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Gibraltar - $62,034
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 PAC Hardscape installment purchase contract Application 7 (Gibraltar) November 2010 $ 62,034.00 Total Authorized Disbursement $, 62,034.00 All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (Equipment and Improvements), dated July 22, 2010, by and between Regions Bank and Carmel Theater Development Company, LLC. Dated: /2 CITY OF CARMEL COMMIS ION By: Printed: Title: REDEVELOPMENT 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 Hardscape (Gibraltar) Up Through June 2010 (applications 1 and 2) Amount reimbursed to CRC $ 55,515.60 July 2010 (application 3) Paid by Carmel Theater Development Company $ 108,784.80 August 2010 (application 4) Paid by Carmel Theater Development Company $ 150,043.50 September 2010 (application 5) Paid by Carmel Theater Development Company $ 667,099.10 October 2010 (application 6) Paid by Carmel Theater Development Company $ 128,715.00 November 2010 (application 7) Amount to be paid by Carmel Theater Development Company $ 62,034.00 AripAIA Document G702 /CMaTM 1992 Application and Certificate for Payment Construction Manager - Adviser Edition TO OWNER: Carmel Redevelopment Commission One Civic Square Carmel, IN 46032 FROM CONTRACTOR: PROJECT: Regional Performing Arts Center VIA CONSTRUCTION MANAGER: Gibraltar Construction Corp 2932 N. Webster Ave. Indianapolis, IN 46219 CONTRACT FOR: Hardscape Package P8 VIA ARCHITECT: CSO Architects, Inc. APPLICATION NO: 7 PERIOD TO: 11/15/10 CONTRACT DATE: 4/13/10 PROJECT NOS: 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 $ 1.268 000 00 2. Net change by Change Orders $ 60,616.00 3. CONTRACT SUM TO DATE (Line 1 ± 2) $ 1,328,616.00 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) $ 1,235,592.00 5. RETAINAGE: a. % of Completed Work (Column .D + E on G703) $ b. % of Stored Material (Column F on G703) $ 63,400.00 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) $ 1,172,192.00 1,110,158.00 $ 62,034.00 156,424.00 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 certifi that to the best of the Contractor's knowledge, information and belief the Work covered by this A lication for Payment has been completed in accordance with the Contract Documents, that •1 i o is have been paid by the Contractor for Work for which previous Certificates for Payment is ued and payments received from the Owner, and that current payment shown herein is CONTRACTOR: Gibralt- j[�,.. truction Corp By: State of: phd County of: gpJr'✓ Subscribed and ' orn to be me this 2 day of Notary Pub My Commission expires: //>227-'70 Date: //--..„2-1--A, 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 .mount applied. Initial all figures on this Application and on the Continuation Sheet tat are cl $ 6.24,334 o.�®- CONSTR TION MAN '0 ' By: 1:11'.:': ARCHITE By: �V��11�11 ged to conform with the amount certified.) )1124)1 © I1 <<e This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance,' payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. h'tects' Inc. Date: 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 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. ATIAIA 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 G703, Continuation Sheet, summary information should be transferred to AIA Document G702 /CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The Contractor should sign G702 /CMa, have it notarized and submit it, together with G703, to the Construction Manager and Architect. The Construction Manager and Architect should review G702 /CMa and G703 and, if they are acceptable, complete the Certificate for Payment on G702 /CMa. The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201 /CMa. They should then initial all figures on G702 /CMa and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 /CMa and G703 should be forwarded to the Owner. D. Completing the G703 Form Heading: This information should be completed to be consistent with similar information on AIA Document G702 /CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. Columns A, B & C: These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted. The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially, this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D: Enter in this column the amount of completed work covered by the previous application (columns D & E from the previous application). Values from column F (Materials Presently Stored) from the previous application should not be entered in this column. Column E: Enter here the value of Work completed at the time of this application, including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored (column F). Column F: Enter here the value of Materials Presently Stored for which payment is sought. The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a deduction from this column. Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E (Work Completed - This Period). Column G: Enter here the total of columns D, E and F. Calculate the percentage completed by dividing column G by column C. Column H: Enter here the difference between column C (Scheduled Value) and column G (Total Completed and Stored to Date). Column I: This column is normally used only for contracts where variable retainage is permitted on a line -item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders: Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done. Usually, Change Orders are listed separately, either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 /CMa form. Construction Change Directives: Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders. Amounts remaining in dispute should be dealt with according to Section 7.3 in A201 /CMa. E. Making Payment • The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager anp Architect on AIA,Doctrnent G702 /CMa, Application and Certificate for Payment, Construction Manager- Adviser Edition. The completed form contains the name and•address of the-Contractor. Payment should not be made to any other party unless specifically indicated on G702 /CMa. AIA Document G702 /CMa TM - 1992. Copyright © 1992 by The American Institute of Architects. All rights reserved. WARNING: This MA° 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 3 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.: 7 APPLICATION DATE: 11/15/2010 PERIOD TO: 11/15/2010 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 1 Concrete Allowance $35,000.00 $32,173.00 $1,681.00 $33,854.00 97% 1,146.00 2 Motorcoach Connect Int. Allow $25,000.00 $0.00 $0.00 0% 25,000.00 3 Motorcoach Connect Ext. Allow $25,000.00 $0.00 $6,648.00 $6,648.00 27% 18,352.00 4 Allowance - 100 CY Stone $4,500.00 $1,350.00 $1,350.00 30% 3,150.00 5 Allowance - 5000 SF Geogrid $3,500.00 $0.00 $0.00 0% 3,500.00 6 Allow. - 30 Galvanized Sleeves $1,500.00 $0.00 $0.00 0% 1,500.00 7 Supervision $10,000.00 $9,500.00 $9,500.00 95% 500.00 8 Bonds $19,940.00 $19,940.00 $19,940.00 100% - 9 Mobilization /Demobilization $1,500.00 $750.00 $750.00 $1,500.00 100% - 10 Submittals $12,000.00 $12,000.00 $12,000.00 100% - 11 Misc. General Conditions $12,000.00 $11,400.00 $600.00 $12,000.00 100% - 12 Rebar Material $7,500.00 $7,500.00 $7,500.00 100% - 13 Trench Drain $4,000.00 $4,000.00 $4,000.00 100% - 14 Concrete Curbs $89,000.00 $89,000.00 $89,000.00 100% - 15 Concrete Walks /Slabs $93,000.00 $91,140.00 $1,860.00 $93,000.00 100% - 16 North Stair $25,000.00 $25,000.00 $25,000.00 100% - 17 Sheet Waterproofing $12,000.00 $12,000.00 $12,000.00 100% - 18 Green Roof & Decomposed Granite $104,500.00 $64,624.00 $64,624.00 62% 39,876.00 63,400.00 19 Electrical $21,000.00 $21,000.00 $21,000.00 100% - 20 Earthwork $240,500.00 $240,500.00 $240,500.00 100% - 21 Site Signs $3,000.00 $0.00 $3,000.00 $3,000.00 100% - 22 Joint Sealants $560.00 $0.00 $560.00 $560.00 100% - 23 Concrete Pavers $128,400.00 $125,832.00 $2,568.00 $128,400.00 100% - 24 Permable Pavers $31,200.00 $23,400.00 $7,800.00 $31,200.00 100% - 25 Porous Pavers $14,400.00 $14,400.00 $14,400.00 100% - CONTINUATION SHEET Page 3of3 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. : 7 11/15/2010 11/15/2010 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 Granite Pavers $296,000.00 $293,040.00 $2,960.00 $296,000.00 100% - 27 Topsoil $48,000.00 $45,600.00 $2,400.00 $48,000.00 100% - 28 Change Order #1 $29,409.00 $29,409.00 $29,409.00 100% - 29 Change Order #2 $31,207.00 $31,207.00 $31,207.00 100% - 30 31 32 33 34 35 36 37 - 38 - 39 40 41 42 43 44 45 46 47 48 49 50 $1,328,616.00 $1,173,558.00 $62,034.00 $0.00 $1,235,592.00 93% $93,024.00 $63,400.00 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 7A, Regional Performing Arts Center, Hardscape Package P8 and owned by Village Financial, LLC. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER) that there is due from the Owner the sum of Sixty Two Thousand Thirty Four and No /100--- - - - - -- Dollars ($62,034.00) ❑ 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 - ccount of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions expr 4.sed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work pe or ed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By Title President WITNESS MY HAND AND NOTORIAL SEAL, t ay of November, 2010. C 1979 4N©IANA SUBCONTRACTORS ASSOCiAT1ON INCORPORATED UNNIP*0 +4ee RepoductOOn Prohrbiad (Notary Public) E ERIA,N R. MCBRIDE RE-s. Hancock Courrty Comm, Exp. 11 -29 -2017 COTT SCion # 611862 Rev 1Q8 Gibraltar Construction Corp 2932 N. Webster Ave. Indianapolis, IN 46219 Check: 28 Date: 12/17/2010 Vendor: GIBR1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 7 -2 69 62,034.00 62,034.00 0.00 0.00 62,034.00 Application 7 62,034.00 62,034.00 0.00 0.00 62,034.00 12/17/2010 * * * * * * * * * ** *62,034.00 THE SUM OF SIXTY TWO THOUSAND THIRTY FOUR DOLLARS Gibraltar Construction Corp 2932 N. Webster Ave. Indianapolis, IN 46219 Gibraltar Construction Corp 2932 N. Webster Ave. Indianapolis, IN 46219 Check: 28 Date: 12/17/2010 Vendor: GIBR1 28 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 7 -2 69 62,034.00 62,034.00 0.00 0.00 62,034.00 Application 7 62,034.00 62,034.00 0.00 0.00 62,034.00