HomeMy WebLinkAboutFebruary 2011 - $137,677.72 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 4(Officeworks) February 2011 $137,677.72
Total Authorized Disbursement $ t
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 Regio s Bank and Carmel Theater Development Company, LLC.
Dated: 3 /� /� CITY OF CARMEL REDEVELOPMENT
COMMISSION
By: c::: __
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)
Paid by the Carmel Theater Development Company $ 148,761.50
December 2010 (application 2)
Paid by the Carmel Theater Development Company $ 266,542.44
January 2011 (application 3)
Paid by the Carmel Theater Development Company $ 246,149.00
February 2011 (application 4)
Amount to be paid by the Carmel Theater Development Company ..$.. ..137;677.72
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APPLICATI.ON AND CERTIFICATE FOR PAYMENT Page 1 of 2Page(s)
TO(OWNER):/ PROJECT:
Carmel Theater Development Commission LLC Carmel Regional Performing Arts Center APPLICATION NO: 4 Distribution to:
11711 No Pennsylvania Street 777 3rd Ave SW ❑OWNER
Suite 200 Carmel IN 46032 PERIOD FROM: 5/21/2010
Carmel IN 46032 PERIOD TO: 2/22/2011 ❑ARCHITECT
CONTRACTOR: VIA(ARCHITECT):
Officeworks INC CSO Architects ARCHITECT'S ❑CONTRACTOR
12000 Exit Five parkway 280 East 96th Street PROJECT NO: 476553 ❑
Fishers IN 46038 Suite 100
CONTRACT FOR: Indianapolis IN 46240 CONTRACT DATE: 5/21/2010 ❑
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 $ 97,171.99
previous months by Owner 3.CONTRACT SUM TO DATE(Line 1 +/-2) $ 815,659.72
TOTAL 4.TOTAL COMPLETED&STORED TO DATE $ 815,659.72
Approved this Month (Column G on Schedule of Values)
Number Date Approved 5. RETAINAGE:
1 1/11/2011 . $11,156.96 10 %of Completed Work $ 16,529.06
(Column D+E on Schedule of Values)
2 1/11/2011 $8,223.96 b. %of Stored Material $
3 12/16/2010 $5,801.40 (Column F on Schedule of Values)
4 10/5/2010 $71,989.37 Total Retainage(Line 5a+5b or
TOTALS $97,171.69 $0.00 Total in Column 1 on Schedule of Values) $ 16,529.06
Net change by Change Orders $97,171.69 6.TOTAL EARNED LESS RETAINAGE $ 799,130.66
(Line 4 less Line 5 Total)
The undersigned Contractor certifies that to the best of the contractor's 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) $ 661,452.94
completed in accordance with the Contract Documents,that all amounts have been 8.CURRENT PAYMENT DUE $ 137,677.72
paid by the Contractor for Work for which previous Certificates for Payment were 9.BALANCE TO FINISH,PLUS RETAINAGE $ 16,529,06
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 sworn to before me this day o 4 o f
CONTRACTOR: Officeworks L Ilk Notary Publi /.6,., "�-•=
My Commission expir `- �p,/41110� `' ft
-
By.. ; Date: L 51/1 AMOUNT CERTIFIED... .. $
y
(Attach explanation if .mo - certified differs from the amount applied for.)
ARCHITE 'S CE' I'IC • 1 E POR 'AYMENT NOTE DIRECTI OF DRAW PROCEEDS-REMITTANCE ADDRESS ATTACHED.
ARCHITECT:
In accordant: with Contract Documents,based on -site observations and the data By: Date.Z/255'6
comprising the a•ove 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 Certificat- is not ne•• 'able. 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. Issue•.e,pa ent and acceptance of payment are without prejudice to any rights of the Owner or
entitled to payment of the AMOUNT CERTIFIED. Contractor under this Contract.
t:
.,... ,,
SCHEDULE OF VALUES SCHEDULE OF VALUES
APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NUMBER: 4 . ..
Contractors signed Certification attached. APPLICATION DATE: 2122/11
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO 2/22/11
Use Column I on Contract where variable retainage for line items may apply. ARCHITECT'S PROJECT NO 476553
I A I B I C _I D I E I F I_ G I H
Item Description of Work Scheduled Work Completed Materials Total % Balance Retainage
No. Value Presently Completed (G/C) 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 815,659.72 677,982.21 137,677.51 0.00 815,659.72 100% 0.00 16,529.06
Performing Arts Center per contract 476553
as specified on Officeworks proposal 31523
•
. " I
Totals 815,659.72 677,982 - 137,678 0 _ 815,660 100%_ 0 16,529
r..
•
• WAIVER OF LIEN TO DATE /.
STATE OF INDIANA SS Job Number: 476553 Gty#
County of Hamilton Draw Number: 4 Loan# __ __
I
TO WHOM IT MAY CONCERN:
WHEREAS the undersigned has been employed by �� Carmel Theater Development Commission LLC to furnish
furniture and installation for the premises known as Carmel Regional Performing Arts Center
of which _ Carmel Theater Development Commission LLC �� is the owner.
The undersigned,for and in consideration of _w ___xonehundredthirtyseventhousandsixhundredseventysevenand72/00x _
( x137,677.72x_)Dollars, 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 and on said above-described premises,and the improvements thereon,and on the material,fixtures, apparatus or machinery furnished,
and 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,furnished to this date by the undersigned for the above-described premises.
Given under my hand and sealed this ..-2.... day of feb — 2011 .
/
Signature and Seal: 'X" 411P __ i ____ __
NOTE:All waivers must be for the full amount paid.If waiver is for a corporation,corporate ame • •uld e use.,corporate seal affixed
and title of officer signing waiver should be set forth;if waiver is for a partnership,the partn- ip name should
v.
CONTRACTOR'S AFFIDAVIT
STATE OF INDIANA ISS
County of Hamilton
TO WHOM IT MAY CONCERN:
THE undersigned, being duly sworn,deposes and says that he/she is Chief Financial Officer
of the Officeworks services LLC who is contractor for the furniture a_n_d installation
work on the building located at 777 3rd Ave SW, Carmel Indiana 46032
owned by Carmel Theater Development Commission LLC .
That the total amount of the contract including extras is 5815,629.72 on which he has received payment of $661,452.94
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 to each,and that the items mentioned include all labor and material required to
complete said work according to plans and specifications.
CONTRACT
• NAMES .WHAT FOR PRICE AMOUNT PAID . . 'THIS PAYMENT . BALANCE DUE
See attached listing
TOTAL LABOR AND MATERIAL TO COMPLETE • •
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.
Signed this ._._._. / °f _ __.___-_-feb A____._. _-...._ 2011 ___ .
Signature: Xri-.
Subscribed and sworn to before me this _�j(, / day f feb 2011 Sign ure: N0' " -- . 7 v o /.Ilk
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