Loading...
HomeMy WebLinkAboutJ.R. Clancy - $670,601.57Exhibit D Disbursement Instructions Mercantile 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 Amounts to be paid by Village Financial as per the PAC Equipment installment purchase contract: Application 14 (JR Clancy) June 2010 $ 613,487.55 Application 15 (JR Clancy) July 2010 $ 57,114.02 Total Authorized Disbursement $ .670,601.57 ' All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (PAC Equipment), dated, as of August 31, 2009, by and betwe-. L nder and Village Financial, LLC. Dated: 'T 1 (o CITY OF CARMEL REDEVELOPMENT COMMISSIO By Printed Title Les S. Olds Executive Director Draft Theater Equipment JR Clancy (Mercantile) January 2010 Paid by Village Financial $ 13,956.69 February 2010 Paid by Village Financial $ 11,219.41 March 2010 Paid by Village Financial $ 2,875,751.98 April 2010 Paid by Village Financial $ 1,321,092.70 May 2010 Paid by Village Financial $ 307,512.15 June 2010 Amount to be paid by Village Financial. $ 613;487:55 July 2010 Amount to be paid by Village Financial .$. ' 57 ;114.02 APPLICATION A a D CERTIFICATE FOR PAY TENT CONSTRUCTION MANAGER - ADVISER EDITION AIA DOCUMENT G702/CM a (Instructions on reverse side) TO OWNERCarr►IC Pedobopmew+ Cam iss► Dyj One CIviL�- `J"�a�2, CallYte,l I '-}[0032 FROM CONTRACTOR: �0}{ lY)4�1S�CIK -Iay ,� Sl�i G1CV$t� 1329q VIA CONSTRUCTION MANAGER% QA CONTRACT FORTRAYCeI 1A, P-Qc 10.11a Tetd-tivvn1113 VIA ARCHITECT: PAGE ONE OF PAGES PROJE G-�l1q� ry e. i7AC _•-fl 3 kol uQ 9N1 (Orimci,IN Ht0032- 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. k75-)iii)o �I�� `0 � 1. ORIGINAL CONTRACT SUM S / 2. Net Change By Change Orders S of 3. CONTRACT SUM TO DATE (Line I + 2) S 0 4� � 0,C1614 /� i �J/_ 8) / 4. TOTAL COMPLETED & STORED TO DATE (Column G on G702) 5. RETAINAGE: "s, of Completed Work 5 (Columns D + E on G703) b. `%, of Stored Material 5 (Column F on G703) Total Retainage (Line 5a s- 5b or Total in Column 1 of G703) 5 CI't'°'! O1 6. TOTAL EARNED LESS RETAINAGE S 51 1 i!q4C.).100 (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT rtr� (Line 6 from prior Certificate) S 5, 11 f (,41 U_ 1+5 8. CURRENT PAYMENT DUE 5 LPl3' -i �5 9. BALANCE TO FINISH, INCLUDING RETAINAGE-7/c-og2n f� (Line 3 Less Line 6) 5 f �JJ �tJJtJ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner C>:00 / (2 1 Lea Y Total approved this Month 0-00 0.0 TOTALS 0 C0 /' C�1�_ 1 ISO CO NET CHANGES by Change Order C. %Il j..QC j APPLICATION NO.: 14 Distribution to: PERIOD TO: U I I 1 ❑ OWNER PROJECT NOS.: 2_t3 5 ❑ CONSTRIJCTION MANAGER CONTRACT DATE:2] I2.I(Y9 ❑ 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. RACTORJ ,p •CIS! CL .Z1f1C. By • State Of: /VLLL County of: 0/76 -r1a...yet_. Subscribed and sworn to before me this ,i37' day of Date• Di I 6 1 i 0 3-0 .'o BRADLEY R. RIVERS Notary Public. State of New York u �_ Q alified in Onondaga County Notary Public: / c. J No 011;15018349 2.0) My Commission expires: Cr, _� Commission Expires September 27, CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on-sitc 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 s osIsi487 AMOUNT CERTIFIED (Attach explanation if amount certified differs from the amount applied for Initial all figures on this.Application and on the Conti ration Sheet that changed to conform to the amount certified.) CO . STRUCTIC N MAN DER: � .� Wk. � ..�� a . u .