Loading...
HomeMy WebLinkAboutMeyer Najem, Gilbraltar, LaFever - $260,987.13Regions 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 -00009 (Meyer Najem) May 2011 $ 21,636.76 Pay application 8 (Gibraltar) May 2011 $ 172,183.00 Pay application 9 (LaFever) May 2011 $ 67,167.37 Total Authorized Disbursement $ 260,987.13 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: L23 // CITY OF CARMEL REDEVELOPMENT COMMISSION 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) Paid by the Carmel Theater Development Company $ 14,853.56 April 2011 (invoice 02 -10- 749 - 00008) Paid by the Carmel Theater Development Company $ 19,206.91 May 2011 (invoice 02 -10- 749 - 00009) Amount to be paid by the Carmel Theater Development Company $ 21,636.76 CONSTRUCTION, May 25, 2011 CSO 8831 Keystone Crossing Indianapolis, IN 46240 Attn: Brandon Bogan I. Staffing II. General Conditions III. Construction Manager Fee 13099 Parkside Drive Fishers, IN 46038 317- 577 -0007 317 - 577 -0286 (fax) Invoice #: 02 -10- 749 -00009 Terms: Net 30 Days Project: Carmel Greenway Parcel 7B For Period Ending: 5/25/11 Schedule of Value' Prior Billings 1Current Billing! Cumulative Total $ 154,050.00 $ 21,950.00 $ 100,000.00 $ 276,000.00 TOTAL AMOU► �;,!,ry_ $ 21,636.76 $ 74,839.46 $ 6,969.69 $ 68,106.02 $ 8,198.49 $ 654.92 $ 12,783.35 Tim Russell, President 83,037.95 $ 7,624.61 $ 80,889.37 $ 171, 551.93 if you have any questions, please reference the invoice number. 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) Paid by the Carmel Theater Development Company $ 102,065.00 April 2011 (application 7) Paid by the Carmel Theater Development Company $ 120,920.00 May 2011 (application 8) Amount to be paid by the Carmel Theater Development Company $ 172,183.00 ocument G702/CMaTM 1992 Application and Certificate for Payment Construction Manager- Adviser. Edition. TO OWNER: PROJECT: Carmel Theatre Development Corporation, LLC 30 West Main Street, Suite 220 Carmel, IN 46032 Parcel 7B - Center for Perfoming Arts FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT FOR: Gibraltar Construction Corp 2932 N. Webster Ave. Indianapolis, IN 46219 VIA ARCHITECT: CSO Architects, Inc. Sitework Package 1 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. �FyFR 1. ORIGINAL CONTRACT SUM APPLICATION NO: 8 PERIOD TO: 5/30/11 R C /(� �6IV.oCONTRACT DATE: °' 23 20 11 PROJECT NOS: 4/13/10 N41_M co NSTR $1,046,700 00 2. Net change by Change Orders $ 0.00 3. CONTRACT SUM TO DATE (Line 1 ± 2) $1 046.700.00 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) $ 974,525.00 5. RETAINAGE: a. % of Completed Work (Column D + E on G703) b. % of Stored Material (Column F on G703) $ 52,335.00 Total Retainage (Lines 5a + 5h or Total in Column 1 of 0703) . $ 6. TOTAL EARNED LESS RETAINAGE $ 922,190.00 (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) 750,007.00 172,183.00 124,510.00 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $ $ Total approved this Month $ $ TOTALS $ $ NET CHANGES by Change Order $ 02.10, The undersigned Contractor certifi belief the Work covered by this A Contract Documents, that all amou Certificates for Payment wer payment shown herein is now Distribution to: OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR ❑ FIELD ❑ 0 CONTRACTOR:Gibraltar C By: State of:r244 County of Subscribed and swo me this Notary My Commission expires: 1S ue. that to the best of the Contractor's knowledge, information and ication for Payment has been completed in accordance with the have been paid by the Contractor for Work for which previous d and payments received from the Owner, and that current tr Date: j��� // BRIAN R. MCBRIDE Res,. of Hancock County My Comm, Exp. 11 -29 -2017 Commission # 611862 CERTIFICATE FOR PAYMENT 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 CERTIFIED. AMOUNT CERTIFIED (Attach explanation if amount certified differs from the amount applied. Initial all fig res on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) CONSTRUCT! By: ARCHITECT: CSO By: This Certificate is no named herein. Issu the Owner or Co Date: Date: ble. The AMOUNT CERTIFIED is payable on `' to t Contractor ment and acceptance of payment are without prejudice to any rights of 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 /CMaT" — 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. 