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HomeMy WebLinkAboutJ.R. Clancy - Parcel 7A - $548,126Mercantile 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 Payment to Carmel Redevelopment Commission for reimbursement of Contract Payments previously made. 548,126.00 Total Authorized Disbursement ` 4, 6: All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (Theater Equipment), dated as of August 31, 2009, by and between Lender and Village Financial, LLC. Dated: December 16, 2009 CITY OF CARMEL COMM SSION By: Printed: Les Olds Title: Director of Redevelopment REDEVELOPMENT .5 al/ hQU(0 deeii pz,3 9S'; Ilfkt-T'LIIuAI OLIN ANL, CLFTIFIOATE FOR PAYMENT CONSTRUCTION MANAGER- ADVISER EDITION A1A DOC iMENT G70'> /C :N1;t (Instructions cm reverse side) TO OWNER.YIN)e_1 ktd..EJQ_\0-prne►'67 OVTIVA'1SSiDV' PRO)T:CT :2.1SCI one CI v i �LYd- mel,. FROM CONTRACTOR: ,J ..CLC hCU inc. ""041 ari -iLY 'e-'1 ,c"',s'CtCt K.& - C ONTRACT FOR y YC.QI 1A . ► )►. i al` (.i- P3,13E ONE t)P i;IC;ES CCy 1 PAC. 111 'f Ale. in 0Q_ SvJ Cac nACil2 tLCG -- VIA CONSTRUCTION MANAGER% 10 •l-1)n Vi t ARCHITECT: CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G"Ci is attached I , ORIGINAL CONTRACT SUM 2. Net Change By Change Orders i. CONTRACT SUM TO DATE (Line 1 1 2) $ .1. TOTAL COMPLETED & STORED TO DATE (Column CT on G7u2) 5. RETAINAGE: iU rlt, of Completed Work (Columns D + I; on G 70 ) b. ' of Stored Material (Column I; on G703) 'Ibtal Retninahe (Line $a ! 5h or 'limit in Column 1 of CT 7(l ) LLD , cc'61: s__.. 2. „ tJ Qis0 G. 00 6, TOTAL EARNED LESS RETAINAGE (Litre ''i fess Line 5 'lbtal) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) S 8. CURRENT PAYMENT DUE 9, BALANCE TO FINISH, iNCL.UOING RETAINA sZ.LeO' BOLL 2-CO 1 1 (Line 3 less Line 6) CI'iANGE ORDER Si1MMARY ADDITIONS r)1 ?f)UCTIONS Total changes approved In previous months by Owner ac._,(..... c.LC Total Apprut'cd this Month 0. (L.) 6, CsQ TOTALS �'. co C) 00 ~ NET CHANGES by Change Order 0.0 .) ANI'L1C :ATTON N().; 1 PER1Of) '1'0; )111211C/C1 PROiECT NOS,: 213 CONTRACT E)e ]'E: 2112_1 L)istrlhnlit:n tu; 0 OWNER 0 CONSTRUCTION MANAGER 0 P RC'i l i'I'iiCi' U CONTI {ACTOR The. undersigned Contractor certifies that to the best Of Lite Contractor's knowledge, Inlur- m:zrit?n and belief the' ark covered by this Application for Payment has been completed In accordance with the Contract Documents, that all amounts have been )said by the Contractor liar Work for which previous Certificates for Payment were Issued and pay- ments received fl't:nn the Owner, and that current payment shown herein Is now dire. CONTRAL :gm: Canto( (( j County of; tiubscrilacd :)1/1CI sworn to before me this %C�4 clay Of Notary Public: / My Commission expires; 2- r 2 en 7 BRADLEY R. RIVERS Elatriry Ptlbl!c Slate of NrrtY York Qualtfmcl in Orioncl :tt);. County No. 01111:5018149 otnmission Expires Sr:pteinber 27. —/3 CERTIFICATE FOR PAYMENT 111 accordance with the Ctantnici Documents, hayed un 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 progres.scd as indicated, the quality of the Work is in accordance with tltr Contract Documents, and the Contractor is entitled to payment of the AMOIiNT CERTIFIED. AMOUNT CERTIFIED $ (Attach ea'ptattation if amount certified differs front the arrtrzntl applied for Initial all figures On this Applicalion and on the C:ontinuatirm .Vb'l (lied cIKnigcd to cearzjorrtz to the amount certified.) Co IN'1"KLrcr N M NAGE By, ARRC :HITEC1'. Dale; 11...Z By: Date: This Certificate k not negotiable. The AMOUNT CERTIFIED is payable only to the Con, tractor named herrlu, Issuance, payment and acceptance of paprient are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702/0 Ma - [CATION AN1) LEH] ric,:ATi; Pon P.M 1 1EN'r • cL)N! (RUCTION n1ANAt;I!lt,tD\ iSLR EDITION 1992 EnfrIQN • A.tA."' - 101992 • TiIE ANtF:uI(AN 1NSTiTUTE OF Am:on—E 'rs, 1^t5 NEux YOatK AvP.NUE, N'x:, WASHING-VON, 0 .C..Y!1!itr`i 5 292 + WARNING; Unlicensed photocopying violates U.S. copyright hews and will subject the violator to legal pruoocutlon. CAUTION: Aso should use on original AIA document which has this caution printed in rod. An orlolnol ossurct that chances wilt not be ahsrumrl I'M mn+r nrrur when rinnumnntrt ern rnnrnrb,enr! G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached, APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 11/15/2009 11/30/2009 2695 A 8 C D E F G H SCHEDULED COMPLETED WORK STORED TOTAL % BALANCE AMOUNT AMOUNT ITEM # WORK DESCRIPTION MATERIALS COMPLETED AND COMP_ TO RETAINAGE AMOUNT PREVIOUS THIS PERIOD (NOT IN D OR E) STORED (G 1 C) COMPLETION (If Variable) PERIODS (D + E + F) (C -G) 1 Bond 547, 266,00 $47,266.00 $0.00 30.00 547,266,00 100% 50,00 2 Engineering /Project 5415,534.00 5103,883,50 562,330.10 50.00 5166,213.60 40% 5249,320.40 Management/Mobilization 3 Master Control System 3238,100.00 50.00 50,00 50.00 50,00 0% 5238,100.00 4 Control System Electrical Work 533,750.00 50.00 50,00 50.00 50.00 0% $33,750.00 5 Control System Turn on and Testing 568,900.00 50.00 30.00 50.00 50,00 0% 568,900,00 6 CYC, I=OW, Lighting Truss Motorized Rigging 31,356,800.00 50.00 50.00 30.00 50.00 0% 51,356,800,00 7 CYC, FOH, Lighting Truss Motorized Rigging Installation 3514,200.00 50.00 50.00 50.00 50.00 0% 5514,200,00 8 Canopy Rigging and Cable Reels 51,301,000.00 30.00 50.00 50.00 50.00 0% $1,301,000.00 4 Canopy Rigging and Real Installation 3348,800.00 30.00 50.00 50.00 50.00 0% 5348,800,00 10 Loudspeaker Motorized Rigging 5316,200.00 30.00 50.00 50.00 30.00 0% 5316,200.00 11 Loudspoakor Rigging Installation 555,800.00 30.00 30.00 50.00 50.00 0% 555,800,00 12 Variable Acoustic Curtains 5118,000.00 50,00 30.00 50.00 50.00 0% 3118,000.00 13 Curtain Installation 517,700.00 30,00 50.00 50,00 30.00 0% 517,700.00 14 Variable Acoustic Tracks/Blocking & Actuators 3426,000.00 5127,800.00 3127,800.00 50.00 5255,600.00 60% 3170,400.00 15 Track & Actuator Installation 3131,745.00 546,110,75 532,936.25 50.00 379,047.00 60% 352,698.00 16 Extension Lift & Railings 3807,521.00 50.00 30.00 50.00 50.00 D% 5607,521.00 SUB - TOTALS $5,997,316.00 5325,060.25 3223,066.35 30.00 3548,126.60 4% 55,449,189.40 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 3 of 4 PROJECT: Payment Application containing Contractor's signature is attached. 