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Meyer Najem, Gibraltar, LaFever - $282,988.45
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 Amounts to be paid by Carmel Theater Development Company for Parcel 7B contracts Invoice 02-10-749-00002(Meyer Najem) October 2010 $ 26,479.76 Pay application 1 (Gibraltar) October 2010 $197,162.10 Pay application 2(LaFever) October 2010 $ 59,346.59 Total Authorized Disbursement $282,988.45 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: // �2//O 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. - 13099 Parkside Drive Fishers, IN 46038 8.6 317-577-0007 '° 317-577-0286(fax) _____ .] A CONSTRUCTION• October 31, 2010 CS C7t2 Invoice#: 02-10-749-00002 280 E. 9 t., Ste. 100 Terms: Net 30 Days Ind' apolis, IN 46240 n: Brandon Bogan Project: Carmel Greenway Parcel 7B For Period Ending: 10/31/10 Schedule of Value' Prior Billings (Current Billing( Cumulative Total I. Staffing $ 154,050.00 $ 12,574.99 $ 10,860.07 $ 23,435.06 II. General Conditions $ 21,950.00 $ 50.00 $ 786.86 $ 836.86 Ill. Construction Manager Fee $ 100,000.00 $ 2,028.37 $ 14,832.83 $ 16,861.20 $ 41,133.12 $ 276,000.00 TOTAL AMOUNT DUE $ 26,479.76 Tim Russell,President If you have any questions, please reference the invoice number. Page 1 Project: Carmel Greenway Parcel 7B 9/30/2010 10/31/2010 TOTAL TO DATE ADMINSTRATIVE 1-1160 A Safety/First Aid $ 22.00 $ 22.00 1-1210 A Project Signage $ 104.86 $ 104.86 1-1240 A Drinking Water $ - 1-1260 A Field Office Supplies $ - 1-1300 A Elect. Usage $ - 1-1330 A Phone/Fax Usage $ 48.07 $ 48.07 1-1340 A Cell Phone Service $ 87.24 $ 87.24 1-1510 A Postage $ 37.69 $ 37.69 1-1520 A Printing/Reproduction $ 50.00 $ 50.00 $ 100.00 1-1540 A F.S. Mileage $ - 1-1550 A P.M. Travel $ - 1-1560 A Builders Risk $ 323.00 $ 323.00 $ - EQUIPMENT $ - 1-1175 E IT Equipment $ 114.00 $ 114.00 1-1190 E Field Office Trailer $ - 1-1250 E Field Office Equipment $ - 1-1350 E Small Tools $ - $ - MATERIAL $ - 1-1530 M Photo-Journal $ - II. GENERAL CONDITIONS SUBTOTAL $ 50.00 $ 786.86 $ 836.86 PROJECT STAFF 1-1160 L/LB Safety $ 127.27 $ 156.65 $ 283.92 1-1910 L/LB Project Manager $ 3,791.32 $ 1,591.42 $ 5,382.74 1-1930 L/LB Field Superintendent $ 8,656.40 $ 9,112.00 $ 17,768.40 I. PROJECT STAFF SUBTOTAL $ , 12,574.99 $ 10,860.07 $ 23,435.06 $ 12,624.99 $ 11,646.93 $ 24,271.92 Meyer Najem Construction Check: 10 13099 Parkside Drive Date: 11/23/2010 Fishers, IN 46038 Vendor: MEYNAJEM Prior Invoice P.O. Num. In_ voice Amt Balance Retention Discount Amt. Paid 02-10-749-00002 86 26,479.76 26,479.76 0.00 0.00 26,479.76 Greenway P7B 26,479.76 26,479.76 0.00 0.00 26,479.76 10 11/23/2010 ************26,479.76 THE SUM OF TWENTY SIX THOUSAND FOUR HUNDRED SEVENTY NINE DOLLARS AND 76 CENTS Meyer Najem Construction 13099 Parkside Drive Fishers, IN 46038 Meyer Najem Construction Check: 10 13099 Parkside Drive Date: 11/23/2010 Fishers, IN 46038 Vendor: MEYNAJEM Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 02-10-749-00002 86 26,479.76 26,479.76 0.00 0.00 26,479.76 Greenway P7B 26,479.76 26,479.76 0.00 0.00 26,479.76 PROJECT : Carmel Greenway Parcel 7B DATE : 10/25/2010 OWNER: City of Carmel Redevelopment Commission CONSTRUCTION MANAGER: MEYER NAJEM CONSTRUCTION TOTAL ORIGINAL CHANGE REVISED COMPLETED & TOTAL TOTAL EARNED LESS PREVIOUS CONTRACT ORDERS TO CONTRACT STORED TO RETAINAGE TO LESS CERTIFICATES CURRENT BALANCE TO CONTRACTOR APP. # AMOUNT DATE AMOUNT DATE DATE RETAINAGE FOR PAYMENTS PAYMENT DUE FINISH Gibraltar