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.: 8 APPLICATION DATE: 5/30/2011 PERIOD TO: 5/30/2011 ARCHITECT'S PROJECT NO. : A B C D I 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) % (G / C) BALANCE TO FINISH (C - G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D +E) THIS PERIOD 1 Supervision $ 21,000 $16,380.00 $3,570.00 $19,950.00 95% 1,050.00 2 Allowance $ 70,000 $34,119.00 $34,119.00 49% 35,881.00 3 Bonds $ 15,315 $15,315.00 $15,315.00 100% - 4 Misc. General Conditions $ 20,985 $16,373.00 $3,568.00 $19,941.00 95% 1,044.00 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 $36,850.00 $36,850.00 100% - 9 Underdrains Labor $ 36,850 $36,850.00 $36,850.00 100% - 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 $17,000.00 $17,000.00 100% - 13 Plumbing Labor $ 10,000 $10,000.00 $10,000.00 100% - 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.: 8 APPLICATION DATE: 5/30/2011 PERIOD TO: 5/30/2011 ARCHITECT'S PROJECT NO. : A B C D 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 (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D +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 2,500 $2,500.00 100% - 41 Earthwork Labor $ 2,500 2,500 $2,500.00 100% - 42 Concrete Curbs Material $ 1,000 1,000 $1,000.00 100% - 43 Concrete Curbs Labor $ 3,000 300 2,700 $3,000.00 100% - 44 Concrete Walks Material $ 2,650 2,650 $2,650.00 100% - 45 Concrete Walks Labor $ 2,650 2,650 $2,650.00 100% - 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 1,800 $1,800.00 100% - 49 Concrete Pavers Labor $ 3,700 3,700 $3,700.00 100% - 50 Permeable Pavers Material $ 4,000 4,000 $4,000.00 100% - 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 I on Contracts where variable retainage for line items may apply. APPLICATION NO.: 8 APPLICATION DATE: 5/30/2011 PERIOD TO: 5/30/2011 ARCHITECT'S PROJECT NO. : 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 (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D + E) THIS PERIOD 51 Permeable Pavers Labor $ 1,000 1,000 1,000 100% - 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 60 40 100 100% - 68 Landscaping Labor $ 100 60 40 100 100% - 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 16,250 16,250 100% - 73 Topsoil Labor $ 16,250 16,250 16,250 100% - 74 Concrete Walks Material $ 12,600 8,190 4,410 12,600 100% - 75 Concrete Walks Labor $ 12,600 8,190 4,410 12,600 100% - 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.: 8 APPLICATION DATE: 5/30/2011 PERIOD TO: 5/30/2011 ARCHITECT'S PROJECT NO. : A B C D I 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) % (G / C) BALANCE TO FINISH (C G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D +E) THIS PERIOD 76 Joint Sealants Material $ 100 - 0% 100 77 Joint Sealants Labor $ 100 - 0% 100 78 Concrete Pavers Material $ 22,400 22,400 22,400 100% - 79 Concrete Pavers Labor $ 11,100 555 10,545 11,100 100% - 80 Granite Pavers Material $ 10,000 10,000 10,000 100% - 81 Granite Pavers Labor $ 5,000 250 4,750 5,000 100% - 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 33,000 33,000 66,000 100% - 85 Decomposed Granite Labor $ 25,000 1,250 23,750 25,000 100% - 86 Landscaping Material $ 10,000 10,000 10,000 100% - 87 Landscaping Labor $ 3,000 3,000 3,000 100% - 88 Irrigation Material $ 3,500 350 3,150 3,500 100% - 89 Irrigation Labor $ 5,000 500 4,500 5,000 100% - 90 Phase 3 91 Earthwork Material $ 2,400 1,200 1,200 50% 1,200 92 Earthwork Labor $ 2,400 1,200 1,200 50% 1,200 93 Topsoil Material $ 1,000 - 0% 1,000 94 Topsoil Labor $ 2,000 - 0% 2,000 95 Site Demolition Material $ 1,000 1,000 1,000 100% - 96 Site Demolition Labor $ 4,000 4,000 4,000 100% - 97 Concrete Curbs Material $ 2,800 - 0% 2,800 98 Concrete Curbs