2895 Carmel PAC APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 7 11/15/2009 11/30/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED (NOT IN 0 OR E) TOTAL COMPLETED AND STORED (0 + tr + F) "� COMP. {G / C} BALANCE TO COMPLETION (C -G) RETAINAGE (if Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation $90,000.00 $0.00 50.00 50.00 50.00 0% 590,000.00 18 Extension LIft Wagons 5111,300.00 50.00 50.00 50.00 50.00 0% 5111,300.00 19 Extension Lift Wagon installation 518,000.00 50.00 50.00 50.00 50.00 0% 518,000.00 20 House Mix Lift & Railings 5248,000.00 50.00 50.00 $0.00 50.00 0% 5248,000,00 21 House Mix tit Installation 560,000.00 50.00 50.00 $0,00 50,00 0% 560,000.00 22 House Mix Lift Wagons 570,000.00 50.00 50.00 50.00 50.00 0% 570,000.00 23 House Mix Lift Wagon Installation 516,000.00 50.00 50.00 50.00 50.00 0% 516,000.00 24 Loudspeaker Wagon 535,384.00 50,00 50.00 50.00 50.00 0% 535,384.00 25 Laudspearker Wagon Installation $7,000.00 $0,00 50.00 50.00 50.00 0% 57,000.00 28 Demountablo Rkser$ 545,000.00 50.00 50.00 50.00 50.00 0% 545,000.00 27 Demountable Risar Installation 54,800.00 50.00 50.00 50.00 50.00 0% 54,800.00 28 Chorus Wagons 5189,000.00 50,00 50.00 50.00 50.00 0% 5189,000.00 29 Package 5170 Allowance $200,000.00 50.00 50.00 50.00 50.00 0% 5200,000.00 30 Package 5180 Allowance 5200,000.00 80.00 50.00 50.00 50.00 0% 5200,000.00 31 Package 5190 Allowance 55,000.00 $0.00 50.00 50,00 50.00 0% 55,000.00 32 CAD As- 8ullts 5170 & 5180 520,000.00 50.00 50.00 50.00 50.00 0% 520,000.00 Allowance SUB- TOTALS 57,316,800.00 5325,080.25 5223,086.35 50.00 5548,126,60 T% 56,768,673.40 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 4 of 4 PROJECT; Payment Application containing Contractor's signature is attached. 2695 Carmel PAC APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT /Is; T 11/15/2009 11/30/2009 2695 A l3 C D E F G H ITEM /# WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN 0 OR E) TOTAL COMPLETED AND STORED (0+E+ F) % COMP. (G 1 C) BALANCE TO COMPLETION (C -G) RETAINAGE (11 Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 33 34 CAD As- Bullts 5190 Allowance Orchestra Risers $5,000.00 $194,000.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 0% 0% $5,000.00 5194,000.00 TOTALS $7,615,600.00 $325.060.25 $223,066,35 $0.00 5546,125.60 7% $6,967,673.40 CONTINUATION PAGE Quantum Software Solutions, Inc. Document APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION AIA DOCUMENT G702 /CMa (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER: mile! Re(fevelopme14 Comli/LIssiav- eG•�lic�ja.ry Cat vvll e�, {.� ► 4Lp032 FROM CONTRACTOR:J K • lav ,JL c p -10 T'14ey s Uk 170 Sy Yra LUSe, Ny CONTRACT FOR: E L -74 zixphed Iii Fi)Y►v�l PROJECT: ZlP C ! APPLICATION NO.: LP ViM,rI ". PERIOD TO: 10/1 109 "1 1� 3 J SvJ �/� ; O/-,T �> , j ��'ROJECT NOS.: 21Ogtj Car wtel, cpoff' =".� �,2, t BOO <COAT ACT DATE: �f MANAGER:' 11 \` Aoc VIA CONSTRUCTION �\TIA ARCHITECT: 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, 515,E O.,CO 2. Net Change By Change Orders $ 0 O 3. CONTRACT SUM TO DATE (Line 1 ± 2) $ 75)5/ ,- CO 4. TOTAL COMPLETED & STORED TO DATE $ 52 , a 25 (Column G on G702) 5. REJ INAGE: a. pp % of Completed Work (Columns D + E on G703) b. la % of Stored Material (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column I of G703) $ ,50L0 o3 $ lJ. 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) $ $ 32,ea0. $ 292,55 22 8. CURRENT PAYMENT DUE 215q ,i j- 1 l alto o 9. BALANCE TO FINISH, INCLUDING RETAINA E t Jj (Line 3 less Line 6) $ I l Z 3,Z -1r'� 778 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 000 (�{ Total approved this Month 0(� IS TOTALS CM O a, NET CHANGES by Change Order O.Cn Distribution to: ❑ OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR The undersigned Contrac�f,,rtifies that to the best of the Contractor's knowledge. infor- mation 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 pay- ments received from the Owner, and that current payment shown herein is now due. .RCOYLJ; mac. CONTRAC By: State of: 1i Yd12ir County of: 6 of 00 p Subscribed and sworn to before me this /VI" d y o� ..CTO& ' �0o J MICHAEL JAY PARKIN • Notary Public, State of New York ,11t Qualified in Onondaga County Reg. No. 01PA4807278 D /3/ fr 0/ 0 My Commission Expires May 31, 201j. Date: /O //q %Oc7 Notary Public: My Commission expires: 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 for Initial all figures on this Application and on the Continuation Sheet that changed to conform to the amount certified.) CO . STRUCT jj M, NAGER: By .•!