- - - /r " By AR I tECT• By: This Ccrtifi c is of negotiable. The AMOUNT CERTIFIED is payable only to the Con- tractor n ed erein. issuance, payment and acceptance of payment are without prejudi • to - ny rights of the Owner or Contractor under this Contract. Date: J 0 Date: 0(o/ ! L$ AIA DOCUMENT G702/CMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER -ADVI: EDITION 1992 EDITION • AIA' • ©1992 • THE-AMERICAN 1NSTI111TE OF ARCHITECTS, 1735 -NEW YORK AVENL'E..NW., \VASFIINGTON, D.C. 201106.5292 • 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: 14 06/15/2010 06/30/2010 2695 A 6 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 (0 + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C-G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 Bond 547,266.00 547,266.00 50.00 50.00 $47 ;266.00 100% 50.00 2 Engineering /Project $415 :534.00 5290,873.80 520,776.70 50.00 5311,650.50 75% 5103,883.50 Management/Mobilization 3 Master Control System 5238,100.00 5214,290.00 $0.00 50.00 5214,290.00 90% 523,810.00 4 Control System Electrical Work $33,750.00 525,312.50 50.00 $0.00 525,312.50 75% $8,437.50 5 Control System Turn on and 568,900.00 $0.00 53,445.00 50.00 $3,445.00 5% 565,455.00 Testing 6 CYC, FOH, Lighting Truss 51,356,800.00 51,221,120.00 $67,840.00 50.00 51,288,960.00 95% $67,840.00 Motorized Rigging 7 CYC, FOH, Lighting Truss 5514,200.00 5359,940.00 5102,840.00 50.00 5462,780.00 90% 551,420.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,:'00.00 $1,301,000.00 50.00 50.00 $1,301,000.00 100% 50.00 9 Canopy Rigging and Reel 5348800.00 $244,160.00 587,200.00 50.00 5331.360.00 95% 517,440.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 5316,200.00 50.00 50.00 5316,200.00 100% 50.00 11 Loudspeaker Rigging Installation 555,800.00 539,060.00 511,160.00 50.00 550,220.00 90% 55,580.00 12 Variable Acoustic Curtains 5118,000.00 50.00 50.00 50.00 50.00 0% 5118,000.00 13 Curtain Installation 517,700.00 50.00 50.00 50.00 50.00 0% 517,700.00 14 Variable Acoustic Tracks /Blocking 5426,000.00 5426,000.00 50.00 S0.00 5426,000:00 100% 50.00 & Actuators 15 Track & Actuator installation 5131,745.00 5125,157.75 50.00 50.00 S125,157.75 95% 56,587.25 16 Extension Lift & Railings $607,521.00 5546,768.90 530,376.05 50.00 5577,144.95 95% $30,376.05 SUB - TOTALS 55,997,316.00 55,157,148.95 $323,637.75 50.00 55,480,786.70 91% $516,529.30 CONTINUATION PAGE Quantum Software Solutions, 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: 14 06/15/2010 06/30/2010 2695 A 8 C 0 E F G H 1 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 590,000.00 572,000.00 59,000.00 50.00 $81,000.00 90% 59,000.00 18 Extension Lift Wagons 5111,300.00 50.00 5105,735.00 50.00 5105,735.00 95% 55,565.00 19 Extension Lift Wagon Installation 518,000.00 50.00 $0.00 $0.00 50.00 0% $18,000.00 20 House Mix Lift & Railings 5248,000.00 5198,400.00 537,200.00 50.00 5235,600.00 95% 512,400.00 21 House Mix Lift Installation 560,000.00 $48,000.00 50.00 50.00 548,000.00 80% 512,000.00 22 House Mix Lift Wagons 570,000.00 50.00 566,500.00 50.00 $66,500.00 95% 53,500.00 23 House Mix Lift Wagon Installation 516,000.00 50.00 $0.00 50.00 $0.00 0% 516,000.00 24 Loudspeaker Wagon 535,354.00 $0.00 533,614.80 50.00 $33,614.80 95% 51,769.20 25 Loudspearker Wagon Installation 57,000.00 50.00 50.00 50.00 50.00 0% 57,000.00 26 Demountable Risers 545,000.00 50.00 $0.00 50.00 50.00 0% 545,000.00 27 Demountable Riser