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HomeMy WebLinkAboutMeyer Najem, Gibraltar, LaFever - $178,319.78Regions 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 Green Improvements installment purchase contract Invoice 02 -10- 749 -00007 (Meyer Najem) March 2011 $ 14,853.56 Application 6 (Gibraltar) March 2011 $ 102,065.00 Application 7 (LaFever) March 2011 $ 61,401.22 Total Authorized Disbursement $ 178,319.78 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: 4/7 l CITY OF CARMEL REDEVELOPMENT COM ,r✓ ION By: Printed: Title: Les S. Olds Executive Director 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 Green Improvements (Meyer Najem) August 2010 (pre- construction invoice 02 -09- 746 -001) Paid by the Carmel Theater Development Company $ 12,594.19 September 2010 (invoice 02 -10- 749 - 00001) Paid by the Carmel Theater Development Company $ 14,653.36 October 2010 (invoice 02 -10- 749 - 00002) Paid by the Carmel Theater Development Company $ 26,749.76 November 2010 (invoice 02 -10- 749 - 00003) Paid by the Carmel Theater Development Company $ 34,022.34 December 2010 (invoice 02 -10- 749 - 00004) Paid by the Carmel Theater Development Company $ 26,668.18 January 2011 (invoice 02 -10- 749 - 00005) Paid by the Carmel Theater Development Company $ 15,325.58 February 2011 (invoice 02 -10- 749 - 00006) Paid by the Carmel Theater Development Company $ 9,146.37 March 2011 (invoice 02 -10- 749 - 00007) Amount to be paid by the Carmel Theater Development Company $ 14,853.56 March 25, 2011 CSO 8831 Keystone Crossing Indianapolis, IN 46240 Attn: Brandon Bogan I. Staffing II. General Conditions III. Construction Manager Fee Project: Carmel Greenway Parcel 7B For Period Ending: 3/25/11 TOTAL AMOUNT DUE Tim Russell, President 13099 Parkside Drive Fishers, IN 46038 317- 577 -0007 317 - 577 -0286 (fax) Invoice #: 02 -10- 749 -00007 Terms: Net 30 Days Schedule of Value Prior Billings 1 Current Billing I Cumulative Total $ 154,050.00 $ 21,950.00 $ 100,000.00 $ 276,000.00 $ 60,798.93 $ $ 5,910.60 $ $ 59,586.06 $ 5,960.60 373.00 8,519.96 $ 14,853.56 66,759.53 $ 6,283.60 $ 68,106.02 $ 141,149.15 If you have any questions, please reference the invoice number. Project: Carmel Greenway Parcel 7B ADMINSTRATIVE 1 -1160 A 1 -1210 A 1 -1240 A 1 -1260 A 1 -1300 A 1 -1330 A 1 -1340 A 1 -1510 A 1 -1520 A 1 -1540 A 1 -1550 A 1 -1560 A EQUIPMENT 1 -1175 E 1 -1190 E 1 -1250 E 1 -1350 E MATERIAL 1 -1530 M Safety /First Aid Project Signage Drinking Water Field Office Supplies Elect. Usage Phone /Fax Usage Cell Phone Service Postage Printing /Reproduction F.S. Mileage P.M. Travel Builders Risk IT Equipment Field Office Trailer Field Office Equipment Small Tools Photo - Journal II. GENERAL CONDITIONS SUBTOTAL PROJECT STAFF 1 -1160 L /LB 1 -1910 L /LB 1 -1930 L /LB Safety Project Manager Field Superintendent Page 1 9/30/2010 10/31/2010 11/30/2010 12/20/2010 1/25/2011 2/24/2011 3/25/2011 TOTAL TO DATE $ 22.00 $ 20.50 $ 9.50 $ 10.00 $ $ 104.86 $ $ $ $ $ 48.07 $ 48.19 $ 48.29 $ 48.11 $ 48.27 $ $ 87.24 $ 86.83 $ 134.01 $ 87.63 $ 87.09 $ $ 37.69 $ 19.31 $ 78.00 $ $ 50.00 $ 50.00 $ 50.00 $ 2,434.97 $ 50.00 $ 50.00 $ 50.00 $ $ $ 12.75 $ $ 323.00 $ 323.00 $ 323.00 $ 323.00 $ 323.00 $ 323.00 $ $ 114.00 $ 144.00 $ 108.00 $ 102.00 $ 84.00 $ $ $ $ 20.29 $ $ 50.00 $ 786.86 $ 692.81 $ 3,077.08 $ 698.74 $ 605.11 $ 373.00 $ $ 127.27 $ 156.65 $ 146.87 $ 107.70 $ 107.70 $ 3,791.32 $ 1,591.42 $ 4,399.79 $ 2,621.15 $ 2,714.78 $ 2,621.15 $ 3,744.50 $ 8,656.40 $ 9,112.00 $ 8,806.43 $ 6,378.40 $ 7,745.20 $ 1,822.40 $ 2,108.40 I. PROJECT STAFF SUBTOTAL $ 12,574.99 $ 10,860.07 $ 13,353.09 $ 9,107.25 $ 10,459.98 $ 4,443.55 $ 5,960.60 62.00 104.86 240.93 482.80 135.00 2,734.97 12.75 1,938.00 552.00 20.29 6,283.60 $ 646.19 $ 21,484.11 $ 44,629.23 $ 66,759.53 $ 12,624.99 $ 11,646.93 $ 14,045.90 $ 12,184.33 $ 11,158.72 $ 5,048.66 $ 6,333.60 $ 73,043.13 Draft Green Improvements (Gibraltar) October 2010 (application 1) Paid by the Carmel Theater Development Company $ 197,162.10 November 2010 (application 2) Paid by the Carmel Theater Development Company $ 198,245.70 December 2010 (application 3) Paid by the Carmel Theater Development Company $ 84,847.50 January 2011 (application 4) Paid by the Carmel Theater Development Company $ 18,270.70 February 2011 (application 5) Paid by the Carmel Theater Development Company $ 28,496.70 March 2011 (application 6) Amount to be paid by the Carmel Theater Development Company ;$ ` ' - _l ;=>102,065.00 , Document G702 /CMaTM 1992, Application and Certificate for Payment Construction Manager- Adviser Edition TO OWNER: Carmel Theatre Development Corporatibii; g�cT' Parcel 7B - Center for Pegoming Arts 30 West Main Street, Suite 220 KECEjvEt) Carmel, IN 46032 FROM CONTRACTOR: Gibraltar Construction Corp VI 2932 N. Webster Ave. Indianapolis, IN 46219 . ` VIA ARCHITECT: MAR 24 20'x. A CONSTRUCTION Mi�FRN A6/4 CONS CONTRACT FOR: Sitework Package 1 CSO Architects, Inc. TRU APPLICATION NO: 6 PERIOD TO:. 3123/11 CONTRACT DATE:4113/10 PROJECT NOS: CTI pN Distribution to: OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR ❑ FIELD ❑ ❑ CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, ALA Document G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders. 3, CONTRACT SUM TO DATE (Line 1 ± 2) 4, TOTAL COMPLETED & STORED TO DATE (Column G on 0703) 5. RETAINAGE: a. r7o of Completed Work, (Column D + E on 0703), ` b. (7c of Stored Material (Column F on 0703) $ $ 1,046,700.00 0.00 $ 1,046,700.00 $ 681,422.00 52,335.00 Total Retainage (Lines 5a + 5b or Total in Column I of 0703) . $ 6. TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) $ 629,087.00 527,022.00 102,065.00 417,613.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $ $ Total approved this Month $ $ TOTALS $ $ NET CHANGES by Change Order $. The undersigned Contractor ce belief the Work covered by this Contract Documents, that all Certificates for Payment payment shown herein is CONTRACTOR: Gibralt By; State of: County of Subscribed an "sworn to befo me this a day of.. • Notary Pub" --� My Commission expires: . ere d 0 les that to the best of the Contractor's knowledge, information and pplication for Payment has been completed in accordance with the nts have been paid by the Contractor for Work for which previous ssuecl and payments received from the Owner, and that current e. struction Corp. CERTIFICATE FOR PAYMENT Date: g-c9 y / f BRIAN R. MCBRIDE Res. of Hancock County /7My Comm. Exp. 11 -29 -2017 es r ems/ ('nmmiccinn # 61-00,62 In accordance with the Contract Documents, based on on -site observations and the data comprising this application, the Construction Manager and Architect certify to the Owner that to the best of their knowledge. information and belief' the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT FIED, CERTI • AMOUNT CERTIFIED• $ 1Z2. t(p5 (Attach explanation if amount certified dif'f`ers from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are &hanged to conform with the amount certified.) CONSTRUCTIO By: ARCHITEC , +it .cis; ,rle By: 10, r Date: This Certificate is not negotiable, The AMOUNT CERFINED is payable only to th Contractor named herein. Issuance; payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. Date: 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 G7021CMaTU — 1992. Copyright ©1992 by The American Institute of Architects. All rights reserved. WARNING: This Ale Document is protected by U.S. Copyright law and International Treaties. Unauthorized reproduction