�:1/ •■ A I : ,;1(1. • By • Date: '�" -•�� This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con- tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G7112ICMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER - ADVISER EDITION 1992 EDITION • Ale • ©1992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006-5292 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 6 10/15/2009 10/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS N (NOT IN D OR TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Bond Engineering /Project Management/Mobilization Master Control System Control System Electrical Work Control System Turn on and Testing CYC, FOH, Lighting Truss Motorized Rigging CYC, FOH, Lighting Truss Motorized Rigging Installation Canopy Rigging and Cable Reels Canopy Rigging and Reel Installation Loudspeaker Motorized Rigging Loudspeaker Rigging Installation Variable Acoustic Curtains Curtain Installation Variable Acoustic Tracks /Blocking & Actuators Track & Actuator Installation Extension Lift & Railings $47,266.00 $415,534.00 $238,100.00 $33,750.00 $68,900.00 $1,356,800.00 $514,200.00 $1,301,000.00 $348,800.00 $316,200.00 $55,800.00 $118,000.00 $17,700.00 $426,000.00 $131,745.00 $607,521.00 $47,266.00 $91,417.48 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $127,800.00 $32,936.25 $0.00 $0.00 $12,466.02 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $13,174.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $47,266.00 $103,883.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $127,800.00 $46,110.75 $0.00 100% 25% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 30% 35% 0% $0.00 $311,650.50 $238,100.00 $33,750.00 $68,900.00 $1,356,800.00 $514,200.00 $1,301,000.00 $348,800.00 $316,200.00 $55,800.00 $118,000.00 $17,700.00 $298,200.00 $85,634.25 $607,521.00 SUB - TOTALS $5,997,316.00 $299,419.73 $25,640.52 $0.00 $325,060.25 5% $5,672,255.75 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 3 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 6 10/15/2009 10/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E ) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE ariable ( If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation $90,000.00 $0.00 $0.00 $0.00 $0.00 0% $90,000.00 18 Extension Lift Wagons $111,300.00 $0.00 $0.00 $0.00 $0.00 0% $111,300.00 19 Extension Lift Wagon Installation $18,000.00 $0.00 $0.00 $0.00 $0.00 0% $18,000.00 20 House Mix Lift & Railings $248,000.00 $0.00 $0.00 $0.00 $0.00 0% $248,000.00 21 House Mix Lift Installation $60,000.00 $0.00 $0.00 $0.00 $0.00 0% $60,000.00 22 House Mix Lift Wagons $70,000.00 $0.00 $0.00 $0.00 $0.00 0% $70,000.00 23 House Mix Lift Wagon Installation $16,000.00 $0.00 $0.00 $0.00 $0.00 0% $16,000.00 24 Loudspeaker Wagon $35,384.00 $0.00 $0.00 $0.00 $0.00 0% $35,384.00 25 Loudspearker Wagon Installation $7,000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 26 Demountable Risers $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 27 Demountable Riser Installation $4,800.00 $0.00 $0.00 $0.00 $0.00 0% $4,800.00 28 Chorus Wagons $189,000.00 $0.00 $0.00 $0.00 $0.00 0% $189,000.00 29 Package 5170 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 30 Package 5180 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 31 Package 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $0.00 $0.00 $0.00 $0.00 0% $20,000.00 Allowance SUB - TOTALS $7,316,800.00 $299,419.73 $25,640.52 $0.00 $325,060.25 4% $6,991,739.75 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 4 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 6 10/15/2009 10/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE If Variable) (If AMOUNT PREVIOUS AMOUNT THIS PERIOD 33 34 CAD As- Builts 5190 Allowance Orchestra Risers $5,000.00 $194,000.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% 0% $5,000.00 $194,000.00 TOTALS $7,515,800.00 $299,419.73 $25,640.52 $0.00 $325,060.25 4% $7,190,739.75 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION AIA DOCUMENT 6702 /CMa (Instructions on reverse side) k TO OWNER WVt V'eI, i5C[ALV 1Op Comm (sc'to v� PROJECT: "I OrteCtv i c a.v_c_ Cay Inc, Cal(Vhd. , L[1v 14032— -ni 3 (Av_ U��,.tSv`� FROM CONTRACTOR: j , -ciCl�c,91:chc Ca y �� `/ '1 ���2 10- +1.1)1.4evs} el Tsou�d KOL • CI70 S yrach r■j 132 1' VIA CONSTRUCTION MANAGER:911d W Y 1 CONTRACT FOR: Th.ittI la/ RE9ilyilkity,GAVvii 45 Nig OiI CHITECT: 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. PAGE ONE OF PAGES APPLICATION NO.: 5 PERIOD TO: CI ti t.)9' PROJECT NOS.:.7 Logg CONTRACT DATE:4/2-4oq 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 G702) "1,5 (5. 60.00 OCR ,S15, y 100 $ 2gq,2-IQ.-73 5. RETAINAGE: (� a. ID % of Completed Work $ 2-934 0 (Columns D + E on G703) b. 10 % of Stored Material (Column F on G703) Total Retainage (Line 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) $ $ 2C1, 91-1-1. q7 $ Zl9q 8. CURRENT PAYMENT DUE 1rl, 35 2 9. BALANCE TO FINISH, INCLUDING RETAINAG t2), ZL' (Line 3 less Line 6) $ I CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner CO 0- W 0 Total approved this Month 0,(x) dg TOTALS " Q 0 Q NET CHANGES by Change Order O, Distribution to: ❑ OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation 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 pay- ments received from the Owner, and that current payment shown herein is now due. CONTRA By• ✓� State of: iv(t.) YDRk County of: o i,i0p pi9.. Subscribed and sworn to before me this 1g tk Notary Public: My Commission expires: m431 ezei Date. q ji a1o9 rem G1- MICHAEL JAY PARKIN 2_00 'Notary Public, State of New-York Qualified in Onondaga County Reg. No. 01PA4807278 My Commission Expires May 31, 201° 2a7 o 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 for Initial all figures on this Application and on the Continuation Sheet that changed to conform to the amoun certified.) CONSTRUCT By • ARC GER: Date: By: ��!