Labor $ 4,000 - 0% 4,000 99 Concrete Walks Material $ 7,500 3,750 3,750 50% 3,750 100 Concrete Walks Labor $ 7,500 3,750 3,750 50% 3,750 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.: 8 APPLICATION DATE: 5/30/2011 PERIOD TO: 5/30/2011 ARCHITECT'S PROJECT NO. : A B C D I 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) % (G / C) BAFNISHTO (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 $802,342.00 $172,183.00 $0.00 $974,525.00 93% $72,175.00 $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 Performinq Arts, Sitework Packaqe 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 Seventy Two Thousand One Hundred Eighty Three and No /100- Dollars ($172,183.00) ❑ 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 the Owner of said premises, any and all lien or claim whatsoever on the above- described property and improvements thereon account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions expres -d herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work pert +rm a or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. 1 Gibraltar Construction Corp By WITNESS MY HAND AND NOTORIAL SEAL W9 4NDIANA SUBCONTRACTORS ASSOCIADQN INCORPORATED UnaulhOr•ted RefooduC4gn Pio^rh11Otl y of May, 2011. Title President (Notary Public) BRIAN R. MCBRIDE Res. of Hancock County My Comm. Exp. 11 -29 -2017 Commission # 611F62 Rey 1 0112 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) Paid by the Carmel Theater Development Company $ 61,401.22 April 2011 (application 8) Paid by the Carmel Theater Development Company $ 71,218.70 May 2011 (application 9) Amount to be paid by the Carmel Theater Development Company $ 67,167.37 Document G702/C a " — 1992 P�CEIVEO Application and Certificate for Payment Construction Manager- Adviser Edition SAY 23 2011 APPLICATI0 • S PERIOD TO 5�31� 01 oNST RV �I0 OWNER ❑ N TO OWNER: 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: CONTRACT DATE: 9/17/2010 Meyer Najem Construction, LLC VIA ARCHITECT: CSO Architects, Inc. PROJECT NOS: 1744 Distribution to: 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, AIA Document 0703, 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 G703) 5. RETAINAGE: a. 10 % of Completed Work (Column D + E on 0703) b. 10 % of Stored Material (Column F on G703) $ $ 658,855.00 $ 118,657.59 $ 777,512.59 $ 761,417.18 $ 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 less Line 6) 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. CONTRACTOR: . LaFeve le,,ctric, Inc. State of: Indiana PrA,,,�..aFever, Vice- President Hamilton .......... B By: Date: 5/20/2011 County of ceQ� Subscribed and sworn to befcr7 74,740.48 me this 20th Notary Public: 1,401.24 My Commission .xpires: A trtf' $ 76,141.72 CERTIFICATE FORVA11' $ 685,275.46 In accordance with the Contracfi,p dyi } ' TI on -site observations and the data comprising this application, the Construction hit 1 iAhitect 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 CERTIFIED. 7 t1ttti (Attach explanation if amount certified differs.frorn the amount applied. Initial all figures on this Application and 00 CONSTRUCT! 1 By: Date: ARCHITECT: $ 618,108.10 $ 67,167.37 $ 92,237.13 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 125,852.68 $ 7,195.09 Total approved this Month $ - $ - TOTALS 125,852.68 $ 7,195.09 NET CHANGES by Change Order $ 118,657.59 Colleen S. Marvel AMOUNT CERTIFIED $ nuation Sheet that are changed to conform with the amount certified.) By: �'`� `' Date: This Certificate gotia . The A " ' �RTIFIED is payable o "y to 1e Contractor named herein.L tp' ce, payi nt and ace cc of payment are without prejudice to any rights of the Owner .