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Meyer Najem, Gilbraltar - $25,480.59
Regions Bank hereby is instructed to make a disbursement of Loan Proceeds from the Borrower Loan Account to (or for the account of) Borrower in: (a) the amount of the "Total Authorized Disbursement" line in the "Amount of Authorized Disbursement" column below; and (b) accordance with the terms and conditions of the Agreement, the other Loan Documents, and the Disbursement Instructions. Purpose of Authorized Disbursement Amount of Authorized Disbursement Amount to be paid by Carmel Theater Development Company as per the Green Improvements installment purchase contract Invoice 02 -10- 749 -00012 (Meyer Najem) August 2011 $ 3,295.84 Application 11 (Gibraltar) August 2011 $ 22,184.75 Total Authorized Disbursement $ 25,480.59 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: " l 9 it 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) Paid by the Carmel Theater Development Company $ 21,636.76 June 2011 (invoice 02 -10- 749 - 00010) Paid by the Carmel Theater Development Company $ 20,921.33 July 2011 (invoice 02 -10- 749 - 00011) Paid by the Carmel Theater Development Company $ 9,539.13 August 2011 (invoice 02 -10 -749- 00012) Amount to be paid by the Carmel Theater Development Company $ 3,295.84 CONSTRUCTION August 25, 2011 CSO 8831 Keystone Crossing Indianapolis, IN 46240 Attn: Brandon Bogan 13099 Parkside Drive Fishers, IN 46038 317 - 577 -0007 317 - 577 -0286 (fax) Invoice #: 02 -10- 749 - 000012 Terms: Net 30 Days Project: Carmel Greenway Parcel 7B For Period Ending: 8/25/11 Schedule of Value' Prior Billings I Current Billing 1 Cumulative Total I. Staffing $ 154,050.00 $ II. General Conditions $ 21,950.00 $ III. Construction Manager Fee $ 100,000.00 $ $ 276,000.00 TOTAL AMOUNT DUE Tim Russell, President 106,328.17 9,400.73 96,724.38 $ 1,837.67 $ 244.80 $ 9,645.53 $ 1,213.37 $ 97,937.75 $ 215,749.12 $ 108,165.84 $ 3,295.84 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) Paid by the Carmel Theater Development Company $ 172,183.00 June 2011 (application 9) Paid by the Carmel Theater Development Company $ 31,130.00 July 2011 (application 10) Paid by the Carmel Theater Development Company $ 40,772.25 August 2011 (application 11) Amount to be paid by the Carmel Theater Development Company $ 22,184.75 Document G702 /CIVIaTM - 19.92 Application and Certificate for Payment Construction Manager - Adviser Edition TO OWNER: Carmel Theatre Development CorporatkiR@i .CT: 30 West Main Street, Suite 220 Carmel, IN 46032 FROM CONTRACTOR: Gibraltar Construction Corp VIA 2932 N. Webster Ave. Indianapolis, IN 46219 VIA CONTRACT FOR: Sitework Package 1 Parcel 7B - Center for Petfonjing Arts CCIV ® MFy N ��G G� 20 CONSTRUCTION 'MANAGERJMCo 1j ARCHITECT:CSO Architects, Inc. APPLICATION NO: 11 PERIOD TO: 8/31/11 CONTRACT DATE: 4/13/10 lilSTi ot, PROJECT NOS: N Distribution to: OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR ❑ FIELD ❑ 0 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 $ $ 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) $ 3. CONTRACT SUM TO DATE (Line 1 ± 2) 1,046,700.00 21,912.00 1,0GO 612.00 1,068,612.00 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 + 5b or Total in Column I of 6703). 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) 994,092.25 The undersigned Contractor certifi4. that to the best of the Contractor's knowledge, information and belief the Work covered by th!s Ai plication for Payment has been completed in accordance with the Contract Documents, that a ,, i noun is have been paid by the Contractor for Work for which previous ed and payments received from the Owner, and that current truction Corp . Certificates for Payment payment shown beF6idit CONTRACTOR: By: State of: County of: Subscribed an me this Notary - My CcimmiSsion expires: Date: E3RIAN R. MCBRIDE Res. of Hancock County My Comm, Exp. 11- 29.2017 mmisson # 611862 CERTIFICATE Fe R' PAYMEN In accordance with the Contract Dociiinents, 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 CER'I'L1 -#D. 22 184 75 AMOUNT CERTIFIED $ .(b4 z` (Attach explanation if amount certified differs from the;amoitrit applied. Initial all figures on this 52,335.00 Application and on the Continuation Sheet that are changed to conform with the amount certified.) aY% 11 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Totalchanges approved in previous months by Owner $ $ Total approved:this Month $. $ TOTALS $ . NET CHANGES by Change' Order $ CONSTRUCTIO By: ARCHITECT: CSO By: This Certificate is i of negoti named herCin. I ante,; pay the Own ontractor and hitects, Inc. Date: Date: 613e44, The AMOUNT CERFIF'JJD is payable only to the Contractor and acceptance of payment are without prejudice to any rights of this Contract. CAUTION: You should sign an original AIA Contract Document; onwhich this' text appears in RED. An original assures that changes will not be obscured.. AIA Document G702/CMan" —1992. Copyright ©'1992' by. the American Institute of Architects. Ali rights reserved: WARNING: This AIA ®' Docunientis protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution ofthisAIA® 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. 