��� Date. This Certificate is not negotiable. The AMOUN CERTIFIED is payable only to the Con- tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702ICMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER - ADVISER EDITION 1992 EDITION • AIA® • ©1992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 -5292 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 5 09/15/2009 09/30/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 Bond $47,266.00 $47,266.00 $0.00 $0.00 $47,266.00 100% $0.00 2 Engineering /Project $415,534.00 $83,106.80 $8,310.68 $0.00 $91,417.48 22% $324,116.52 Management/Mobilization 3 Master Control System $238,100.00 $0.00 $0.00 $0.00 $0.00 0% $238,100.00 4 Control System Electrical Work $33,750.00 $0.00 $0.00 $0.00 $0.00 0% $33,750.00 5 Control System Turn on and $68,900.00 $0.00 $0.00 $0.00 $0.00 0% $68,900.00 Testing 6 CYC, FOH, Lighting Truss $1,356,800.00 $0.00 $0.00 $0.00 $0.00 0% $1,356,800.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $0.00 $0.00 $0.00 $0.00 0% $514,200.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,301,000.00 9 Canopy Rigging and Reel $348,800.00 $0.00 $0.00 $0.00 $0.00 0% $348,800.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $0.00 $0.00 $0.00 $0.00 0% $316,200.00 11 Loudspeaker Rigging Installation $55,800.00 $0.00 $0.00 $0.00 $0.00 0% $55,800.00 12 Variable Acoustic Curtains $118,000.00 $0.00 $0.00 $0.00 $0.00 0% $118,000.00 13 Curtain Installation $17,700.00 $0.00 $0.00 $0.00 $0.00 0% $17,700.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $0.00 $127,800.00 $0.00 $127,800.00 30% $298,200.00 & Actuators 15 Track & Actuator Installation $131,745.00 $0.00 $32,936.25 $0.00 $32,936.25 25% $98,808.75 16 Extension Lift & Railings $607,521.00 $0.00 $0.00 $0.00 $0.00 0% $607,521.00 SUB - TOTALS $5,997,316.00 $130,372.80 $169,046.93 $0.00 $299,419.73 5% $5,697,896.27 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 3 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 5 09/15/2009 09/30/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation $90,000.00 $0.00 $0.00 $0.00 $0.00 0% $90,000.00 18 Extension Lift Wagons $111,300.00 $0.00 $0.00 $0.00 $0.00 0% $111,300.00 19 Extension Lift Wagon Installation $18,000.00 $0.00 $0.00 $0.00 $0.00 0% $18,000.00 20 House Mix Lift & Railings $248,000.00 $0.00 $0.00 $0.00 $0.00 0% $248,000.00 21 House Mix Lift Installation $60,000.00 $0.00 $0.00 $0.00 $0.00 0% $60,000.00 22 House Mix Lift Wagons $70,000.00 $0.00 $0.00 $0.00 $0.00 0% $70,000.00 23 House Mix Lift Wagon Installation $16,000.00 $0.00 $0.00 $0.00 $0.00 0% $16,000.00 24 Loudspeaker Wagon $35,384.00 $0.00 $0.00 $0.00 $0.00 0% $35,384.00 25 Loudspearker Wagon Installation $7,000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 26 Demountable Risers $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 27 Demountable Riser Installation $4,800.00 $0.00 $0.00 $0.00 $0.00 0% $4,800.00 28 Chorus Wagons $189,000.00 $0.00 $0.00 $0.00 $0.00 0% $189,000.00 29 Package 5170 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 30 Package 5180 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 31 Package 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $0.00 $0.00 $0.00 $0.00 0% $20,000.00 Allowance SUB - TOTALS $7,316,800.00 $130,372.80 $169,046.93 $0.00 $299,419.73 4% $7,017,380.27 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 4 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 5 09/15/2009 09/30/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 33 34 CAD As- Builts 5190 Allowance Orchestra Risers $5,000.00 $194,000.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% 0% $5,000.00 $194,000.00 TOTALS $7,515,800.00 $130,372.80 $169,046.93 $0.00 $299,419.73 4% $7,216,380.27 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION AIA DOCUMENT G702 /CMa (Instructions on reverse side) TO OWNER: Canqd Paitveb 9i - �"unis li lc PROJECT: ) (9q CO Cie Ctv'lc aavr e Carmel Prc CGvvvie l , -ni vaAvem ue. Sy.) FROM CONTRACTOR 3 .cloy 1l1 .Th , CaYlIA ; 1-4U661— 104l3�+e?.�t iStaYjci Syek..cUe, k_J3 ��j VIA CONSTRUCTION MANAGER t With ' CONTRACT FOR: rj f' yI � Qgl l\..ym .I iyv,A Ivt3 mSti1, wc,I;ECT: CONTRACTOR'S APPLICATION FOR PAYMENT PAGE ONE OF PAGES APPLICATION NO.: "t g131 ioq CONTRACT DATE: "7 ()CI PERIOD TO: PROJECT NOS Distribution to: ❑ OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR 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 DATE (Column G on G702) 5. RET�NAGE: a % of Completed Work (Columns D + E on G703) b. lb % of Stored Material (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column I of G703) $ 1,515 OD $ OCY') $ 1,515 , �SC� $ I ?)D,7S)2., $ 13,0O.ZV $ 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 I-3)05) :26 $ il7,333'z $ c89 9. BALANCE TO FINISH, INCLUDING RETAINA ''I (Line 3 less Line 6) I `T CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 0-CD Q LO Total approved this Month oyO Orte TOTALS ,c -t � C c° NET CHANGES by Change Order 6,61 The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation 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 pay- ments received from the Owner, and that current payment shown herein is now due. CONTRA By: State of: /JFW 10ki, County of: Onfb J f j /1" Subscribed and sworn me this 19.0- Notary Public: / "Z My Commission expires: CERTIFICATE FOR PAYMENT Date: ) I ` MICHAEL JAY PARKIN Notary Public, State of New York Qualified in Onondaga County - Reg. No. 01 PA4807278 My Commission Expires May 31, 20 /0 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, an the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED $ (Attach explanation if amount certified differs from the amount applied for Initial all figures on this Application and