or distribution of this Ale 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 @ala.org. CONTINUATION SHEET Page 2 of 6 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION NO. : APPLICATION DATE: PERIOD TO: ARCHITECTS PROJECT NO. : 6 3/23/2011 3/23/2011 A B C D I E F G H l ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN D OR E) TOTAL COMPLETED AND STORED TO DATE (D + £ + F) % (G l C) BA CE FINISH (C G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D + E) THIS PERIOD 1 Supervision $ 21,000 $9,870.00 $1,260.00 $11,130.00 53% 9,870.00 2 Allowance $ 70,000 $16,949.00 $16,949.00 24% 53,051.00 3 Bonds $ 15,315 $15,315.00 $15,315.00 100% - 4 Misc. General Conditions $ 20,985 $9,863.00 $1,260.00 $11,123.00 53% 9,862.00 5 Phase 1 6 Earthwork Material $ 27,000 $27,000.00 $27,000.00 100% - 7 Earthwork Labor $ 67,000 $67,000.00 $67,000.00 100% - 8 Underdrains Material $ 36,850 $35,008.00 $1,842.00 $36,850.00 100% - 9 Underdrains Labor $ 36,850 $18,425.00 $18,425.00 50% 18,425.00 10 Structural Soil Material $ 20,000 $20,000.00 $20,000.00 100% - 11 Structural Soil Labor $ 2,000 $2,000.00 $2,000.00 100% - 12 Plumbing Material $ 17,000 $12,750.00 $3,400.00 $16,150.00 95% 850.00 13 Plumbing Labor $ 10,000 $7,500.00 $2,000.00 $9,500.00 95% 500.00 14 Asphalt Paving Material $ 10,000 $10,000.00 $10,000.00 100% - 15 Asphalt Paving Labor $ 6,000 $6,000.00 $6,000.00 100% - 16 Concrete Curbs Material $ 5,500 $5,500.00 $5,500.00 100% - 17 Concrete Curbs Labor $ 30,000 $30,000.00 $30,000.00 100% - 18 Temporary Walk Material $ 2,000 $2,000.00 $2,000.00 100% - 19 Temporary Walk Labor $ 2,000 $2,000.00 $2,000.00 100% - 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 $8,000.00 $8,000.00 100% - 23 Concrete Pavers Labor $ 4,000 $4,000.00 $4,000.00 100% - 24 Permeable Pavers Material $ 100,000 $100,000.00 $100,000.00 100% - 52,335.00 25 Permeable Pavers Labor $ 26,000 $26,000.00 $26,000.00 100% - CONTINUATION SHEET Page 3 of 6 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column i on Contracts where variable retainage for line items may apply. APPLICATION NO.: 6 APPLICATION DATE: 3/23/2011 PERIOD TO: 3/23/2011 ARCHITECT'S PROJECT NO. : A B C D 1 E F G H I ITEM NO. DESCRIPTION OF WORK LED VALUE SCHEDULED WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN DORE) TOTAL COMPLETED STORED TO DATE (D +E +F) % (G 1 C) BALANCE TO FINISH (C - G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (p +E) THIS PERIOD 26 Phase 1A 27 Earthwork Material $ 3,000 $3,000.00 $3,000.00 100% - 28 Earthwork Labor $ 5,000 $5,000.00 $5,000.00 100% - 29 Concrete Curbs Material $ 2,300 $2,300.00 $2,300.00 100% - 30 Concrete Curbs Labor $ 4,000 $4,000.00 $4,000.00 100% - 31 Concrete Walks Material $ 6,250 $6,250.00 $6,250.00 100% - 32 Concrete Walks Labor $ 6,250 6,250 $6,250.00 100% - 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 3,700 $3,700.00 100% - 36 Concrete Pavers Labor $ 1,800 1,800 $1,800.00 100% - 37 Granite Pavers Material $ 20,000 20,000 $20,000.00 100% - 38 Granite Pavers Labor $ 7,000 7,000 $7,000.00 100% - 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 AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column! on Contracts where variable retainage for line items may apply. APPLICATION NO. : APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO. : 6 3/23/2011 3/23/2011 A B C D ( E F G H 1 ITEM N0. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN DORE) TOTAL COMPLETED AND STORED TO DATE (D +E +F) (G / C) BALANCE TO FINISH (C - G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (+E) D THIS PERIOD 51 Permeable Pavers Labor $ 1,000 - 0% 1,000 52 Phase 1C 53 Earthwork Material $ 1,200 1,200 1,200 100% - 54 Earthwork Labor $ 1,200 1,200 1,200 100% - 55 Topsoil Material $ 500 500 500 100% - 56 Topsoil Labor $ 500 500 500 100% - 57 Site Demolition Material $ 500 500 500 100% - 58 Site Demolition Labor $ 1,500 1,500 1,500 100% - 59 Concrete Curbs Material $ 2,400 2,400 2,400 100% - 60 Concrete Curbs Labor $ 6,000 6,000 6,000 100% - 61 Concrete Walks Material $ 12,500 12,500 12,500 100% - 62 Concrete Walks Labor $ 12,500 12,500 12,500 100% - 63 Joint Sealants Material $ 100 - 0% 100 64 Joint Sealants Labor $ 100 - 0% 100 65 Concrete Pavers Material $ 15,400 15,400 15,400 100% - 66 Concrete Pavers Labor $ 7,600 7,600 7,600 100% - 67 Landscaping Material $ 100 - 0% 100 68 Landscaping Labor $ 100 - 0% 100 69 Phase 2 70 Earthwork Material $ 10,150 10,150 10,150 100% - 71 Earthwork Labor $ 10,150 10,150 10,150 100% - 72 Topsoil Material $ 16,250 - 0% 16,250 73 Topsoil Labor $ 16,250 - 0% 16,250 74 Concrete Walks Material $ 12,600 5,040 5,040 40% 7,560 75 Concrete Walks Labor $ 12,600 5,040 5,040 40% 7,560 CONTINUATION SHEET Page 5 of 6 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION NO. : APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO. : 6 3/23/2011 3/23/2011 A B C D 1 E F G H I ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN DORE) TOTAL COMPLETED AND STORED TO DATE (D +E +F) % (0 / C) BALANCE TO FINISH (C - 0) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (ID +E) THIS PERIOD 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 10,000 10,000 100% - 81 Granite Pavers Labor $ 5,000 - 0% 5,000 82 Pourous Pavers Material $ 60,000 60,000 60,000 100% - 83 Pourous Pavers Labor $ 15,000 15,000 15,000 100% - 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 5,000 89 Irrigation Labor $ 5000 - 0% 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 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION NO.: 6 APPLICATION DATE: 3/23/2011 PERIOD TO: 3/23/2011 ARCHITECTS PROJECT NO. : A B C D I E F G H ll ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN DORE) TOTAL COMPLETED AND STORED TO DATE (D +E +F) % (G ! C) BALANCE TO FINISH (C - G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D +E) THIS PERIOD 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 $585,580.00 $95,842.00 $0.00 $681,422.00 65% $365,278.00 $52,335.00 ISA Form # 1 -402 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 Two Thousand Sixty Five and No /100 ---- -- Dollars ($102,065.00) ❑ 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 t on the above - described property and improvements there undersigned thereto, subject to limitations of conditions has any claim or right to a lien on account of any work p and within the scope of this affidavit and waiver. Gibraltar Construction Corp By Owner of said premises, any and all lien or claim whatsoever account of LABOR or material or both, furnished by the essed herein, if any; and further certifies that no other party rmed or material furnished to the undersigned for said project, WITNESS MY HAND AND NOTORIAL SEAL, "'" 2 h ay of March, 2011. Q 1979 IN[>+A *A SUBCOt1TIACTOTIS ASSOCIATION INCOmPOTIATED W INAtit 'tee ANNNtoNlore Pro *Malted tilted Title President (Notary Public) BRIAN R. MCBRIDE Res. of Hancock County My Comm. Exp. 11 -29 -2017 Commission # 611862 Pow 'O W Draft Green Improvements (LaFever Electric) September 2010 (application 1) Paid by the Carmel Theater Development Company $ 25,148.11 October 2010 (application 2) Paid by the Carmel Theater Development Company $ 59,346.59 November 2010 (application 3) Paid by the Carmel Theater Development Company $ 148,688.77 December 2010 (application 4) Paid by the Carmel Theater Development Company $ 164,895.86 January 2011 (application 5) Paid by the Carmel Theater Development Company $ 46,690.61 February 2011 (application 6) Paid by the Carmel