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: ARCHITECT'S PROJECT NO. : 11 8/31/2011 8/31/2011 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 FINI G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D +E) THIS PERIOD 1 Supervision $ 21,000 $21,000.00 $21,000.00 100% - 2 Allowance $ 70,000 $69,727.25 $272.75 $70,000.00 100% - 3 Bonds $ 15,315 $15,315.00 $15,315.00 100% - 4 Misc. General Conditions $ 20,985 $20,985.00 $20,985.00 100% - 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 $100.00 $100.00 100% - 21 Joint Sealants Labor $ 100 $100.00 $100.00 100% - 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 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. : Page 3 of 6 11 8/31/2011 8/31/2011 A B C D 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 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 $ 100 100 $100.00 100% - 34 Joint Sealants Labor $ 100 100 $100.00 100% - 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 3,000 $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 $ 100 100 $100.00 100% - 47 Joint Sealants Labor $ 100 100 $100.00 100% - 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. : APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO. : 11 8/31/2011 8/31/2011 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 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 $ 100 100 100 100% - 64 Joint Sealants Labor $ 100 100 100 100% - 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 $ 100 100 100 100% - 68 Landscaping Labor $ 100 100 100 100% - 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 12,600 12,600 100% - 75 Concrete Walks Labor $ 12,600 12,600 12,600 100% - CONTINUATION SHEET Page 5of6 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. : 11 8/31/2011 8/31/2011 A B C D I E F G H I 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 (D +E) THIS PERIOD 76 Joint Sealants Material $ 100 100 100 100% - 77 Joint Sealants Labor $ 100 100 100 100% - 78 Concrete Pavers Material $ 22,400 22,400 22,400 100% - 79 Concrete Pavers Labor $ 11,100 11,100 11,100 100% - 80 Granite Pavers Material $ 10,000 10,000 10,000 100% - 81 Granite Pavers Labor $ 5,000 5,000 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 66,000 66,000 100% - 85 Decomposed Granite Labor $ 25,000 25,000 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 3,500 3,500 100% - 89 Irrigation Labor $ 5,000 5,000 5,000 100% - 90 Phase 3 91 Earthwork Material $ 2,400 2,400 2,400_ 100% - 92 Earthwork Labor $ 2,400 2,400 2,400 100% - 93 Topsoil Material $ 1,000 1,000 1,000 100% - 94 Topsoil Labor $ 2,000 2,000 2,000 100% - 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 2,800 2,800 100% - 98 Concrete Curbs Labor $ 4,000 4,000 4,000 100% - 99 Concrete Walks Material $ 7,500 7,500 7,500 100% - 100 Concrete Walks Labor $ 7,500 7,500 7,500 100% - CONTINUATION SHEET Page 6of6 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. : 11 8/31/2011 8/31/2011 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) ° �0 (G / C) BALANCE TO FINISH (C - G) RETAINAGE (IF VARIABLE RATE) h KUM PREVIOUS APPLICATION (D + El THIS PERIOD 101 Joint Sealants Material $ 100 100 100 100% - 102 Joint Sealants Labor $ 100 100 100 100% - 103 Concrete Pavers Material $ 10,000 10,000 10,000 100% - 104 Concrete Pavers Labor $ 3,200 3,200 3,200 100% - 105 Landscaping Material $ 50 50 50 100% - 106 Landscaping Labor $ 50 50 50 100% - 107 Change Order #1 $21,912 21,912 21,912 100% - 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 $1,068,612.00 $1,046,427 $22,184.75 $0.00 $1,068,612.00 100% $0.00 $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 Twenty Two Thousand One Hundred Eighty Four and No /100 Dollars ($22,184.75) ❑ receipt of which is hereby acknowledged; or Fl 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; (FI,NAL WAIVER) that the final balance due from the Owner is the sum of Dollars ($00) ❑ 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 .1 count of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions e pr:,.i.ed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work p orm,-d or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. off WITNESS MY HAND AND NOTORIAL SEAL, +�• d of August, 2011. Gibraltar Construction Corp By Title President C 1979 *N©ILNA SUBCONTRACTORS ASSOCIATION INCORPORATED unaurnor. ed Rbp+oduciton Pionrhnod (Notary Public) C..�. BRIAN R. MCBRIDE °►� Res of Hancock County My Comm, Exp, 11 -29 -2017 Commission # 611862 Re. ifygq