on the Con uation Sheet that changed to conform to the amount certified.) STRUCTI M AGER: By. Date Date 9 del) /74PCPCir This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con- tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. /, AIA DOCUMENT G702 /CMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER - ADVISER EDITION 1992 EDITION • AIA© • ©1992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON. .333ii' e : D.C. 20006 -5292 • WARNING: Unlicensed photocopying violates U.S. copyright Is and will subject the violator to legal prosecution. G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 4 08/15/2009 08/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) o % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 Bond $47,266.00 $47,266.00 $0.00 $0.00 $47,266.00 100% $0.00 2 Engineering /Project $415,534.00 $58,174.76 $24,932.04 $0.00 $83,106.80 20% $332,427.20 Management/Mobilization 3 Master Control System $238,100.00 $0.00 $0.00 $0.00 $0.00 0% $238,100.00 4 Control System Electrical Work $33,750.00 $0.00 $0.00 $0.00 $0.00 0% $33,750.00 5 Control System Turn on and $68,900.00 $0.00 $0.00 $0.00 $0.00 0% $68,900.00 Testing 6 CYC, FOH, Lighting Truss $1,356,800.00 $0.00 $0.00 $0.00 $0.00 0% $1,356,800.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $0.00 $0.00 $0.00 $0.00 0% $514,200.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,301,000.00 9 Canopy Rigging and Reel $348,800.00 $0.00 $0.00 $0.00 $0.00 0% $348,800.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $0.00 $0.00 $0.00 $0.00 0% $316,200.00 11 Loudspeaker Rigging Installation $55,800.00 $0.00 $0.00 $0.00 $0.00 0% $55,800.00 12 Variable Acoustic Curtains $118,000.00 $0.00 $0.00 $0.00 $0.00 0% $118,000.00 13 Curtain Installation $17,700.00 $0.00 $0.00 $0.00 $0.00 0% $17,700.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $0.00 $0.00 $0.00 $0.00 0% $426,000.00 & Actuators 15 Track & Actuator Installation $131,745.00 $0.00 $0.00 $0.00 $0.00 0% $131,745.00 16 Extension Lift & Railings $607,521.00 $0.00 $0.00 $0.00 $0.00 0% $607,521.00 SUB - TOTALS $5,997,316.00 $105,440.76 $24,932.04 $0.00 $130,372.80 2% $5,866,943.20 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 3 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 4 08/15/2009 08/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % /o COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation $90,000.00 $0.00 $0.00 $0.00 $0.00 0% $90,000.00 18 Extension Lift Wagons $111,300.00 $0.00 $0.00 $0.00 $0.00 0% $111,300.00 19 Extension Lift Wagon Installation $18,000.00 $0.00 $0.00 $0.00 $0.00 0% $18,000.00 20 House Mix Lift & Railings $248,000.00 $0.00 $0.00 $0.00 $0.00 0% $248,000.00 21 House Mix Lift Installation $60,000.00 $0.00 $0.00 $0.00 $0.00 0% $60,000.00 22 House Mix Lift Wagons $70,000.00 $0.00 $0.00 $0.00 $0.00 0% $70,000.00 23 House Mix Lift Wagon Installation $16,000.00 $0.00 $0.00 $0.00 $0.00 0% $16,000.00 24 Loudspeaker Wagon $35,384.00 $0.00 $0.00 $0.00 $0.00 0% $35,384.00 25 Loudspearker Wagon Installation $7,000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 26 Demountable Risers $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 27 Demountable Riser Installation $4,800.00 $0.00 $0.00 $0.00 $0.00 0% $4,800.00 28 Chorus Wagons $189,000.00 $0.00 $0.00 $0.00 $0.00 0% $189,000.00 29 Package 5170 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 30 Package 5180 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 31 Package 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $0.00 $0.00 $0.00 $0.00 0% $20,000.00 Allowance SUB - TOTALS $7,316,800.00 $105,440.76 $24,932.04 $0.00 $130,372.80 2% $7,186,427.20 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 4 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 4 08/15/2009 08/31/2009 2695 A B C D 1 E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 33 34 CAD As- Builts 5190 Allowance Orchestra Risers $5,000.00 $194,000.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% 0% $5,000.00 $194,000.00 TOTALS $7,515,800.00 $105,440.76 $24,932.04 $0.00 $130,372.80 2% $7,385,427.20 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT 11-1-,619c1.22. APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION AA DOCUMENT G702 /CMa (Instructions on reverse side) TO OWNER:tarOlet M/P.IMmet&-COM1 4 iSS1tw cr Cc ' c Sc Q, 5Ayme,t LLDO32 FROM CONTRACTOR) •e-GCI,. C ) 251IC 'Icy 1 z 0- s-1c�+ a- e ,tavtd r &L Strict cvse, tv\j 1'31_09 PROJECT: -5 � Car me j J // th Avu_12. 5V' Cat(imet , pp '� VIA CONSTRUCTION MANAGER CONTRACT FOR: MIeLCL-0. 1 1 eyfe rni,,,,s �S l DANA_ 3 HITECT: CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in Continuation Sheet, AIA Document G703, is attached. l . ORIGINAL CONTRACT SUM 2. Net Change By Change Orders 3. CONTRACT SUM TO DATE (Line 1 ± 2) 4. TOTAL COMPLETED & STORED (Column G on G702) 5. RETAINAGE: a. % of Completed Work (Columns D + E on G703) b % of Stored Material (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column I of G703) connection with the Contract. $ ._115(5, ), $ o.co $ -1,505,141411(0 115,,co TO DATE .