Theater Development Company $ 40,718.24 March 2011 (application 7) Amount to be paid by the Carmel Theater Development Company $ 61,401.22 =S Document G702 /CMaTM —1992 RECEIVE® Application and Certificate for Payment Construction Manager- Adviser Edition MAR 25 2011 TO OWNER: APPLICATIDMIN NT4 j PERIOD TO: : 3/ 1 /ZO'T1NSTRUCTION OWNER ❑ CONSTRUCTION MANAGER ❑ CONTRACT DATE: 9/17/2010 ARCHITECT ❑ PROJECT NOS: 17441 / CONTRAC ❑ FIELD TOR ❑ Carmel Theatre Dev. Commission 30 West Main Street, Suite 220 Carmel, Indiana 46032 FROM CONTRACTOR: LaFever Electric, Inc. 131 N. Rangeline Road Carmel, Indiana 46032 CONTRACT FOR: PROJECT: Parcel 7B 3rd Avenue SW Carmel, Indiana 46032 VIA CONSTRUCTION MANAGER: Meyer Najem Construction, LLC VIA ARCHITECT: CSO Architects, Inc. Distribution to: CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders $ 658,855.00 $ 106,499.05 $ .765,354.05 (Column G on G703) $ 607,654.88 3. CONTRACT SUM TO DATE (Line 1 ± 2) 4. TOTAL COMPLETED & STORED TO DATE 5. RETAINAGE: a. 10 % of Completed Work (Column D + E on G703) b. 10 % of Stored Material (Column F on G703) $ 42,753.67 18,011.82 60,765.49 Total Retainage (Lines 5a + 5b or Total in Column I of G703) . 6. TOTAL EARNED LESS RETAINAGE (Line 4 Less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 Tess Line 6) $ 546,889.39 $ 485,488.17 $ 61,401.22 $ 218,464.66 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 113,694.14 $ 7,195.09 Total approved this Month $ - $ - TOTALS 113,694.14 $ 7,195.09 NET CHANGES by Change Order $ 106,499.05 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 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. CONTRACTR: , LaFever Electric, Inc. By: M 4 State of: Indiana County of: Hamilton Subscribed and sworn to before me this 24th day, of Mar Notary Public: My Commission pnre�s. 'Date: 3/24/2011 Michael A. Leever Vice - President • r Colleen S. Marvel i a CERTIFICATE FOR PA rt' �f: In accordance with the Contract Docume*s, based on op, rte o ervations and the data comprising this application, the Construction Manager *,�,ft 1Fft,� to the Owner that to the best of their knowledge, information and belief the Work_14013vrAg;,e��e ��as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 22 AMOUNT CERTIFIED $ (4A (4\251 (Attach explanation if amoumt certified differs from the amount applied. Initial all figures on this Application and on t Continuation Sheet that are changed to conform with the amount certified.) CONSTRUCTIO By: ARCHITECT: By: This Cer name the Date: a ' ' Date: `11 NT CERTIFIED is payable only v t e Contractor nce of payment are without prejudice to any rights of 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 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. �I�G • kg, A N '''= IA Document G702/CMaTM- 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 6703, 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 cginmencement 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;andjtotaled 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 beentered in this column. Column E: Enter here the value of Work completed at the time of this application, includingthe 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 owri'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 on41A 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. x _. AIA Document G702 /CMaTM —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 APPLICATION NUMBER Parcel 7B- Center for Performing Arts 7 APPLICATION DATE PERIOD TO 3/24/2011 3/31/2011 PAGE NUMBER A B C D I E F G H I ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN D OR E) TOTAL COMPLETED AND STORED TO DATE (D +E +F) % (G =C) BALANCE TO FINISH (C -G) RETAINAGE FROM PREVIOUS APPLICATION (D +E) THIS PERIOD 