion of a satisfactory inspection by CRC of the portions of the Equipment and/or the Improvements to which the disbursement relates; and (b) receipt of customary submittals. Draft PAC Signage (Bunting Graphics) December 2010 (application 1) Paid by the Carmel Theater Development Company $ 121,933.35 January 2011 (application 2) Paid by the Carmel Theater Development Company $ 76,496.85 March 2011 (application 3) Paid by the Carmel Theater Development Company $ 58,942.80 September 2011 (application 4) Amount to be paid by the Carmel Theater Development Company $ 37,562.00 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF I PAGES TO: CSO Architects PROJECT: The Palladium at the APPLICATION NO: 04 Distribution to: 280 East 96th Street,Suite 100 Center for Performing Arts OWNER Indianapolis,IN 46240 ARCHITECT Attn:Brandon Bogart PERIOD TO: 09/30/11 CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Bunting Graphics,Inc. 20 River Road,Verona,PA 15147 PROJECT NOS: 66780 CONTRACT FOR: CONTRACT DATE: 09/22/10 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due. I. ORIGINAL CONTRACT SUM $ 454,080.00 COMMONWEALTH OF PENNSYLVANIA 2. Net change by Change Orders $ CONTRACT►tf Notarial Seal 3. CONTRACT SUM TO DATE(Line 1±2) $ 454,080.00 Marjorie R.German Allegheny Notary Public ( ) Verona Born,Mlegherry County 4. TOTAL COMPLETED&STORED TO $ 327,706.00 a.. I My Commis on expires June 20,2014 DATE (Column G on G703) By: '+1. � '� 1J!► Members Pennsvitr ttle> Mgrgfdries 5. RETAINAGE: Richard Z:'.., .F.O. .. a. 10 %of Completed Work g 32,771 State of:Pennsylvania County of: Allegheny (Column D+E on G703) Subscribed and sworn to before meeth' 12t day of October,2011 b. 10 %of Stored Material $ 0 Notary Public: (Column F on G703) My Commission expires: June 20,2014 Total Retainage(Lines 5a+5b or Total in Column I of 0703) $ 32,771.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 294,935.00 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 257,373.00 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 37,562.00 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 159,145.00 ' (Line 3 less Line 6) AMOUNT CERTIFIED $ ;-7 N 5cQZ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Total changes approved Application and onthe Continuation Sheet that are changed to conform with t a unt certified.) in previous months by Owner ARCH IT . Total approved this Month By: 7 4UI ll Date: I\ \ 1 TOTALS $0.00 $0.00 Th. Certificate is n9t n::otiable. The k OUN..- RTIFIED is payable only o the C1 ntractor name here . Issuance,payyen and acceptance of payment are without NET CHANGES by Change Order $0.00 pr dice tom rights of the O�.dr. Contractor under this Contract. AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT•1992 EDITION-AIA-01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,OC 20008.5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. CONTINUATION SHEET AIA DOCUMENT G703 AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT,containing