$ I $ )0,56.0` 0 00 $ /110 5417 Cl`� 6. TOTAL EARNED LESS RETAINAGE $ 4 , 5-gJ1 • l9 S (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 RETAINA. (Line 3 less Line 6) $ E CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 002 0,00 Total approved this Month 600 6,00 TOTALS 6 0O O. O NET CHANGES by Change Order C) 00 APPLICATION NO.: 3 PERIOD TO: 1 131 PROJECT NOS.:2 isa5 ACT DATE2+ /LI (A PAGE ONE OF PAGES Distribution to: ❑ OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR The undersigned Contrac c , ifies that to the best of the Contractor's knowledge, infor- mation and belief the Work vered 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 pay- ments received from the Owner, and that current payment shown herein is now due. CONTRA By: � State of: ,JEw'?xZ k County of: 0,40,/00/`1" Subscribed and sworn to before me this /•7J:: cWy o� u L 1do9 Notary Public: 0 My Commission expires: orAi .7,/, 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 CERTIFI D $ 11 Date: 1 n� MICHAEL JAY PARKIN Notary Public, State of New York Qualified in Onondaga County Reg. No. 01PA4807278 My Commission Expires May 31, 20 / ° AMOUNT CERTIFIED (Attach explanation if amount certified differs from the amount applied for Initial all figures on this Application and on the Continuation Sheet that changed to conform to the amount certified.) STRUC N ANAGE Date: 7/213/o By. / _ Date: • This Certificate "ute. The AMOUNT CERTIFIED is payable only to the Con- tractor na :'ierein. Issuance, payment and acceptance of payment are without prejudic . any rights of the Owner or Contractor under this Contract. / AIA DOCUMENT G702 /CMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER - ADVISER EDITION e2 1992 EDITION • Ale • ©1992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON. DC 20006-5292 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 3 07/15/2009 07/31/2009 2695 A B C D I E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) o % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 Bond $47,266.00 $47,266.00 $0.00 $0.00 $47,266.00 100% $0.00 2 Engineering /Project $415,534.00 $41,553.40 $16,621.36 $0.00 $58,174.76 14% $357,359.24 Management/Mobilization 3 Master Control System $238,100.00 $0.00 $0.00 $0.00 $0.00 0% $238,100.00 4 Control System Electrical Work $33,750.00 $0.00 $0.00 $0.00 $0.00 0% $33,750.00 5 Control System Turn on and $68,900.00 $0.00 $0.00 $0.00 $0.00 0% $68,900.00 Testing 6 CYC, FOH, Lighting Truss $1,356,800.00 $0.00 $0.00 $0.00 $0.00 0% $1,356,800.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $0.00 $0.00 $0.00 $0.00 0% $514,200.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,301,000.00 9 Canopy Rigging and Reel $348,800.00 $0.00 $0.00 $0.00 $0.00 0% $348,800.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $0.00 $0.00 $0.00 $0.00 0% $316,200.00 11 Loudspeaker Rigging Installation $55,800.00 $0.00 $0.00 $0.00 $0.00 0% $55,800.00 12 Variable Acoustic Curtains $118,000.00 $0.00 $0.00 $0.00 $0.00 0% $118,000.00 13 Curtain Installation $17,700.00 $0.00 $0.00 $0.00 $0.00 0% $17,700.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $0.00 $0.00 $0.00 $0.00 0% $426,000.00 & Actuators 15 Track & Actuator Installation $131,745.00 $0.00 $0.00 $0.00 $0.00 0% $131,745.00 16 Extension Lift & Railings $607,521.00 $0.00 $0.00 $0.00 $0.00 0% $607,521.00 SUB - TOTALS $5,997,316.00 $88,819.40 $16,621.36 $0.00 $105,440.76 2% $5,891,875.24 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 4 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 3 07/15/2009 07/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 33 34 CAD As- Builts 5190 Allowance Orchestra Risers $5,000.00 $194,000.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% 0% $5,000.00 $194,000.00 TOTALS $7,515,800.00 $88,819.40 $16,621.36 $0.00 $105,440.76 1% $7,410,359.24 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 3 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 3 07/15/2009 07/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation $90,000.00 $0.00 $0.00 $0.00 $0.00 0% $90,000.00 18 Extension Lift Wagons $111,300.00 $0.00 $0.00 $0.00 $0.00 0% $111,300.00 19 Extension Lift Wagon Installation $18,000.00 $0.00 $0.00 $0.00 $0.00 0% $18,000.00 20 House Mix Lift & Railings $248,000.00 $0.00 $0.00 $0.00 $0.00 0% $248,000.00 21 House Mix Lift Installation $60,000.00 $0.00 $0.00 $0.00 $0.00 0% $60,000.00 22 House Mix Lift Wagons $70,000.00 $0.00 $0.00 $0.00 $0.00 0% $70,000.00 23 House Mix Lift Wagon Installation $16,000.00 $0.00 $0.00 $0.00 $0.00 0% $16,000.00 24 Loudspeaker Wagon $35,384.00 $0.00 $0.00 $0.00 $0.00 0% $35,384.00 25 Loudspearker Wagon Installation $7,000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 26 Demountable Risers $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 27 Demountable Riser Installation $4,800.00 $0.00 $0.00 $0.00 $0.00 0% $4,800.00 28 Chorus Wagons $189,000.00 $0.00 $0.00 $0.00 $0.00 0% $189,000.00 29 Package 5170 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 30 Package 5180 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 31 Package 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $0.00 $0.00 $0.00 $0.00 0% $20,000.00 Allowance SUB - TOTALS $7,316,800.00 $88,819.40 $16,621.36 $0.00 $105,440.76 1% $7,211,359.24 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION AVA DOCUMENT G702 /CMa (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER:COTMCt �P.e ev.c.iaprre. &-- Cowl{ I ■SSI bh PROJECT: 21015 _ 5/ 7U O C'v ► ��a� e. Carne Cay hill , TN ituO3 Z - T 11 '3 AYkt1UtL�SUnv%r�) FROM CONTRACTOR: .Q. (161-Midi 1v1C . CCx 4c\ ° (9v"" —1041 ah -krs} 1k �'s IQ`h( P. ci yCiCVS-e, Nk-j 1 2JY5 }VIA ACRONSTRUCTION MANAGERg(Q 'ftI�I CONTRACT FOR:WI'ce( 1A Dnn'Om\ Toy foyl�l ll�'S hiL41,RcHITECT: CONTRACTOR'S APPLICATION FOR PAYMENT APPLICATION NO.: PERIOD TO: Oio,(1 PROJECT NOS.: lugs CONTRACT DATE:21 j2409 f Distribution to: ❑ OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT El CONTRACTOR Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM $ J 5(5, i.1O 2. Net Change By Change Orders $ r /W� 3. CONTRACT SUM TO DATE (Line 1 ± 2) $ 7t ���, I ,_l V 4. TOTAL COMPLETED & STORED TO DATE $ J 0p` >. O lG. (Column G on G702) 5. RETAINAGE: p i I Q4. a. of Completed Work $ 0 b (J I (Columns D + E on G703) 660 b. %, of Stored Material $ ' (Column F on G703) Total Retainagc (Line 5a + 5b or �l Total in Column 1 of G703) $ 2 / f 6. TOTAL EARNED LESS RETAINAGE $ 4? 