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Home My WebLink AboutNovember 2010 - #148,761.50 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 FF&E installment purchase contract Application 1 (Officeworks Inc.) November 2010 $148,761.50 Total Authorized Disbursement $148,761.50 , • 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 Bank and Carmel Theater Development Company, LLC. Dated: 12 /'l io 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 FF and E (Officeworks) November 2010 (application 1) Amount to be paid by the Carmel Theater Development Company $ 148,761.50 APPLICATION AND CERTIFICATE FOR PA YMENT Page 1 of 2Page(s) TO(OWNER): PROJECT: Carmel Theater Development Commission LLC Carmel Regional Performing Arts Center APPLICATION NO: 1 Distribution to: 11711 No Pennsylvania Street 777 3rd Ave SW ❑OWNER Suite 200 Cannel IN 46032 PERIOD FROM: 5/21/2010 Carmel IN 46032 PERIOD TO: 11/22/2010 ❑ARCHITECT CONTRACTOR: VIA(ARCHITECT): Officeworks INC CSO Architects ARCHITECTS ❑CONTRACTOR ffi 12000 Exit Five parkway 280 East 96th Street PROJECT NO: 476553 0 Fishers IN 46038 Suite 100 CONTRACT FOR: Indianapolis IN 46240 CONTRACT DATE: 5/21/2010 0 Office Furnishings CONTRACTOR'S APPLICATION FOR PAYMENT Application Is made for Payment,as shown below,In connection with the Contract. Continuation Sheet,Schedule of Values,is attached. CHANGE ORDER SUMMARY 1.ORIGINAL CONTRACT SUM $ 718,487.73 Change Orders approved in ADDITIONS DEDUCTIONS 2.Net change by Change Orders $ 0.00 previous months by Owner 3.CONTRACT SUM TO DATE(Line 1 +/-2) $ 718,487.73 TOTAL 4.TOTAL COMPLETED&STORED TO DATE $ 165,290.56 Approved this Month (Column G on Schedule of Values) Number Date Approved 5.RETAINAGE: 10%of Completed Work $ 18,529.06 (Column D+Eon Schedule of Values) b. %of Stored Material $ (Column F on Schedule of Values) Total Retainage(Line 5a+5b or TOTALS $0.00 $0.00 Total in Column 1 on Schedule of Values) $ 16,529.06 Net change by Change Orders $0.00 6.TOTAL EARNED LESS RETAINAGE $ 148,761.50 (Line 4 less Line 5 Total) The undersigned Contractor certifies that to the best of the contractors knowledge, 7.LESS PREVIOUS CERTIFICATES FOR information and belief the Work covered by this Application for Payment has been PAYMENT(Line 6 from prior Certificate) $ 0.00 completed In accordance with the Contract Documents,that all amounts have been 8.CURRENT PAYMENT DUE $ 148,781.50 paid by the Contractor for Work for which previous Certificates for Payment were 9.BALANCE TO FINISH,PLUS RETAINAGE $ 589,726.23 Issued and payments received from the Owner,and that current payment shown (Line 3 less Line 6) herein Is now due. State of: Subscribed and swom to before me this day of C•,,,n - : .-. ri -: .1:1( Auk Notary Public: ,�..,,,,// My Commission expires: {{ pp By: —_ IllklkVllii), Date: j /o AMOUNT CERTIFIED $ iiPt`1(91 (Attach explanation if amount certified differs .• • the amount applied for.) ARCHIT' ER IFICA F• -AYMENT NOTE DIRECTIVE OFD:.• •' • - • ' EDS-REMITTANCE ADDRESS ATTA HED. ARCHITECT: In accordance with the Contract Documents,based on on-site observations and the data By: Date: comprising the above 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 This Ce •r :to is not n-••.=ble. The AMOUNT CERTIFIED Is payable only to the Contractor named quality of the Work Is in accordance with the Contract Documents,and the Contractor is herein. I:- ance,pa• ent and acceptance of payment are without prejudice to any rights of the Owner or entitled to payment of the AMOUNT CERTIFIED. Contract• und: • s Contract. SCHEDULE OF VALUES SCHEDULE OF VALUES APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NUMBER: 1 Contractor's signed Certification attached. APPLICATION DATE: 11/22/10 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 11/22/10 Use Column I on Contract where variable retainage for line items may apply. ARCHITECTS PROJECT NO: 476553 hi A I B I C I D I E I F f G I H I I 1 Item Description of Work Scheduled Work Completed Materials Total % Balance Retalnage No. Value Presently Completed (GIC) to Finish From Previous This Period Stored and Stored (C-G) Application (NOT IN) (D+E) D or E) _ 1 furniture and installation for Carmel 718,487.73 0.00 165,290.56 0.00 165,290.56 23% 553,197.17 16,529.06 Performing Arts Center per contract 476553 as specified on Officeworks proposal 31523 Totals 718,487.73 0 165,291 0 165,291 23% 553,197 16,529 U.S. Department of Labor PAYROLL : i Wage and Hour Division (For Contractor's Optional Use;See Instructions at www.doi.gov/whdlforms/wh347instr.htm) U.S.Wage and Hour Division Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. Rev.Dec.2008 NAME OF CONTRACTOR 0 OR SUBCONTRACTOR® ADDRESS 12000 Exit Flve Parkway Fishers IN 46037-7940 OMB No.:1215-0149 OfficeWorks Services LLC Expires: 12/31/2011 PAYROLL NO. FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO. #1 11/14/2010 Carmel Regional Performing Arts Center/Carmel,IN #25310-Furniture Package (1) (2) (3) (4)DAY AND DATE (5) (6) (7) (9) (8) IT; M .1.0 W DEDUCTIONS NET NAME AND INDIVIDUAL IDENTIFYING NUMBER o F o $ 9 (0 GROSS WITH- WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY .€ WORK O TOTAL RATE AMOUNT HOLDING TOTAL PAID NUMBER)OF WORKER 2 3 CLASSIFICATION HOURS WORKED EACH DAY }LOURS OF PAY EARNED FICA TAX OTHER DEDUCTIONS FOR WEEK BRIAN JACKSON LABORER o $27.36 $273.60 3982 $16.96 $17.51 $34.47 $239.13 s ion 10.0( 19.26 8.10 KEITH HEADY LABORER o $26.92 $565.32 2076 - $35.05 $63.14 $34.42 $132.61 $432.71 S S.00 7.00 6.00 21.0( 18.76 8.16 MARK HENDERSHOTT LABORER o $27.20 $217.60 4090 $13.49 $12.73 $26.22 $191.38 S SAO 8,00 19.26 7.94 MICHAEL SAMPIERE LABORER o $24.39 $615.85 1207 $38.18 $49.05 $46.62 $133.85 $482.00 S 10.25 7.23 7.75 25.2E 19.76 4.63 MOISES BELTRAN LABORER o $25.38 $532'98 1428 $33.04 $34.48 $67.52 $465.46 S 5.00 7.00 6.00 21.0( 19.26 6.12 JEFF MILLER LABORER o $25.38 $374.36 1809 $23.21 $24.17 $34.22 $81.60 $292.76 S 7.25 7.50 14.7; 19.26 6.12 LEON CUNNINGHAM LABORER o $25.41 $184.22 5287 $11.42 $10.77 $22.19 $162.03 S 715 7.25 19.26 6.13 O / S While completion of Form WH-347 is optional,it Is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.§§3.3,5.5(a).The Copeland Act (40 U.S.C.§3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to`furnish weekly a statement with respect to the wages paid each employee during the preceding week'U.S.Department of Labor(DOL)reputations at 29 C.F.R.§5.5(a)(3Xii)require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed'Statement of Compliance'indicating that the payrolls are cored end complete end that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the Infoma5tton to determine that employees have received legally required wages end fringe benefits. Public Burden Statement We estimate that Is will take an average of 55 minutes to complete this collection,Including time for reviewing instructions,searching existing data sources.gathering and maintaining the data needed,and completing and reviewing the collection of information.tf you have any comments regarding these estimates or any other aspect of this collection,Including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,U.S.Department of Labor,Room S3502,200 Constitution Avenue,N.W, Washington,D.C.20210 (over) Date 11/15/2010 (b)WHERE FRINGE BENEFITS ARE PAID IN CASH Joyce Posson Vice President Administration ❑ — Each laborer or mechanic listed in the above referenced payroll has been paid, (Name of Signatory Party) (Title) as indicated on the payroll,an amount not less than the sum of the applicable do hereby state: basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract,except as noted in section 4(c)below. (1)That I pay or supervise the payment of the persons employed by OfficeWorks Services LLC (c)EXCEPTIONS on the (Contractor or Subcontractor) EXCEPTION(CRAFT) EXPLANATION Carmel Regional Performing Arts ;that during the payroll period commencing on the (Building or Work) Current hourly paid benefits have been 7th chy of November 2010 end ending the 13th day of November 2010 subtracted from fringe rate of$8.16 all persons employed on said project have been paid the full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said OfficeWorks Services LLC from the full (Contractor or Subcontractor) weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person,other than permissible deductions as defined in Regulations,Part 3(29 C.F.R.Subtitle A),issued by the Secretary of Labor under the Copeland Act,as amended(48 Stat.948, 63 Start.108,72 Stat.967;76 Stat.357;40 U.S.C.§3145),and described below: REMARKS: (2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete;that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3) That any apprentices employed in the above period are duly registered In a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training,United States Department of Labor,or if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Training,United States Department of Labor. (4)That: (a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS NAME AND TITLE AP Joyce Posson,Vice President — In addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract THE WILLFUL FALSIFICATION OF ANY OF THE Aar EMENTS MAY SUBJECT THE CONTRACTOR OR have been or will be made to appropriate programs for the benefit of such SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTI• ECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. employees,except as noted in section 4(c)below. , Carmel Performing Arts Center-Recap# 1 Vendor I Installed Ail—Washroom 1 $ 3,228.19 Acorn j $ 20,165.85 Amcase _ $ 1,655.14 American Seating $ 356.79 Bernina $ 2,243.86 1 Claridge 3,557.61 Community $ 846.23 Edelman $ 14,729.85 Global I $ 7,359.94 Herman Miller j $ 26,991.69 Installation 1 $ 10,001.71 Jiffy 1 $ 868.03 Knoll $ 5,227.04 Koala 1 $ 4,705.88 Lakeside ! $ 2,929.04 Lyon $ 24,606.06 Magnuson grp $ 1,004.32 Manhasset $ 2,474.11 MTS , $ 624.82 National Safety , $ 165.78 Peoria Winnelson $ 871.64 Polder $ 245.98 Pollack $ 9,099.51 Railex $ 14,512.41 . Rowenta $ 235.47 -7 --- SPG ' $ 2,804.54 , Uline 1 $ 3,533.28 Warren ! $ 245.79 Total 1 1 $ 165,290.56