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HomeMy WebLinkAboutPoynter, General Piping - $24,516 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 Café Improvements installment purchase contract Application 1 (Poynter) October 2010 $ 5,506.00 Application 1 (General Piping) April 2011 $ 19,010.00 Total Authorized Disbursement •$ 24,516.00 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 Bank and Carmel Theater Development Company, LLC. Dated: (.•,// CITY OF CARMEL REDEVELOPMENT COMMISSION By: C-)rte ---- 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 Cafe Improvements (Poynter) October 2010 (application 1) Amount to be paid by the Carmel Theater Development Company $ 5,506.00 APPLICATION AND CERTIFICATION FOR PAYMENT A.1A DOCUMENT G702 PAGE ONE OF Two PAGES TO OWNER: Cannel Theater Development Co LI_C_ PROJECT: Carmel RPAC Cafe APPLICATION NO 1 Distribution to: 1 171 1 N.Pennsylvania St.,Ste#200 Buildout-HVAC OWNER'S Carmel,IN 46032 PERIOD TO : 10/30/2010 ARCHITECT FROM CONTRACTOR: VIA ARCHITECT: CONTRACTOR Poynter Sheet Metal,Inc. PSM# 14065 PO Box 427 Bloomington,IN 47402 CONTRACT DATE: CONTRACT FOR: Contract#2695-02607 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,AlA Document G703,is attached. completed in accordance with the Contract Documents,thatlall amounts have been paid by the Contractor for Work for which previous Certific.tes for Payment were issued and payments received from the Owner,and that current payment shown herein is now due. I. ORIGINAL CONTRACT SUM $ 5,506.00 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1.±2) $ 5,506.00 • 4. TOTAL COMPLETED&STORED TO $ 5,506.00 DATE (Column G on G703) By: /Pride �`�� Date: (31.-://029/// 5. RETAINAGE: Josep •. Gip resident a. %of Completed Work $ State of:In iana Cot my of: Monroe (Column D+Eon G703) Subscribed an swore me this o�9Tt-{ day o ,p f--/7/, o2�O// b. %of Stored Material $ Notary Public: `/\ ( I Column F on 0703) My Commission expires: Total Retainage(Lines 5a+5b or August 29,2014 Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 5,506.00 In accordance with the Contract Documents,based cn on-sic observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Ow er that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the\ ork has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ the quality of the Work is in accordance with the Co tract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 5,506.00 is entitled to payment of the AMOUNT CERTIFIE . 9 IP . BALANCE TO FINISH,INCLUDING RETAINAGE $ 0.00 'r' f (Line 3 less Line 6 ( 6) AMOUNT CERTIFIED $ _ ,; , 'y.*' • CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from he amount applied.Initial all figures on this Total changes approved Application 4. d onthe Continuation Sheet that are cllhanged!o conform with the amount certified.) in previous months by Owner ARCH t Total approved this Month By: ,r ��'" Date: h` `' TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance,payment and acceptance of payment are iIlthout NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under thi Contract. 1 ALA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT-1992 EDITION•AIA •01992 TH, CA N T 116wI -i,'',A73 -- ✓N E WASHINGTON,DC 20005-5292 0 • I w ©+!z .. � 1 I CONTINUATION S E ET AM DOCUMENT G703 FACE 2 OF 2 PAGES AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT,containing APPLICATIO NO: 1 Contr actor's signed certification is attached. APPLICATION ATE: 0/23/2010 In tabulations below,amounts are stated to the nearest dollar. JOB#: CarmelRPAC PERIO TO: 10/30/2010 Use Column I on Contracts where variable retainage for line items may apply. NAME: Cafe Buildout CONTRAC NO: d695-02607 A B C D E F G H I LINE DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL BALANCE RETAINAGE 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) 1 HVAC Sheet Metal Work per Contract $5,506.00 $5,506.00 $5,506.00 I t 0.00% 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 _ (I 5,506.00 5,506.00 5,506.00 100% AIA DOCUMENT G703•CONTINUATION SHEET FOR G702•1992 EDITION•AIA•01992 I G703-1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON,D.0 20006-5232 I t ∎ Cat Ri' 4 # :7i: SHEET METAL POYNTER SHEET METAL,INC. CONTRACTOR'S AFFIDAVIT AND WAIVER OF LIEN PARTIAL () FINAL (X) We,the undersigned,having been employed by CARMEL THEATER DEVELOPMENT CO LLC furnish labor and materials to do construction work on the premises known as PARCEL 7A, CARMEL REGIONAL PERFORMING ARTS CENTER- CAFE BUILDOUT hereby warrant that the premises of the above named job cannot be made subject to any valid lien by anyone who furnished material, supplies, labor or services to the undersigned for use in the above named project for any labor, materials or supplies furnished or services performed through 04/30/11 to the extent that the undersigned has been paid as set forth herein. This waiver is given in order to induce payment in the amount of$5,506.00 and upon receipt of the amount due by the undersigned,this waiver as to the amount due becomes valid, enforceable and of full effect. Upon attachment of the canceled check and the legal description of the project,this waiver may be recorded by the Owner or mortgage holder(s) of the project. This Contractor's Affidavit and Waiver of Lien only applies to the extent paid, and does not apply to or cover retention,unresolved claims or unresolved changes, change orders or change requests. Given under our hand and seal this 29TH day of APRIL,2011 POYNTER SHEET METAL, INC. SignatL .011rized Representative Joseph 1 PRESIDENT Title of Authorized Representative STATE OF: Indiana ) COUNTY OF: Monroe ) Subscribed and sworn to before me this 29111 day of APRIL,2011 (C) /14/1 (Notary Public) Commission-Expires:August 29,, 2014 County of Residence: Monroe Draft