Construction 1 $1,046,700.00 $0.00 $1,046,700.00 $219,069.00 $21,906.90 $197,162.10 $197,162.10 $849,537.90 LaFever Electric 2 $658,855.00 $0.00 $658,855.00 $93,883.00 $9,388.30 $84,494.70 $25,148.11 $59,346.59 $574,360.30 _ $0.00 $0.00 $0.00 _ $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $1,705,555.00 $0.00 $1,705,555.00 $312,952.00 $31,295.20 $281,656.80 $25,148.11 $256,508.69 $1,423,898.20 rim ' AIA Document G702/CMa - 1992 S7 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: Distribution to: Carmel Theatre Development Corporation,LLC Parcel 7B-Center for Perfoming Arts 1 '1 30 PERIOD TO: 10/22/10 OWNER ❑ C�e,-' �r "' Ca mel West Street,Suite 220 ,„ CONSTRUCTION MANAGER ❑ FROM CON,TR'A(CTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ t� y ,s. Gibraltar Construction Corp 4/13/10 '� 2932 N.Webster Ave. PROJECT NOS: I I CONTRACTOR I: \.�r�' ) Indianapolis,IN 46219 VIA ARCHITECT: FIELD ❑ �� CSO Architects, Inc. CONTRACT FOR: Sitework Package 1 ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifi.s 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 A iplication 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 Payment ,;)e 'sued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM • $ 1,04R.700.n0 payment shown herein is // ,d,:. . 2. Net change by Change Orders $ 0.00 CONTRACTOR: Gibral Yt struction Corp 3.CONTRACT SUM TO DATE(Line.] ±2) $ 1.046.700.00 By: Date: /0-o2„9---/0 /'i 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 219,069.00 State of: ,Q/a 1 / 5.RETAINAGE: County of:�i_ r �K�y✓�<,.,..,,, BRIAN R. MCBRIDE a. %of Completed Work Subscribed un worn to before .2Q�4;t� t1=3, Ci HE7CCCk County (Column D+Eon G703) $ 21,906.90 me this ' day of�i/!� I / My Comm . Ex,o, 11-29-2017 b. %of Stored Material Notary Publi • ✓D I PN Commission # 611862 (Column F on G703) $ My Commission expires: //.--.25,..-1-7 Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 197,162.10 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 $ 0.00 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 $ 197.162.10 AMOUNT CERTIFIED $ 1q1 I CO2_ •rc) 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) $ 849,537.90 CONSTRUCTI AGER: By: _Ada Date: 'O)2-S/ 1c> CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: i'" I Total changes approved in'previous months by Owner $ $ i - • : ch' ets' nc.. kin ��( g PP P Y By: Date: JV 1v Total approved this Month $ $ This •rtificate is of negotiable. The AMOUNT CERTIFIED is payable only tote Contractor TOTALS $ $ nam-i herein. I . ance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the lwner o "ontractor 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/CMaTM-1992.Copyright ©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 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. 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. © Document G702/CMaTM - 19 92 Instructions • Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition, 1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). - Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment - -- The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and_.Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMa M-1992.Copyright ©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 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.