7•4Lo (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" cd (Line 3 less Line 6) $ �•S CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner C)t Cao0 Total approved this Month d) Q, TOTALS 6130 O NET CHANGES by Change Order c.a.) The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation 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 pay- ments received from the Owner, and that current payment shown herein is now due. CONTR By State of: County of: 1 c77 Lt.5c Subscribed and sworn to before me this / day of a.i i .Z.&O') BRADLEY R. RIVERS Notary Public, State of New York _ �� Qualified in Onondaga County Notary Public: A No 01R15018349 3 My Commission expires: J_.. z7 _�q Commission Expires September 27 Date. LP \ I 169 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 $ Z.(4 j I `5 (Attach explanation if amount certified differs from the amount applied for Initial all figures on this Application and on the Continuation Sheet that changed to conform to the amount certified.) Date: Date: This Ce tific e is not negotiable. The AMOUNT CERTIFIED is payable only to the Con- tractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 /CMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER - ADVISER EDITION 1992 EDITION • AIA • ©1992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, DC 20006 -5292 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 2 06/15/2009 06/30/2009 2695 A B C D T E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % . COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 Bond $47,266.00 $47,266.00 $0.00 $0.00 $47,266.00 100% $0.00 2 Engineering /Project $415,534.00 $12,466.02 $29,087.38 $0.00 $41,553.40 10% $373,980.60 Management/Mobilization 3 Master Control System $238,100.00 $0.00 $0.00 $0.00 $0.00 0% $238,100.00 4 Control System Electrical Work $33,750.00 $0.00 $0.00 $0.00 $0.00 0% $33,750.00 5 Control System Turn on and $68,900.00 $0.00 $0.00 $0.00 $0.00 0% $68,900.00 Testing 6 CYC, FOH, Lighting Truss $1,356,800.00 $0.00 $0.00 $0.00 $0.00 0% $1,356,800.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $0.00 $0.00 $0.00 $0.00 0% $514,200.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,301,000.00 9 Canopy Rigging and Reel $348,800.00 $0.00 $0.00 $0.00 $0.00 0% $348,800.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $0.00 $0.00 $0.00 $0.00 0% $316,200.00 11 Loudspeaker Rigging Installation $55,800.00 $0.00 $0.00 $0.00 $0.00 0% $55,800.00 12 Variable Acoustic Curtains $118,000.00 $0.00 $0.00 $0.00 $0.00 0% $118,000.00 4 13 Curtain Installation $17,700.00 $0.00 $0.00 $0.00 $0.00 0% $17,700.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $0.00 $0.00 $0.00 $0.00 0% $426,000.00 & Actuators 15 Track & Actuator Installation $131,745.00 $0.00 $0.00 $0.00 $0.00 0% $131,745.00 16 Extension Lift & Railings $607,521.00 $0.00 $0.00 $0.00 $0.00 0% $607,521.00 SUB - TOTALS $5,997,316.00 $59,732.02 $29,087.38 $0.00 $88,819.40 1% $5,908,496.60 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 3 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 2 06/15/2009 06/30/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation $90,000.00 $0.00 $0.00 $0.00 $0.00 0% $90,000.00 18 Extension Lift Wagons $111,300.00 $0.00 $0.00 $0.00 $0.00 0% $111,300.00 19 Extension Lift Wagon Installation $18,000.00 $0.00 $0.00 $0.00 $0.00 0% $18,000.00 20 House Mix Lift & Railings $248,000.00 $0.00 $0.00 $0.00 $0.00 0% $248,000.00 21 House Mix Lift Installation $60,000.00 $0.00 $0.00 $0.00 $0.00 0% $60,000.00 22 House Mix Lift Wagons $70,000.00 $0.00 $0.00 $0.00 $0.00 0% $70,000.00 23 House Mix Lift Wagon Installation $16,000.00 $0.00 $0.00 $0.00 $0.00 0% $16,000.00 24 Loudspeaker Wagon $35,384.00 $0.00 $0.00 $0.00 $0.00 0% $35,384.00 25 Loudspearker Wagon Installation $7,000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 26 Demountable Risers $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 27 Demountable Riser Installation $4,800.00 $0.00 $0.00 $0.00 $0.00 0% $4,800.00 28 Chorus Wagons $189,000.00 $0.00 $0.00 $0.00 $0.00 0% $189,000.00 29 Package 5170 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 30 Package 5180 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 31 Package 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $0.00 $0.00 $0.00 $0.00 0% $20,000.00 Allowance SUB - TOTALS $7,316,800.00 $59,732.02 $29,087.38 $0.00 $88,819.40 1% $7,227,980.60 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 4 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 2 06/15/2009 06/30/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 33 34 CAD As- Builts 5190 Allowance Orchestra Risers $5,000.00 $194,000.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0% 0% $5,000.00 $194,000.00 TOTALS $7,515,800.00 $59,732.02 $29,087.38 $0.00 $88,819.40 1% $7,426,980.60 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION AIA DOCUMENT G702 /CMa (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER: COx Vvte-112eci,.Ve,iapmen U3MV11 IYIOYI PROJECT: 2L 9 — 5170 6he CI v ■ c. Scipo rz Cal w,d 1-4,C rw>e 1, 3)- —111 31��r1? huP 5.) FROM CONTRACTOR:j. j2 ,u( CI A, CQ Yw1C1,.TN v032- `104 l -11A-4e r94-0 JJSs La c' i- S YGL(Us.e, 32_. ►VI VVIA CONSTRUCTION MANAGER:CA € 3-�dJ CONTRACT FORPay 11A ) 12916.nal ?du i'tsikv.k, al RCHITECT: 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 DATE (Column G on G702) 5. RETAINAGE: a 10 % of Completed Work (Columns D + E on G703) b. 10 % of Stored Material $ (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column 1 of G703) $ -1, 515,U.Q3 $ Q_oc) $ 7,5 I5 ,`15UU.