APPLICATION NO: 04 Contractor's signed certification is attached. APPLICATION DATE: 10/12/11 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 0 9/3 0/1 1 Use Column Ion Contracts where variable retainage for line items may apply. ARCHITECTS PROJECT NO: 6 67 8 0 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK CON PLETED MATERIALS TOTAL % BALANCE RETAIN AGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G+C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C-G) RATE) (D+E) (NOT IN TO DATE D OR E) (D+E+F) I General Conditions(Sep.-Dec.2010) S158,928.00 $158,928.00 $0.00 $0.00 $158,928.UU ' 100% $0.00 $15,892.80 2 Submittals $14,758.00 $14,758.00 $0.00 $0.00 $14,758.00 100% $0.00 $1,475.80 3 Alt#l Sign Type A Wall&Letters $31,229.00 $0.00 $0.00 $0.00 $0.00 0% $31,229.00 $0.00 4 Alt#2 Sign Type B $8,255.00 $0.00 $0.00 $0.00 $0.00 0% $8,255.00 $0.00 5 Sign Type C Fabrication $3,369.00 $0.00 $0.00 $0.00 $0.00 0% $3,369.00 $0.00 6 Sign Type C Installation $1,925.00 $0.00 $0.00 $0.00 $0.00 0% $1,925.00 $0.00 7 Alt#3 Sign Type D $1,216.00 $0.00 $0.00 $0.00 $0.00 0% $1,216.00 $0.00 8 Alt#4 Sign Type E $9,155.00 $0.00 $0.00 $0.00 $0.00 0% $9,155.00 $0.00 9 Sign Type F Fabrication $17,570.00 $0.00 $0.00 $0.00 $0.00 0% $17,570.00 $0.00 10 Sign Type F Installation $7,796.00 $0.00 $0.00 $0.00 $0.00 0% $7,796.00 $0.00 11 Sign Type G Fabrication $1,146.00 $1,146.00 $0.00 $0.00 $1,146.00 100% $0.00 $114.60 12 Sign Type G Installation $91.00 $91.00 $0.00 $0.00 $91.00 100% $0.00 $9.10 13 SignTypeJ Fabrication $2,437.00 $2,437.00 $0.00 $0.00 $2,437.00 100% $0.00 $243.70 14 Sign Type J Installation $1,997.00 $1,997.00 $0.00 $0.00 $1,997.00 100% $0.00 $199.70 15 Sign Type K Fabrication $884.00 $884.00 $0.00 $0.00 $884.00 100% $0.00 $88.40 16 Sign Type K Installation $128.00 $128.00 $0.00 $0.00 $128.00 100% $0.00 $12.80 17 Sign Type L Fabrication $1,419.00 $1,419.00 $0.00 $0.00 $1,419.00 100% $0.00 $141.90 18 Sign Type L Installation $97.00 $97.00 $0.00 $0.00 $97.00 100% $0.00 $9.70 19 Sign Type H Fabrication $162.00 $0.00 $0.00 $0.00 $0.00 0% $162.00 $0.00 20 Sign Type H Installation $989.00 $0.00 $0.00 S0.00 $0.00 0% $989.00 $0.00 21 Sign Type AA Fabrication $508.00 $508.00 $0.00 $0.00 $508.00 100% $0.00 $50.80 22 Sign Type AA Installation $614.00 $614.00 $0.00 $0.00 $614.00 100% $0.00 $61.40 23 Sign Type BB Fabrication $2,418.00 $2,418.00 $0.00 $0.00 $2,418.00 100% $0.00 $241.80 24 Sign Type BB Installation $693.00 $693.00 $0.00 $0.00 $693.00 100% $0.00 $69.30 25 Sign Type CC Fabrication $210.00 $180.00 $0.00 $0.00 $180.00 86% $30.00 $18.00 26 Sign Type CC Installation $189.00 $150.00 $0.00 $0.00 $150.00 79% $39.00 $15.00 27 Sign Type DD Fabrication $883.00 $0.00 $0.00 $0.00 $0.00 0% $883.00 $0.00 28 Sign Type DD Installation $189.00 $0.00 $0.00 $0.00 $0.00 0% $189.00 $0.00 29 Sign Type BE Fabrication $1,363.00 $0.00 $1,363.00 $0.00 $1,363.00 100% $0.00 $136.30 30 Sign Type EE Installation $199.00 $0.00 $199.00 $0.00 $199.00 100% $0.00 $19.90 