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 Page 2 of 6 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION NO. : 1 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where APPLICATION DATE: 10/22/2010 PERIOD TO: 10/22/2010 variable retainage for line items may apply. ARCHITECT'S PROJECT NO. A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO RETAINAGE ITEM DESCRIPTION OF WORK SCHEDULED VALUE FROM PREVIOUS PRESENTLY COMPLETED AND % FINISH (IF VARIABLE NO. APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) (C-G) RATE) (D+E) DORE) (D+E+F) 1 Supervision $ 21,000 $5,250.00 $5,250.00 25% 15,750.00 525.00 2 Allowance $ 70,000 $4,808.00 $4,808.00 7% 65,192.00 480.80 3 Bonds $ 15,315 $15,315.00 $15,315.00 100% - 1,531.50 4 Misc. General Conditions $ 20,985 $5,246.00 $5,246.00 25% 15,739.00, 524.60 5 Phase 1 6 Earthwork Material $ 27,000 $13,500.00 $13,500.00 50% 13,500.00 1,350.00 7 Earthwork Labor $ 67,000 $50,250.00 $50,250.00 75% 16,750.00 5,025.00 8 Underdrains Material $ 36,850 $18,425.00 $18,425.00 50% 18,425.00 1,842.50 9 Underdrains Labor $ 36,850 $18,425.00 $18,425.00 50% 18,425.00 1,842.50 10 Structural Soil Material $ 20,000 $20,000.00 $20,000.00 100% - 2,000.00 11 Structural Soil Labor $ 2,000 $2,000.00 $2,000.00 100% - 200.00 12 Plumbing Material _ $ 17,000 $0.00 0% 17,000.00 - 13 Plumbing Labor $ 10,000 $0.00 0% 10,000.00 - 14 Asphalt Paving Material $ 10,000 $10,000.00 _ $10,000.00 100% - 1,000.00 15 Asphalt Paving Labor $ 6,000 $6,000.00 $6,000.00 100% - 600.00 16 Concrete Curbs Material $ 5,500 $2,750.00 $2,750.00 50% 2,750.00 275.00 17 Concrete Curbs Labor $ 30,000 $15,000.00 $15,000.00 50% 15,000.00 1,500.00 18 Temporary Walk Material $ 2,000 $0.00 0% 2,000.00 - 19 Temporary Walk Labor _ $ 2,000 $0.00 0% 2,000.00 - 20 Joint Sealants Material $ 100_ _ $0.00 0% 100.00 - 21 Joint Sealants Labor $ 100 $0.00 0% 100.00 - _ 22 Concrete Pavers Material $ 8,000 $0.00 0% 8,000.00 - 23 Concrete Pavers Labor $ 4,000 $0.00 0% 4,000.00 - 24 Permeable Pavers Material $ 100,000 $0.00 0% 100,000.00 - 25 Permeable Pavers Labor $ 26,000 $0.00 0% 26,000.00 - CONTINUATION SHEET Page 3 of 6 APPLICATION NO. : 1 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION DATE: 10/22/2010 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 10/22/2010 ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS ITEM °0 TOTAL COMPLETED BALANCE TO DESCRIPTION OF WORK SCHEDULED VALUE FROM PREVIOUS PRESENTLY AND STORED TO FINISH RETAINAGE NO. APPLICATION THIS PERIOD STORED(NOT IN (G I C) (IF VARIABLE RATE) (p+E) DORE) DATE(D+E+F) (C-G) 26 Phase 1A 27 Earthwork Material $ 3,000 $3,000.00 $3,000.00 100% - 300.00 28 Earthwork Labor $ 5,000 _ $5,000.00 $5,000.00 100% - 500.00_ 29 Concrete Curbs Material $ 2,300 $2,300.00 $2,300.00 100% - 230.00 30 Concrete Curbs Labor $ 4,000 $4,000.00 $4,000.00 100% - 400.00 31 Concrete Walks Material $ 6,250 $6,250.00 $6,250.00 100% - 625.00 32 Concrete Walks Labor $ 6,250 6,250 $6,250.00 100% - 625.00 33 Joint Sealants Material $ 100 $0.00 0% 100.00 - 34 Joint Sealants Labor $ 100 $0.00 0% 100.00 - 35 Concrete Pavers Material $ 3,700 $0.00 0% 3,700.00 - 36 Concrete Pavers Labor $ 1,800 $0.00 0% 1,800.00 - 37 Granite Pavers Material $ 20,000 - $0.00 0% 20,000.00 - 38 Granite Pavers Labor $ 7,000 - $0.00 0% 7,000.00 - 39 Phase 1B 40 Earthwork Material $ 2,500 $0.00 0% 2,500.00 - 41 Earthwork Labor $ 2,500 $0.00 0% 2,500.00 - 42 Concrete Curbs Material $ 1,000 _ $0.00 0% 1,000.00 - 43 Concrete Curbs Labor $ 3,000 $0.00 0%, 3,000.00 - 44 Concrete Walks Material $ 2,650 $0.00 0% 2,650.00 - 45 Concrete Walks Labor $ 2,650 $0.00 0% 2,650.00 - 46 Joint Sealants Material $ 100 $0.00 0%, 100.00 - 47 Joint Sealants Labor $ 100 $0.00 0% 100.00 - 48 Concrete Pavers Material $ 1,800 $0.00 0% 1,800.00 - 49 Concrete Pavers Labor $ 3,700 $0.00 0% 3,700.00 - 50 Permeable Pavers Material $ 4,000 $0.00 0% 4,000.00 - CONTINUATION SHEET Page 4 of 6 APPLICATION NO. : 1 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 10/22/2010 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts PERIOD TO: 10/22/2010 where variable retainage for line items may apply. ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE RATE) (D+E) DORE) (D+E+F) (C G) 51 Permeable Pavers Labor $ 1,000 - 0% 1,000 - 52 Phase 1C 53 Earthwork Material $ 1,200 600 600 50% 600 60.00 54 Earthwork Labor $ 1,200 600 600 50% 600 60.00 55 Topsoil Material $ 500 - 0% 500 - 56 Topsoil Labor $ 500 - 0% 500 - 57 Site Demolition Material $ 500 500 500 100% - 50.00 58 Site Demolition Labor $ 1,500 1,500 1,500 100% - 150.00 59 Concrete Curbs Material $ 2,400 600 600 25% 1,800 60.00 60 Concrete Curbs Labor $ 6,000 1,500 1,500 25% 4,500 150.00 61 Concrete Walks Material $ 12,500 - 0% 12,500 - 62 Concrete Walks Labor $ 12,500 - 0% 12,500 - 63 Joint Sealants Material $ 100 - 0% 100 - 64 Joint Sealants Labor $ 100 - 0% 100 - 65 Concrete Pavers Material $ 15,400 - 0% 15,400 - _ 66 Concrete Pavers Labor $ 7,600 - 0% 7,600 - 67 Landscaping Material $ 100 - 0% 100 - 68 Landscaping Labor $ 100 _ - 0% 100 - 69 Phase 2 70 Earthwork Material $ 10,150 - 0% 10,150 - 71 Earthwork Labor $ 10,150 - 0% 10,150 - 72 Topsoil Material $ 16,250 - 0% 16,250 - 73 Topsoil Labor $ 16,250 - 0% 16,250 - 74 Concrete Walks Material $ 12,600 - 0% 12,600 - 75 Concrete Walks Labor $ 12,600 - 0% 12,600 - CONTINUATION SHEET Page 5 of 6 APPLICATION NO. : 1 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 10/22/2010 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 10/22/2010 ARCHITECT'S PROJECT NO. : A B C D ( E F G H I WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE RATE) (D+E) DORE) (D+E+F) (C G) 76 Joint Sealants Material $ 100 - 0% 100 - 77 Joint Sealants Labor $ 100 - 0% 100 - 78 Concrete Pavers Material $ 22,400 - 0% 22,400 - 79 Concrete Pavers Labor $ 11,100 - 0% 11,100 - 80 Granite Pavers Material $ 10,000 - 0% 10,000 - 81 Granite Pavers Labor $ 5,000 - 0% 5,000 - 82 Pourous Pavers Material $ 60,000 - 0% 60,000 - 83 Pourous Pavers Labor $ 15,000 - 0% 15,000 - 84 Decomposed Granite Material $ 66,000 - 0% 66,000 - 85 Decomposed Granite Labor $ 25,000 - 0% 25,000 - 86 Landscaping Material $ 10,000 _ - 0% 10,000 - 87 Landscaping Labor $ 3,000 - 0% 3,000 - 88 Irrigation Material $ 3,500 - 0% 3,500 - 89 Irrigation Labor $ 5,000 - 0% 5,000 - 90 Phase 3 91 Earthwork Material $ 2,400 - 0% 2,400 - 92 Earthwork Labor $ 2,400 - 0% 2,400 - 93 Topsoil Material $ 1,000 - 0% 1,000 - 94 Topsoil Labor $ 2,000 - 0% 2,000 - 95 Site Demolition Material $ 1,000 - 0% 1,000 - 96 Site Demolition Labor $ 4,000 - 0% 4,000 - 97 Concrete Curbs Material $ 2,800 - 0% 2,800 - 98 Concrete Curbs Labor $ 4,000 - 0% 4,000 - 99 Concrete Walks Material $ 7,500 - 0% 7,500 - 100 Concrete Walks Labor $ 7,500 - 0% 7,500 - CONTINUATION SHEET Page 6 of 6 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION NO. : 1 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where APPLICATION DATE: 10/22/2010 variable retainage for line items may apply. PERIOD TO: 10/22/2010 ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE RATE) (D+E) DORE) (D+E+F) (C G) 101 Joint Sealants Material $ 100 - 0% 100 102 Joint Sealants Labor $ 100 - 0% 100 103 Concrete Pavers Material $ 10,000 - 0% 10,000 104 Concrete Pavers Labor $ 3,200 - 0% 3,200 105 Landscaping Material $ 50 - 0% 50 106 Landscaping Labor $ 50 - 0% 50 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 $1,046,700.00 $0.00 $219,069.00 $0.00 $219,069.00 21% $827,631.00 $21,906.90 ISA Form# 1-402 • / 4�1 AFFIDAVIT AND WAIVER OF LIEN ❑ FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Parcel 7B, Center for Performing Arts, Sitework Package 1 and owned by Carmel Theatre Development Corporation, LLC. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of One Hundred Ninety Seven Thousand One Hundred Sixty Two and 10/100 Dollars ($197,162.10) ❑ receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration of this 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 the final balance due from the Owner is the sum of Dollars ( ) ❑ receipt of which is hereby acknowledged; or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto the O er of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon a•lount of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions exfr;s fd herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work pe or fd or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By /i/I Title President WITNESS MY HAND AND NOTORIAL SEAL, "s 22nd dayi.f October, 2010. (Notary Public) o 1979 awor.Ka SUBCONTRACTORS S assotI•rio« INCORPORATED �`"Po BRIAN R, MCBRIDE Unyutho•,ted PeDtodvction P➢ohrblted Z pp j Rev IOW My Comm Eao, 11-29.2017 o -oi0 Commis o,7 # 611862 Gibraltar Construction Corp Check: 12 2932 N.Webster Ave. Date: 11/23/2010 Indianapolis, IN 46219 Vendor: GIBR1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 5-1 87 219,069.00 219,069.00 21,906.90 0.00 197,162.10 Application 1 on Sitework Pack 219,069.00 219,069.00 21,906.90 0.00 197,162.10 12 11/23/2010 **********197,162.10 THE SUM OF ONE HUNDRED NINETY SEVEN THOUSAND ONE HUNDRED SIXTY TWO DOLLARS AND 10 CENT; Gibraltar Construction Corp 2932 N. Webster Ave. Indianapolis, IN 46219 Gibraltar Construction Corp Check: 12 2932 N. Webster Ave. Date: 11/23/2010 Indianapolis, IN 46219 Vendor: GIBR1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 5-1 87 219,069.00 219,069.00 21,906.90 0.00 197,162.10 Application 1 on Sitework Pack 219,069.00 219,069.00 21,906.90 0.00 197,162.10 'AIA Z,.....A IA Document 6702/CMa TM - 1992 a8 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: Parcel 78 APPLICATION NO: 2 Distribution to: Cannel Theatre Dev. Commission 3rd Avenue Southwest PERIOD TO: 10/31/2010 OWNER ❑ 30 West:Main Street, Suite 220 Carmel, Indiana Carmel, Indiana 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: • 9/17/2010 ARCHITECT ❑ LaFever Electric, Inc. Meyer Najem Construction, LLC PROJECT NOS: 1744 / / CONTRACTOR X] 131 N. Rangeline Road Cannel, Indiana 46032 VIA ARCHITECT: FIELD ❑ CONTRACT FOR: CSO Architects, Inc. ❑ 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 $658,855.00 payment shown herein is now due. 2. Net change by Change Orders $ 0.00 CONTRACTORL'• LaFe er leccttric, Inc. 3.CONTRACT SUM TO DATE(Line 1 ±2) $658,855.00 By: • a ,�/ Date: 10/25/2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 93,883.00 State of: Indiana . Michael A. LaFever, Vice-President 5.RETAINAGE: County of: Hamilton ``\`hhpupuuunnpry,,,,„,/' a. 10 %of Completed Work Subscribed and sworn o before ° Q,F`( .Ut4r (Column D+Eon G703) $ 4,569.13 me this 25th ,ay ,_' . O J= ii- • 110 /0' b. 10 %of Stored Material Notary Public Colleen S. Marvel '1:!..I F' IA!i - (Column F on G703) $ 4,819.18 My Commis in ex.i es. _,.,, 51�_. 