1.00 Conduit M 64,205.00 38,523.00 6,420.50 19,261.50 64,205.00 100 - 6,420.50 - - L 105,840.00 63,504.00 10,584.00 74,088.00 70 31,752.00 7,408.80 2.00 Wire M 87,610.00 48,185.50 - 39,424.50 87,610.00 100 - 8,761.00 L 49,530.00 27,241.50 - 27,241.50 55 22,288.50 2,724.15 3.00 Switchgear M 11,610.00 11,377.80 - 232.20 11,610.00 100 - 1,161.00 - - L 9,460.00 9,270.80 - 9,270.80 98 189.20 927.08 4.00 Light Fixtures M 202,000.00 80,800.00 - 121,200.00 202,000.00 100 - 20,200.00 - - L 36,000.00 14,400.00 - 14,400.00 40 21,600.00 1,440.00 5.00 Excavating 58,000.00 37,700.00 5,800.00 43,500.00 75 14,500.00 4,350.00 6.00 Allowance 18,000.00 18,000.00 - 18,000.00 100 - 1,800.00 7.00 Payment and Performance Bond 7,600.00 7,600.00 - 7,600 00 100 - 760.00 8.00 Submittals 3,000.00 3,000.00 - 3,000.00 100 - 300.00 9.00 Mobilization 3,000.00 3,000.00 - 3,000.00 100 - 300.00 10.0 Closeout 3,000.00 - - - 3,000.00 - 11.0 ASI #1 &2 (Part of C.0 #1) 52,191.56 33,924.51 2,609.58 36,534.09 70 15,657.47 3,653.41 12.0 ASI #3 Fixtures (Part of C.O. #1) 612.58 612.58 - 612.58 100 - 61.26 13.0 ASI #3R 60,890.00 6,089.00 6,089.00 12,178.00 20 48,712.00 1,217.80 14.0 Conduit Credit (7,195.09) (7,195.09) - (7,195.09) 100 - (719.51) - - M - - - - - - - L - - - - - - - - M - - - - - - - - L - - - - - - M - - - - - - L- - - - - - 765,354.05 396,033.60 31,503.08 180,118.20 607,654.88 157,699.17 60,765.49 Slats of Indiana County of Hamilton TO W1ROM rr mite CONCERN: WHEREAS the undersigned bas been employed by WAIVER OF MIEN TO DATE }SS LaFever Electric, Inc. RoeetQtam,.Orp.ticrwLtEU me to tarnish Electrical Work fir the pt+emieas described as Parcel 7B CF,L (>104, Warms M M,h de ,.rT.aa, aw,a(>104, of which Carmel Theatre Development Commission is the ovine Sixth ne nousand Four Hundred One Dollar and Twenty -two Cents THE wtdetsigned, for and ;n eonsiderr#Icn of (S 61 401.22 Deans, and Other pod end vahtable consideration, die receipt whets is batty acknowledged, do(ca) haeby waive and tele a eny and all lien or claim or right of lien under the Statues of dta State wherein the land is loci rdatfng to I &ebanlces liens. on the +drove dmeribed premises and iatProymnents thereon, and an the minim or other aonside:atione due at to become due from the owner, an room tat of tabor or seraicea, tetanal, fixtunO3 or nroaratts hire Mnished to tale data by tiro undersigned the the !Mora daserlbed nrsadees. Signed this 24th day of March 20 11 "AkAl 0..4.. -- Michael A. LaFcvcr, Vice-President son NOM Ali waver* mat be far the fug amount paid. If watvrsr is for a corperetion, corporate name dental be teed, corporate seal tinted and tido °fofiicer signing waiver should be set foram If svalver k Ibr a partnership, the partterehtp name shontd be nerd. tmrttner abotsld tio end designate Mmsdras partite'. CONTRACTOR'S AFFIDAVIT }sS State of Indiana County or Hamilton TO WHOM IT MAY coreCE,Wib till~ endersigned, being duly worn,, deposes and says that he Is LaFever Electric, Inc. Vice - President who his the contractor ibr the, Electrical Work bulldog located at .ird Avenue 'Southwest, Carmel Indiana 4603'2 _._..W. awned by That the to amount of the contract wetting cocas is S 765354.05 on r vhich he has received payment of S 444,769 _94 prior to this payment. That all waivers are ttur; eorr of and &ermine and ddivt red unconditionally and that these is no Mahn either legal or equitable to defter the validity of acid aaivets 11int the following are the natty= of all prates who have tlntttsltcd matraild at tabor, or both, for Said work and e!1 Pettier having contracts Of subcontracts fbr specific portoes orsaid WO* Of for material /oaring trtto tee carrot motion Woof and tho motet euo as to bow= des to each, and that the items ment4oeed