31 Sign Type FF Fabrication $1,229.00 $492.00 $737.00 $0.00 $1,229.00 100% $0.00 $122.90 32 Sign Type FF Installation $370.00 $0.00 $370.00 $0.00 $370.00 100% $0.00 $37.00 AtA DOCUMENT G703•CONTINUATION SHEET FOR 0702•1992 EDITION•AIA•©1992 THE AMERICAN INSTITUTE OF ARCHITECTS.1735 NEW YORK AVENUE.N.W.WASHINGTON.D.C. 20006-5232 G703-1992 CONTINUATION SHEET AIA DOCUMENT G703 AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT,containing APPLICATION NO: 04 Contractor's signed certification is attached. APPLICATION DATE: 10/12/11 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 09/30/11 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECTS PROJECT NO: 66780 A B C D E F G H I ' ITEM DESCRIPTION OF WORK SCHEDULED WORK CO1v.PLETED MATERIALS TOTAL % BALANCE RETQIIJAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G+C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C-0) RATE) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 33 Sign Type 1111 Fabncation $15,199.00 $15,199.00 $0.00 $0.00 $15,199.00 100% $0.00 $1,519.90 34 Sign Type HH Installation $14,664.00 $14,664.00 $0.00 $0.00 $14,664.00 100% $0.00 $1,466.40 35 Sign Type JJ Fabrication $16,710.00 $10,026.00 $6,684.00 $0.00 $16,710.00 100% $0.00 $1,671.00 36 Sign Type 1J Installation $2,514.00 $0.00 $2,514.00 $0.00 $2,514.00 100% $0.00 $251.40 37 Sign Type KK Fabrication $17,531.00 $10,519.00 $7,012.00 $0.00 $17,531.00 100% $0.00 $1,753.10 38 Sign Type KK Installation $3,608.00 $0.00 $3,608.00 $0.00 $3,608.00 100% $0.00 $360.80 39 Sign Type LL Fabrication $4,532.00 $2,719.00 $1,813.00 $0.00 $4,532.00 100% $0.00 $453.20 40 Sign Type LL Installation $682.00 $0.00 $682.00 $0.00 $682.00 100% $0.00 $68.20 41 Sign Type MM Fabrication $2,512.00 $1,256.00 $1,256.00 $0.00 $2,512.00 100% $0.00 $251.20 42 Sign Type MM Installation $620.00 $0.00 $620.00 $0.00 $620.00 100% $0.00 $62.00 43 Sign Type NN Fabrication $16,009.00 $8,005.00 $8,004.00 S0.00 $16,009.00 100% $0.00 $1,600.90 44 Sign Type NN Installation $3,676.00 $0.00 $3,676.00 $0.00 $3,676.00 100% $0.00 $367.60 45 Sign Type OO Fabrication $5,259.00 $5,259.00 $0.00 $0.00 $5,259.00 100% $0.00 $525.90 46 Sign Type OO Installation $976.00 $0.00 $0.00 $0.00 $0.00 0% $976.00 $0.00 47 Sign Type PP Fabrication $3,999.00 $3,999.00 $0.00 $0.00 $3,999.00 100% $0.00 $399.90 48 Sign Type PP Installation $381.00 $0.00 $0.00 $0.00 $0.00 0% $381.00 $0.00 49 Sign Type QQ Fabrication $1,752.00 $0.00 $1,752.00 $0.00 $1,752.00 100% $0.00 $175.20 50 Sign Type QQ Installation $29.00 $0.00 $29.00 $0.00 $29.00 100% $0.00 $2.90 51 Sign Type RR&SS Fabrication $3,805.00 $2,664.00 $0.00 $0.00 $2,664.00 70% $1,141.00 $266.40 52 Sign Type RR&SS Installation $1,541.00 $0.00 $0.00 $0.00 $0.00 0% $1,541.00 $0.00 53 Sign Type IT Fabrication $2,339.00 $2,105.00 $0.00 $0.00 $2,105.00 90% $234.00 $210.50 54 Sign Type TT Installation $369.00 $0.00 $0.00 $0.00 $0.00 0% $369.00 $0.00 55 Alt#5 Cast Mounting Brackets $14,093.00 $14,093.00 $0.00 $0.00 $14,093.00 100% $0.00 $1,409.30 56 Sign Type AAA Fabrication $731.00 $731.00 $0.00 $0.00 $731.00 100% $0.00 $73.10 57 Sign Type AAA Installation $126.00 $126.00 $0.00 $0.00 $126.00 100% $0.00 $12.60 58 Sign Type BBB Fabrication $2,413.00 $2,413.00 $0.00 $0.00 $2,413.00 100% $0.00 $241.30 59 Sign Type BBB Installation $984.00 $984.00 $0.00 $0.00 $984.00 100% $0.00 $98.40 60 Sign Type BBB-2 Fabrication $300.00 $300.00 $0.00 $0.00 S300.00 100% $0.00 $30.00 61 Sign Type BBB-2 Installation $65.00 $65.00 $0.00 $0.00 $65.00 100% $0.00 $6.50 62 Sign Type CCC Fabrication $966.00 $966.00 $0.00 $0.00 S966.00 100% $0.00 $96.60 63 Sign Type CCC Installation $419.00 $419.00 $0.00 $0.00 $419.00 100% $0.00 $41.90 64 Sign Type DOD Fabrication $477.00 $477.00 $0.00 $0.00 $477.00 100% $0.00 $47.70 65 Sign Type DDD installation $195.00 $195.00 $0.00 $0.00 S195.00 100% $0.00 $19.50 66 Sign Type FFF Fabrication $212.00 $212.00 $0.00 $0.00 $212.00 100% $0.00 $21.20 67 Sign Type FFF Installation $86.00 $86.00 $0.00 $0.00 $86.00 100% $0.00 $8.60 68 Sign Type HHH Fabrication $118.00 $118.00 $0.00 $0.00 $118.00 100% $0.00 $11.80 69 Sign Type HHH Installation $43.00 $43.00 $0.00 $0.00 $43.00 100% $0.00 $4.30 AIA DOCUMENT G703•CONTINUATION SHEET FOR 0702 1992 EDITION•AIA•01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE.N.W.WASHINGTON.D.C. 20008-5232 G703-1992 CONTINUATION SHEET AIA DOCUMENT G703 AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT,containing APPLICATION NO: 04 Contractor's signed certification is attached. APPLICATION DATE: 10/12/11 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 09/30/11 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECTS PROJECT NO: 66780 A B C D E F G H I ITEM DESCRIPTION OF WORT SCHEDULED WORK CON PLETED MATERIALS TOTAL % BALANCE REDAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (0+C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C-0) RATE) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 70 Sign Type 1JJ Fabrication $206.00 $0.00 $0.00 $0.00 $0.00 0% $206.00 $0.00 71 Sign Type J11 Installation $365.00 $0.00 $0.00 $0.00 $0.00 0% $365.00 $0.00 72 Sign Type MMM Fabrication $2,312.00 $1,387.00 $925.00 $0.00 $2,312.00 100% $0.00 $231.20 " 73 Sign Type MMM Installation $492.00 $0.00 $492.00 $0.00 $492.00 100% $0.00 $49.20 74 Sign Type NNN Fabrication $256.00 $0.00 $0.00 $0.00 $0.00 0% $256.00 $0.00 75 Sign Type NNN Installation $101.00 $0.00 $0.00 $0.00 $0.00 0% $101.00 $0.00 76 Allowence General $18,998.50 $0.00 $0.00 $0.00 $0.00 0% $18,998.50 $0.00 77 Allowence Lime Stone Engraving $18,998.50 $0.00 $0.00 $0.00 $0.00 0% $1 8,998.50 $0.00 GRAND TOTALS $454,080.00 $285,970.00 $41,736.00 $0.00 5327,706.00 72% $126,374.00 $32,771.00 Users may obtain validation of this document by requesting of the license a completed AIA Document 0401-Certification of Document's Authenticity • ALA DOCUMENT G703-CONTINUATION SHEET FOR 6702,1992 EDITION.AIA•C1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON.D.C. 20006-5232 13703.1992