9,388.31 - Total Retainage(Lines 5a+5b or Total in Column I of 0703).. $ CERTIFICATE FOR Pin 6.TOTAL EARNED LESS RETAINAGE $ 84,494.70 In accordance with the ContractVoctitients, based,,on o, ite observations and the data comprising this application, the Construction Ittad•4 'certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief th : l ssed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 25,148.11 accordance with the Contract Documents,a't�t8'V Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 59,346.59 AMOUNT CERTIFIED $ 51 3`l iO- c9 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial A figures on this Application and on t1w continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 574,360.31 CONSTRUCTION ANAL R: By: - Date: /0/L-e--/1 Q CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: q Total changes approved in previous months by Owner $ - $ ■- By: -�- Date: '�`Z 1 Total approved this Month $ - $ - This Cer. icate is no negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ - $ - name erein. Issu• •ce,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ - the • ner or Co ractor 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/CMa TM-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 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. 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. ''' G702/CMaTM 1 } ® Document - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors.have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,.Construction Manager-Adviser Edition,1992 Edition. • B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document;nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. " D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). _ Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment v± The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Do€€ument G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. „J1 AIA Document G702/CMa M-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.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. JOB NAME Parcel 7B-Center for Performing Arts APPLICATION DATE 10/25/2010 PAGE NUMBER 1 APPLICATION NUMBER 2 PERIOD TO 10/31/2010 A B C D E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 1 Conduit M 64,205.00 1,926.15 14,125.10 22,471.75 38,523.00 60 25,682.00 3,852.30 - - L 105,840.00 3,175.20 23,284.80 26,460.00 25 79,380.00 2,646.00 2 Wire M 87,610.00 - - - - 87,610.00 - - - L 49,530.00 - - - 49,530.00 - 3 Switchgear M 11,610.00 - - - - 11,610.00 - - - L 9,460.00 - - - 9,460.00 - 4 Light Fixtures M 202,000.00 - - - - 202,000.00 - - - L 36,000.00 - - - 36,000.00 - 5 Excavating M 58,000.00 - - 17,400.00 17,400.00 30 40,600.00 1,740.00 6 Allowance L 18,000.00 - - - 18,000.00 - 7 Payment and Performance Bond M 7,600.00 2,280.00 - 5,320.00 7,600.00 100 - 760.00 8 Submittals L 3,000.00 900.00 - 900.00 30 2,100.00 90.00 9 Mobilization M 3,000.00 - - 3,000.00 3,000.00 100 - 300.00 10 Closeout L 3,000.00 - - - 3,000.00 - - - M - - - - - - L - - - - M - - - - - L - - - - M - - - L - - - - M - - - - - - L - - - - M - - - - - . - - L - - I658,855.00 8,281.35 37,409.90 48,191.75 93,883 00 564,972 00 9,388.30 WAIVER OF LIEN TO DATE . State of Indiana 1 ss County of Hamilton l Pile fir TO WHOM Yr MAY coNcERN: WHEREAS the undersigned bas beta employed by LaFever Electric, Inc. Mee t .CoviasrerBY err to finish Electrical Work dm the premises described