Cafe Improvements (General Piping) April 2011 (application 1) Amount to be paid by the Carmel Theater Development Company $ 19,010.00 1.l-�. Document / 'l ® 1992 Application and Certificate for Payment Constniction Manager-Adviser Edition TO OWNER: Carmel Theater Dvl pmnt Co PROJECT: CPAC Cafe Bull dout APPLICATION NO: 1 Distribution to: 11711 N. Pennsylvania Street OWNER:❑ Suite 200 PERIOD TO: 04/30/11 CONSTRUCTION MANAGER:❑ FROM VIA CONSTRUCTION CONTRACT DATE: ARCHITECT:❑ CONTRACTOR: General Piping Inc. MANAGER: CONTRACTOR:❑ PROJECT NOS: / / CONTRACT FOR: PO Box 34367 VIA ARCHITECT: FIELD:❑ Indianapolis. IN 46234 4,A fGtwMh F 4 2695--O2606 OTHER:❑ 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 for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIG NAL CONTRACT SUM $ 19.010.00 payment shown herein is now due. 2.Net change by Change Orders $ 0.00 CONTRACTOR: 'J 3.CONTRACT SUM TO DATE(Line 1*2) $ 19.010.00 By /// . Date: —1/r2 // 4.TOTAL COMPLETED&STORED TO DATE(Column G on 0703) $ 19.010.00 State of:Indiana 5.RETAINAGE: County of:Hendricks a- 0%of Completed Work Subscribed and sworn to before (Column D+E on 0703) $ 0.00 me this (1. day of ci l t 20( b. 0%of Stored Material Notary Public:Luke Roseboo (Column F on G703) $ 0.00 My Commission expires:July 7,2012 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ p on CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ pknin nil In accordance with the Contract Documents,based on on-site observations and the data comprising (Line 4 Less Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ knowledge.,information and belief the Work has progressed as indicated,the quality of the Work is (1 n in accordance with the Contract Documents, and the Contractor is entitled to payment of the (Line 6 from prior Certificate) AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE $ 19.010.00 AMOUNT CERTIFIED $ 19.010.00 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from t:e amo t applied Initial all figures on this Application and on ?e ontinuation Shea hat are '•• gad o conform with the amount certified) (Line 3 less Line 6) $ 0.00 C• CT10 • • E•: B 05-/ Ill Y `%' tom i' Date: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AR ' T e Total changes approved in previous months by Owner$ $ c 6 t 0.00 0.00 By: _ . rr Date: Total approved this Month $ 0.00 $ 0.00 This ':x to is 1,,• negotiab The MINT CERT RrIED is payable only to the Contractor TOTALS $ n nn $ named .,-in. .,•∎•K.ce,payment and a; .tance of payment are without prejudice to any rights of n nn the 0..■ ;;:0.4n-tractor under ' ,K.. NET CHANGES by Change Order $ 0.00 MA Document G702lt2a*•—1992.Copyright 01992 by The American Institute of Architects.All eights 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 produced by AIA software at 11:0959 on 04/01/2010 under Order No.1000389341 1 which expires on 5/13/2010,and Is not for resale. User Notes: — (1503841120) re A...i.g.. IA Document 6703 - 1992 Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO: 1 containing Contractor's signed certification is attached. In tabulations below.amounts are stated to the nearest dollar. APPLICATION DATE: 04/12/11 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 04/30/11 ARCHITECT'S PROJECT NO: A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS ITEM SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE DESCRIPTION OF WORK PREVIOUS AND STORED FINISH (IF VARIABLE NO. VALUE APPLICATION THIS PERIOD STORED(NOT (Cr_C) IN TO DATE (C-G) RATE) (D+E) D OR E) (D+E+F) 990001 Agreement 2695-02606 19,010 19,010 19,010 100 Grand Totals 19.010 0 19.010 0 19,010 100 0 0 AIA Document 07031v-1 992.Copyright®1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects,An rights reserved.WARNING:This AlA°Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®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 produced by AIA software at 10:46:07 on 04/01/2010 under Order No.1000389341 1 which expires on 5/13/2010.and is not for resale. User Notes: (4151515913) CONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT PROJECT: CPAC Cafe Buildout Upon receipt by the undersigned of a check from Carmel Theater Dvlpmnt Co in the sum of $19,010.00 payable to General Piping Inc. and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanic's lien, stop notice, any state or federal statutory bond right, any private bond right, any claim for payment and any rights under any similar ordinance, rule or statute related to claim or payment rights for persons in the undersigned's position, the undersigned has on the job of located at , to the following extent. This release covers a progress payment for labor, services, equipment or materials furnished to the jobsite or to Carmel Theater Dvlpmnt Co through 04/30/11 only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date or pending modifications and changes. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that furnished labor, services, equipment or material was not compensated by the progress payment. The undersigned warrants that he either has already paid or will use the monies he receives from this progress payment to promptly pay in full all of his laborers, subcontractors, materialmen and suppliers for all work, materials, equipment or services provided for or to the above-referenced project up to the date of this waiver. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned. DATE: til 12 l General Plpi Inc. (signature) sec. Teas. (title) General Piping, Inc. P.O. Box 34367 Indianapolis, Indiana 46234 (317)388-0552 Fax(317)388-0554 To: Carmel Theater Development Company Date: 4/12/11 11711 N. Pennsylvania Street, Suite 200 Carmel, IN 46032 Attn: Jeremy Stephenson Transmittal Items Transmitted Qty Description 1 Invoice for Café Build-out Work(Agreement 2695-02606)