included all labor and material to work rice ,; to WI and tons: arme eatre eve 0 ment ommtssion work on the KIND OPYONIK IlA IA ... a: _ • PR IMIII111111 1 11 SWUM" .1 'MO tie aaa oo other apalrarts fix aid work outstanding, end at there . aothlate that or to become due to any peroo done of to be dhnn upon ee in Oenneetka with Bald work other ten above stated. S1to this 24th ow of March , 20 I . . Subscriber/ end sworn to before me this 24th day of TSI CD16 otiN7ft007 1 5 80 • 1I11171 31 500.00 Mal 1 IME 11 1 ! t011-9III17al %denial, tabor or otlrer work o ,.R „rt , lA , ,.e a .,........ �chael A. LaFever, Vice President Marc , 20 11 * : 23_x. ,� ; p., ihAae } Co leen 4 arvel /J sea kind Stato Of Indiana County of Hamilton TO WHOA[ TT MAY CONCERN: WHEREAS the unrler8hgned has been empleyed by to furnish for the premieos described as anew Mrnu,.rraingeelemmu WAIVER DR' LIEN TO DATE ?SS File #: LaFever Electric, Inc. Electrical Work Parcel 7B named alrea Nneorwauemmemar of which Carmel Theatre Development Commission h the ovine Sixth -one i'iiousand Four Hundred One Dollar and Twenty -two Cents (S 61,401.22 �xflE utldctsigned, for and in `vellum of 1 Deltaic, and outer good and valuable auwidaathon, the ncoelpt wham( is het Eby acknowledged, dofcaj hereby waive area mime any and :finial or claim or right of fief under the Statutes of the Stine wherein the land is located, slating to I &ebonies Bens. on the above described premises and improvements thereat. end on the Mies Or ether considerations due or to become due Isom the owner, on moos rat of labor or services, material, fixinna or apparatua henstaihre tkrid ded to Otte dote by the uodereigaed Or the above daseelbed pwmiaas. Signed this 24th 63,0 March zp 11 —11nutimi nom_ Michael A. LaFcvcr, Vice-President led NOTE: Ail waivers meat be for the Tau amount paid. tf wehver is for a earpnrrtlon, corporate Borne shoal& be reed, corporate seal alibied and tide ofoflicar during waiver afxndd be act forttsc If waiver is for a portrait/lip, the partnership saw should he med. partner shoubi ibm and decimate Wadi as partner. CONTRACTOR'S AFFIDAvit }ss State of Indiana County of Hamilton TO WHOM IT MAY CONCERN: THE andersigtivd. bein duly Moe, deposes and says that he Is Vice- President of LaFever Electric, Inc. who is the oo tractor Dar the Electrical Work wank oa the building located at Tic Avenue Southwest, Carmel Indiana 46b72 owned by acme eatre p eve oement ommisslon. Tbat the to amount of the contract lnatedlng extras 13$ 765,354.05 on r W►ieh he has reoeived payment of S 444.769.94 prior to this payment. 'tint all waivers we true, comas and genuine and ddivi rod unconditionally and that there Is tw chain either legal or equitable to defeat the validity of said wai'4ers. That the Sofowing ono the rums oda1I parties who have furnished material er tabor, or both, £err said work and all pantos having contracts or arbaorrtrme fir specific porttoos ofsstd work or for metered entering m w the coma motion maeof and rho wuourn tun or w become ChM to each, and rival the Wants mentioned included an labor and material . , - m aces add work =cording to dares and ens: NAIX5 urm i ore r ro pR: •I.. Y • ti6lvi.,��'r • ` 1 1 11111111MMIII �1i111� 111 811 I nal 31 500.00 • 1 i 1]111111TJ: 11 11 it I11•1111Tin 'That ttwru ary no ilhcr %wawa fur said work outstanding, and at tune is nothing; doe or to bourne duo to nay penro r . • msderisi, tabor or other we* . any kind dune ar to be dare upon or in connection with said work other quern nbave stated. Sad this 24th day of March , 2n 11 SubscrTbod end sworn to before rite this 24th day of March T31 CD16 06/07/2007 uolk,J a. PG— 11,11\11111111111 hael A. LaFever, Vice - President _ glpm�Y �pd6tir! /rAfB1d L