ss Parcel 713 ortmas*Ow erattef 1Api mogul of which_ Carmel Theatre Development Commission is the ovme Fifty-nine Thousand Three Hundred Forty-six Dollars and Fifty-nine Cent! THE untersi fir and la (S 59,346.59 )l]ollars,and Ohm goad and valuable consideration,she receipt whereof is her shy acknowledged,do(ca)hereby wain and relesee any and all lien or claim or right of lien under the Statutes of the State wherein the land is located,relating to 1 declhamics liens,on the above described premises and improvements thereon,and on the monies t>r error considerations due of to become due nom the owner,on*am art of labor or aQrrioes,mamrial,footling or apps h estothre limtlnbed to this data by the undersigned for the above described premises. stgzad this 25th des,of October ,z0 10 .__ . Michael A. LaFever, Vice-President kit NOTEr All waivers must be for the fan amount paid.If waiver is for a corporation,corporate name should be reed,corporate seat affixed and tide of officer signing waiver should be set forth;limiter is for a Partnership,the parenarghip name should be need,Farmer should sign and demote Inman Fanner. CONTRACTOR'S AFFIDAVIT State of Indiana )ss County of Hamilton 1 TO WHOM IT MAY CONCFRN: 'YltE andersi,gecd,being dully sworn,deposes and says diet ha Is Vice-President of LaFever Electric, Inc. whole the ocatractor for the Electrical Work work on the bulbs l r venue Southwest, Carmel Indiana 460Jf — owned by Carne cairn eve o.ment Commission _ That the total sestet of the contract Including extras is S 65 8,85 5.00 on+dhieb ha hag ready-0d- pgrnent of s 0.00 prior to this payment.That all vetivers are true,correct and genuine and dative rod unconditionally and that theta is no claim either legal or equitable to dokoet the validity of said waivers.That the following are the names of all parties aho have kmtubed material or Mbar,Or both,for said work and all parties having contras or aabootraacte for specific portions of saki work or for material entering into the coma ruction thereof and the amount dire at to become dud to-•.- raid affil the stems mtatitl cd included all labor and material -:to...„• - Said work atm ,; .to lam)and .. ,out•___ KatD OF WORK— — — . MAIM rr �..•� PRY c..Y u —T.—urin '.ore pro — : II tree Iona :oring 58,00Q.Q0_ 1.11 �1� f fit To COMPr _ t�f: TOM.LOOK ARID M/T7taw til[T1• & P I . in:,- labor or other work o miy kind 'I�then are no other contract;fir said uroek outstanding,mid d►ot titan is Heflin due or to become due to any peso dace or to be done upon or in connection with said work other that above stated. Signor this 25th day of _ October ,ze 10 . /i't iL / Michael A. LaFever ice-President Subscribed end sworn to before me this 25th day of October .tip 1.1 ,i,uiw„ ``�\ • V P �/4" ' ••••••' •••' Colle- ' ..Marvel T$1 GD18 oti�noo7 _ _------- La Fever Electric, Inc. Check: 11 131 N Rangeline Road Date: 11/23/2010 Carmel, IN 46032 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3-2 88 65,940.66 65,940.66 6,594.07 0.00 59,346.59 Applicatin 2 65,940.66 65,940.66 6,594.07 0.00 59,346.59 11 11/23/2010 ************59,346.59 THE SUM OF FIFTY NINE THOUSAND THREE HUNDRED FORTY SIX DOLLARS AND 59 CENTS LaFever Electric, Inc. 131 N Rangeline Road Carmel, IN 46032 La Fever Electric, Inc. Check: 11 131 N Rangeline Road Date: 11/23/2010 Carmel, IN 46032 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3-2 88 65,940.66 65,940.66 6,594.07 0.00 59,346.59 Applicatin 2 65,940.66 65,940.66 6,594.07 0.00 59,346.59