() $ 5,9'7,320 U ,CO 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 aC ) 9. BALANCE TO FINISH, INCLUDING RETAINAGE� 1 �)� Q (Line 3 less Line 6) $ 1 i- 1�D2,�•'`t'�.,1 lJ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner O!• COO Total approved this Month 0,410 0 C TOTALS 000 0 00 NET CHANGES by Change Order 0Cr) APPLICATION NO.: 1 Distribution to: PERIOD TO: cj I ❑ OWNER PROJECT NOS.: 2QQCj ❑ CONSTRUCTION -,I MANAGER CONTRACT DATE: U 1242mq ❑ ARCHITECT ❑ CONTRACTOR The undersigned Contractor certifies that to the best of the Contractor's knowledge, infor- mation 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 pay- ments received from the Owner, and that current payment shown herein is now due. CO ]R ,ACTOR: By. State of: pal/VC/0'k- County of: 6041-yCdQ$� Subscribed and sworn to before me this 4,?,e)74, day of Notary Public: My Commissio expires: 9._ gCl 0 Date • BRADLEY R. RIVERS Notary Public, State of New York Qualified in Onondaga County mmission EoxpiireslSep83m September 27, 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 $ 5 � I Sr?) "� v (Attach explanation if amount certified differs from the amount applied for. Initial all figures on this Application and on the Continuation Sheet that changed to conform to the amount certified.) STRUC 0• N MM NAGE 1 Aghorook Date. CO By• b, d ARCHITEC By. This Cert tractor pre) Date• is not negotiable. The AMOUNT CERTIFIED is payable only to the Con - d herein. Issuance, payment and acceptance of payment are without to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 /CMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER - ADVISER EDITION 1992 EDITION • AIA° • ©1992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006-5292 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. r7n9lrmo_ioo9 CONTINUATION PAGE Page 2 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 1 05/15/2009 05/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 Bond $47,266.00 $0.00 $47,266.00 $0.00 $47,266.00 100% $0.00 2 Engineering /Project $415,534.00 $0.00 $12,466.02 $0.00 $12,466.02 3% $403,067.98 Management/Mobilization 3 Master Control System $238,100.00 $0.00 $0.00 $0.00 $0.00 0% $238,100.00 4 Control System Electrical Work $33,750.00 $0.00 $0.00 $0.00 $0.00 0% $33,750.00 5 Control System Turn on and $68,900.00 $0.00 $0.00 $0.00 $0.00 0% $68,900.00 Testing 6 CYC, FOH, Lighting Truss $1,456,800.00 $0.00 $0.00 $0.00 $0.00 0% $1,456,800.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $0.00 $0.00 $0.00 $0.00 0% $514,200.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,395,000.00 $0.00 $0.00 $0.00 $0.00 0% $1,395,000.00 9 Canopy Rigging and Reel $348,800.00 $0.00 $0.00 $0.00 $0.00 0% $348,800.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $0.00 $0.00 $0.00 $0.00 0% $316,200.00 11 Loudspeaker Rigging Installation $55,800.00 $0.00 $0.00 $0.00 $0.00 0% $55,800.00 12 Variable Acoustic Curtains $118,000.00 $0.00 $0.00 $0.00 $0.00 0% $118,000.00 13 Curtain Installation $17,700.00 $0.00 $0.00 $0.00 $0.00 0% $17,700.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $0.00 $0.00 $0.00 $0.00 0% $426,000.00 & Actuators 15 Track & Actuator Installation $131,745.00 $0.00 $0.00 $0.00 $0.00 0% $131,745.00 16 Extension Lift & Railings $607,521.00 $0.00 $0.00 $0.00 $0.00 0% $607,521.00 SUB - TOTALS $6,191,316.00 $0.00 $59,732.02 $0.00 $59,732.02 1% $6,131,583.98 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 3 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 1 05/15/2009 05/31/2009 2695 A B C D E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation $90,000.00 $0.00 $0.00 $0.00 $0.00 0% $90,000.00 18 Extension Lift Wagons $111,300.00 $0.00 $0.00 $0.00 $0.00 0% $111,300.00 19 Extension Lift Wagon Installation $18,000.00 $0.00 $0.00 $0.00 $0.00 0% $18,000.00 20 House Mix Lift & Railings $248,000.00 $0.00 $0.00 $0.00 $0.00 0% $248,000.00 21 House Mix Lift Installation $60,000.00 $0.00 $0.00 $0.00 $0.00 0% $60,000.00 22 House Mix Lift Wagons $70,000.00 $0.00 $0.00 $0.00 $0.00 0% $70,000.00 23 House Mix Lift Wagon Installation $16,000.00 $0.00 $0.00 $0.00 $0.00 0% $16,000.00 24 Loudspeaker Wagon $35,384.00 $0.00 $0.00 $0.00 $0.00 0% $35,384.00 25 Loudspearker Wagon Installation $7,000.00 $0.00 $0.00 $0.00 $0.00 0% $7,000.00 26 Demountable Risers $45,000.00 $0.00 $0.00 $0.00 $0.00 0% $45,000.00 27 Demountable Riser Installation $4,800.00 $0.00 $0.00 $0.00 $0.00 0% $4,800.00 28 Orchestra Risers $189,000.00 $0.00 $0.00 $0.00 $0.00 0% $189,000.00 29 Package 5170 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 30 Package 5180 Allowance $200,000.00 $0.00 $0.00 $0.00 $0.00 0% $200,000.00 31 Package 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $0.00 $0.00 $0.00 $0.00 0% $20,000.00 Allowance SUB - TOTALS $7,510,800.00 $0.00 $59,732.02 $0.00 $59,732.02 1% $7,451,067.98 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT CONTINUATION PAGE Page 4 of 4 PROJECT: 2695 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: 1 05/15/2009 05/31/2009 2695 A B C D 1 E F G H I ITEM # WORK DESCRIPTION SCHEDULED AMOUNT COMPLETED WORK STORED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE If Variable) (If AMOUNT PREVIOUS AMOUNT THIS PERIOD 33 CAD As- Builts 5190 Allowance $5,000.00 $0.00 $0.00 $0.00 $0.00 0% $5,000.00 TOTALS $7,515,800.00 $0.00 $59,732.02 $0.00 $59,732.02 1% $7,456,067.98 CONTINUATION PAGE FOR PAYMENT APPLICATION QSS, INC. DOCUMENT