•ter ractor un r 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 G702ICMaTM - 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 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 @aia.org. Tr r• e JOB NAME APPLICATION NUMBER Parcel 7B- Center for Performing Arts 9 APPLICATION DATE PERIOD TO 5/20/2011 5/31/2011 PAGE NUMBER 1 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 60,994.75 1,926.15 1,284.10 64,205.00 100 - 6,420.50 - L 105,840.00 100,548.00 3,175.20 103,723.20 98 2,116.80 10,372.32 2.00 Wire M 87,610.00 78,849.00 6,132.70 2,628.30 87,610.00 100 - 8,761.00 - - L 49,530.00 44,577.00 3,46710 48,044 10 97 1,485.90 4,804.41 300 Switchgear M 11,610.00 11,377.80 232.20 0.00 11,610.00 100 - 1,161.00 - - L 9,460.00 9,270.80 189.20 9,460.00 100 - 946.00 4.00 Light Fixtures M 202,000.00 121,200.00 70,700.00 10,100.00 202,000.00 100 - 20,200.00 - L 36,000.00 21,600.00 12,600.00 34,200.00 95 1,800.00 3,420.00 5.00 Excavating 58,000.00 55,100.00 1,160.00 56,260.00 97 1,740 00 5,626.00 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 41,753.25 10,438.31 52,191.56 100 - 5,219.16 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 15,222.50 42,623.00 57,845.50 95 3,044.50 5,784.55 14.0 Conduit Credit (7,195.09) (7,195.09) - (7,195.09) 100 - (719.51) 15.0 Sign light 7,270.52 4,362.31 - 4,362.31 60 2,908.21 436.23 16.0 ASI #5 4,888.02 3,910.42 977.60 4,888.02 100 - 488.80 - - M - - - - - - - - L - - - - - - M - - - - L - - - - 777,512.59 593,783 32 153,621 .46 14,012 40 761,417.18 16,095 41 76,141 72 Mato of Indiana County of Hamilton TO WHOM ff MAY CONCEItfit WAIVER OF LIEN TO DATE 1ss WHEREAS the undersigned 9n been eumpteyed by LaFever Electric, Inc. to Xh El cal Work for the premises described es Parcel 7B naeipya amine era,n.rmseh�w ay/Nth _ Carmel Theatre Development Commission is the qc S seven Thousaa i?ne Hundred Sixty -seven Dollars and Thirty-seven Cents (s 67,167.37 undessigtted. for and in con art of } Dogs, and other good and vatuaAh consideration, Ore receipt whereof is h rty acknowledged, dotes) btuby waive ad release any and all lien or claim or right alien raider the Std oftsc Stet whereto the lase k located, relating to Jecbantes liras. an the dewat described Mercian and nolnornments the' d on the monies der other cautions due or to boa= due tom the ease✓, Oft woos at of labor or services, rnaiedat, fame,; or mean hrratofere t6relsbed to edit data by*, uedareigaed the the shave deaeritsed matins. File #_ AMMO Rood this 20th day May zo 11 Michael A. LaFever, Vicc-Prcsidcnt Safi NOM AB waivers meat ba for the fed amount paid. If waiver is for a eorpwrration, arpotete name litterald be seed, corporate treat mitered tad Ma of officer signing Waiver rescind be set fant.t If waiver is for t partnership, the partnership name should be mid. Immo shoal tit and designate himself= panes'. CONTRACTOR'S AFFIDAVIT ) Ss State of Indiana County of Hamilton TO WHOM IT MAY CONCERN: TFTE andwgned. being duly sworn,, deposes and says that he 19 of LaFever Electric, Inc. Vice- President who is doe contractor ire tire Electrical Work bang lyg at —3rd Avenue Southwest, Carmel Indiana 46b2 owerd by CITrin—Zrir Theatre eve o r meat omnusston Mat the tout amoktrit olfthe cmtraat bhe ug extras is s 777, 512.59 o r Yhkeb he has remised payment of g 546,889.40 prior to this payment ]list all weivas �ec ttuc, comet ad genuine and ddtvr rod mtconditionally aad that dare la no elahn either had or equitable to defers the validity *raid waivers. nag the Mowing ore the reamers of all patties who have fanai*cd material or labor, or both, fir said walk and all patties Wins contracts or srbaarmmts for specific porticos ofsaid work or rbr material entering trite tie coast WW2 tweed momimeo du cr w become Onto each, tad that the items ttstattonal included all Ear and rrmtaria] - . m said mark =carom to 18119 and ens: work on tie KD Trenchin l Inc. revia eti :dlt/�1�ITr= .iiC:7iF1 . h : E�'�LZIasihi •- • 1 a t i t 317 891 -1202 37 300 0 25 575.00 1685.00 fiee steno are uric other comma fur said orott outstanding, and at three nothing act or to become dna to any mew dome or to be done upon or in commotion with said week other titan above stated. Signed tads 20th der of Mav , Ztl 11 TSI CD16 06= 007 1 lax 1 x 1 1 1 ir1d;Y1ii1111 rde■in1, tabor or Mbar work , my kind Q_ q ;. .. chael A. LaFever Vice- President een