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Home My WebLink AboutSmock Fansler, Signature - $14,733.31Regions 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 Decorative Fountains installment purchase contract Application 1 (Smock Fansler) January 2011 $ 13,957.87 Application 1 (Signature) January 2011 $ 775.44 Total Authorized Disbursement $ 14,73341. . 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 B.nk and Carmel Theater Development Company, LLC. Dated: 3 Z /l 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. Decorative Fountains (Smock Fansler) January 2011 Application 1 Amount to be paid by Carmel Theater Development $ 13,957.87 REQUEST FOR PAYMENT From: Smock Fansler Corporation 2910 W. Minnesota Street Indianapolis, IN 46241 -4541 Contract For: To: CARMEL THEATER DEVELOPMENT CORP 11711 N PENNSYLVANIA ST. CARMEL, IN 46032 Invoice: 3064 Draw: APP00001 Invoice date: 1/21/2011 Period ending date: 1/31/2011 G \I tP "" Request for payment: Original contract amount Approved changes Revised contract amount Contract completed to date Add -ons to date Taxes to date Less retainage Total completed less retainage Less previous requests Current request for payment Current billing Current additional charges Current tax Less current retainage Current amount due $62,035.00 $0.00 $0.00 $0.00 $1,550.88 $0.00 $0.00 $0.00 $1,550.88 Remaining contract to bill $48,077.13 $62,035.00 $15,508.75 Project: 11010 CITY CTR. CHANDELIER CT FOUNT Contract date: Architect: $13,957.87 Scope: $13,957.87 $15,508.75 $13,957.87 Q gC CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Changes approved in previous months by Owner Total approved this Month TOTALS NET CHANGES by Change Order I hereby certify that the work performed and the materials supplied to date, as shown on the above represent the actual value of the accomplishment under the terms of the Contract (and all authorized changes thereof) between the undersigned and the CARMEL THEATER DEVELOPMENT CORP relating to the above referenced project. I also certify that the contractor has paid all amounts previously billed and paid by the owner. CONTRACTOR: Smock Fansler Corporation B Data. 2 / -l! State Of INDIANA County Of MORGAN Subscribed and sworn to before me this day of Notary Public .1/14/Z. ' /1 w, My commission expires: I/ D oz cm. 9.617 lz") 04a, 2 /zsA, :��F INDIPNP \ Director of Redevelopment /'/yG69 go 5- REQUEST FOR PAYMENT DETAIL Project: 11010 / CITY CTR. CHANDELIER CT FOUNT Invoice: 3064 Draw: APP00001 Period Ending Date: 1/31/2011 Detail Page 2 of 2 Pages Item ID Description Total Previously Work Presently Completed % Balance Retainage Contract Completed Completed Stored And Stored Comp To Balance Amount Work This Materials To Date Finish Period 01 CHANDELIER CT. FOUNTAIN 62,035.00 15,508.75 15,508.75 25.00 46,526.25 1,550.88 Totals 62,035.00 15,508.75 15,508.75 25.00 46,526.25 1,550.88 AFFIDAVIT AND WAIVER OF LIEN [ ] Final [X] Partial [X] Payment to Follow State of Indiana County of Marion Jerry M Davee , being duly sworn states that he is the Executive Vice - President of SMOCK FANSLER CORP. having contracted with: Carmel Theater Development Corp. to furnish certain labor, materials, and /or services as follows: Misc. Construction for a project known as: SFC #11 -010 City Center Chandelier Ct. Fountain located at Carmel, IN and does hereby state on behalf of the aforementioned contractor: (PARTIAL WAIVER) that there is due from the owner the sum of: (513,957.87) Thirteen Thousand Nine Hundred Fifty Seven Dollars and 87/100 [] receipt of which is hereby acknowledged; or [X] 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 ($0.00) [] receipt of which is hereby acknowledged; or [ ] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, 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 on account of Labor, Materials, and /or Services, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work performed, materials, or services furnished to the undersigned for said project, and within the scope of this affidavit and waiver. SMOCK FANSLER CORP. By Title Executive Vice - President WITNESS MY HAND AND NOTARIAL SEAL, this 21st day of January , 2011. My commission expires November 30, 2016 /)72j , M elissa J. BishO p N otar/Public Residing in Morgan County Decorative Fountains (Signature) February 2011 Application 1 Amount to be paid by Carmel Theater Development $ 775.44 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Carmel PROJECT: Parcel 5 Fountains Carmel Indiana 46032 FROM CONTRACTOR: Signature Construction Services LLC 720 3rd Avenue S.W. Carmel, Indiana 46032 CONTRACT FOR: VIA ARCI- IITECT: Pedcor Design APPLICATION NO Invoice/11 1 Distribution to: Signature costs OWNER ARCHITECT PERIOD TO: 02/22/201 1 X CONTRACTOR PROJECT NOS: CONTRACT DATE: 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 3. CONTRACT SUM TO DATE (Line 1 ± 2) 4. TOTAL COMPLETED & STORED TO 5 RETAINAGE: a 0 %ofCompleted Work (Column D + E on G703) b % of Stored Material $ (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column I of G703) 6. 'TOTAL EARNED LESS RETAINAGE (Lint 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) $ 0 6,203.50 0.00 6,203.50 775.44 $ $ 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: By L Date: Thomas E oontz, President Subscribed and : vorn to before me this dayoftTit, ,7 Z 23 / LINDA BUCHANAN Hancock County My Commission Expires August 20, 2011 o.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 775.44 0.00 775.44 5,428.06 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner Total approved this Month TOTALS $0.00 $0.00 NET CHANGES by Change Order $0 00 In accordance with the Contract Documents, based on on -site observations and the data comprising the application, the Architect certifies to the Owner that to the best of the Architect's 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 amo Application and . • on r •trop J eet that are cl ARCHITECT: AIM By: %_ This C ificate is not te;.otiable. The 1 0 '4T CERTIFIED is payabl only to the Contract • named lien in. issuance, payment and acceptance of payment are wrtnout prejudice to : • s of the Owner or Contractor under this Contract. • 11 applied. Initial all figures on this 7/%It/1e an unt certified.) Date AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 01992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE,. N.W., WASHINGTON, DC 20006 -5292 Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee. Director of Redevelopment i%'-1 603° s �Dv SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 1 2/22/11 Parcel 5 Fountains Carmel, Indiana ITEM NO. DESCRIPTION OF WORK SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED TOTAL COMPLETED AND STORED TO DATE % BALANCE TO FINISH Committed Cost FROM PREVIOUS APPLICATIONS THIS PERIOD General Requirements: Site Supervision Construction Management Fee 3,101.75 3,101.75 0.00 0.00 0.00 775.44 0.00 0.00 0.00 775.44 0% 25% 3,101.75 2,326.31 0.00 775.44 6,203.50 0.00 775.44 0.00 775.44 13% 5,428.06 775.44 CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and / or labor as follows: Construction Management Services for a project known as Parcel 5 Fountains, located at Carmel, Indiana and owned by the Carmel Redevelopment Commission and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of seven hundred seventy -five dollars and forty -four cents ($775.44) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above - described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC Thomas E. tz, President Subscribed and sworn to before me this: / ,)Z- Notary Public: - -`T _-c,�� a: tiy9 . LINDA BUCHANAN ..NOT•ar L Hancock County Sr L My Commission Expires August 20, 2011