Installation S4,800.00 50.00 50.00 50.00 50.00 0% 54,800.00 28 Chorus Wagons 5189,000.00 50.00 $37,800.00 $0.00 $37,800.00 20% 5151,200.00 29 Package 5170 Allowance 5200,000.00 5193,289.50 50.00 50.00 5193,289.50 97% 56,710.50 30 Package 5180 Allowance S200,000.00 $152,124.00 50.00 50.00 5152,124.00 76% $47,876.00 31 Package 5190 Allowance 55,000.00 $5,000.00 50.00 S0.00 55,000.00 100% 50.00 32 CAD As- Builts 5170 8 5180 Allowance $20,000.00 $10,000.00 $0.00 50.00 510,000.00 50% $10,000.00 SUB - TOTALS 57,316,800.00 55,835,962.45 5613,487.55 $0.00 56,449,450.00 88% 5867,350.00 CONTINUATION PAGE Quantum Software Solutions, 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: 14 06/15/2010 06/30/2010 2695 A B C 0 E F G H I ITEM # WORK DESCRIPTION COMPLETED WORK STARED MATERIALS (NOT IN D OR E) TOTAL COMPLETED AND STORED (D + E+ F) o /o COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) SCHEDULED AMOUNT AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 33 CAD As- Buiits 5190 Allowance $5,000.00 $5,000.00 50.00' 50.00 55,000.00 100% 50.00 34 Orchestra Risers 5194,000.00 50.00 50.00 50.00 50.00 0% $194,000.00 35 37 C/O #1 Orchestra riser /slack line deletions, chairwagon - bronze, C/O #2 Allowance Reductions (5203,040.00) (5322,720.00) 50.00 (5320,000.00) 50.00 50.00 50.00 50.00 50.00 (5320,000.00) 0% 99% (5203,040.00) (52,720.00) 38 C/O #3 Work Directive 50.00 50.00 50.00 50.00 $0.00 50.00 TOTALS 56,990,040.00 55,520,962.45 $613,487.55 50.00 56,134,450.00 88% 5855,590.00 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONDITIONAL W AEV ER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from 1 e (Maker of Check) in the sum of $ (11i, 24-057. (Amount of Check) payable to (Payee or Payees of Check) and when the check has been properly endorsed and has been paid by the bank upon which it is drawn this document shall become effective to relpil ,se any me ha ic's lien, stop notice, or bond right the undersigned has n the job �f Lar me J r-i f ' 'At- (Owner) located at X77 t AV.Q SA/ ?� y' NP 1 1-H .PO32 (Job Description) to the following extent. This release co rs a p grey payment for labor, services, equipment, or material furnished to ') i- 1 j/) (Your Customer) through \JVV)e.Y, 2iD L) (Date) only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract rights including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for fumished labor, services, equipment, or material covered by this release if that furnished labor, services equipment, or material was not compensated by the progress payment. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned. 1 Dated:du ne 18 , .2_0)0 J, R. CQni, COMPANY NAME " (PRINT NAME AND TITLE) Payroll #16 Date : 06/17/2010 GENERAL STEEL ERECTORS, INC. Page : 6 Time: 9:21:17AM 5230 E. 26TH STREET INDIANAPOLIS IN46218- CERTIFIED PAYROLL REGISTER For the pay period ending 06/15/2010 Job : 7569 CARMEL REG PERF ARTS CTR - EREC EMPLOYEE MINORITY SOC SEC NUM 6110 6111 6/12 6/13 6/14 6/15 6116 PAY BFT THIS JOB SKILL LEV SEX TYP Thu Frl Sat Sun Mon Tue Wed TOTAL RATE RATE ADJUSTMENTS - - - -- HOURS WORKED EACH DAY --- - -- JOHNSON M J None Male S 24.00 0.00 0.00 0.00 0.00 0.00 0.00 24.00 27.500 IRONWORKER XXX -XX -0674 Journeyman KNOTTDAVID None XXX -XX -4007 06/17/2010 THU 08:55 [TX /RX NO 9412] Totals for Job Male S 24.00 0.00 0.00 0.00 0.00 0.00 0.00 24.00 30.250 IRONWORKER Journeyman 7569 ------ Earnings -- - - - - -- JOB EARN TOT EARN TAX EARN THIS PAY PERIOD - - -- DEDUCS UNIONIWCOMP TAXES NET DED 95.00 FIT 184.01 660.00 EFT 784.17 SSMD 84.15 11Q0.00 BFTNET 0.00 State 37,40 1,100.00 Local 12.65 413.21 Other 0.00 685.79 DED 36.20 FIT 68.33 726.00 EFT 790.34 SSMD 92.57 1,210.00 BFTNET 0.00 State 41.14 1,210.00 Local 19,97 258.31 Other 0.00 051.69 -- ---- -- Taxes -- - - -- Job 1,386.00 FIT 252.34 Gross 2,310.00 SSMD 176.72 Tax Gross 2;310.00 State 76.54 Net 1,638.48 Local 32.62 Hours 48.00 Other 0.00 PY ertR ,+.rpt 010Z!L 1190 innrmnn•,4 OTOZ /LT /90 L000 [ZT66 ONXXI /XL] 49:80 RH1 Dare June 17, 2010 Elaine A. Lee (Name ol81Qnaloty Party) do hereby state: Sec/Treasurer (Alai (1) That I pay or supervise the payment of the persons employed by General Steel Fabricating Co Inc (Contractor or Subcontractor) Carmel Arts Center (BuIldtng or Work) 10th day of June , 2010 and ending the 16th day of : June 2010 all persons employed on said project have been pald the full weekly wages earned, that no rebates have bean or will be made either directly or Indirectly to or on behalf of acid General Steel Fabricating Co Inc Iram the Nil (Conireotor or 8ubcontrodor) weakly wages earned by any parson end that.no deductions have been madeielther directly or indirectly from the full wages eamed by any person, other than pormicslbfa deductions as defined In Regulations, Part 3 (28 CFR Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stet, 948, 83 Start. 108, 72 Stat, 087; 78 Stat. 357; 40 U.S.C. 278o), and desorfbod below: on the ; that during the payroll period commencing on the (2) That any payrolls *anise under this contract required to be submIttea for the above period are correot and complete; that the wage rates for laborers or mechanics contained therein are not fees than the applicable wage rates contained in any wage determination Incorporated Ito the contract; that the cienelfcations eel forth therein for each laborer ormechenloconform with the walk ho performed. (3) That any apprentices employed in the above period are duly registered in a bone fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeshlp and Training, United States Department of Leber, of If no such recognized agency exists In a State, are registered with the Bureau of Appretttceship and Training, United States Department of Labor. (4) That: • (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS — In addition to the basic hourly wage rates pald to each laborer or mocha* listed In the above referenced payroll, paymenle of fringe benefits as listed In the contract have been or will be made to appropdato programs for the benefit of such employees, except as noted In Section 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH 0 m ❑ — Each laborer or mechanic listed In the above referenced payroll has been paid; as Indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed o In the contract, except ae noted In Section 4(o) below. 0 (a) EXCEPTIONS EXCEPTION (CRAFT) EXPLANATION REMAAx8: NAME AND TIME Elaine A. Lee, Sec/Treasurer MATURE 5(4t.,41/4'' THE WILLFUL FALSIFICATION. OF ANY OF THE ABOVE STATEttENTB MAY 8U8JECT THE CONTRACTOR OR 8U8COWTRAOTORTO CIVIL OR CRIMINAL, PR08EC_ UTION. SEE BEOTION 1801 OF ME 18 AND BEGTION 231 OF TITLE 31 OF-11.1E UNITED STATES CODs . '123. U.04107611.16 ton a) Date : 06/09/2010 Time : 10:17:47AM Job : 7569 CARMEL REG PERF ARTS CTR - EREC Payroll #15 GENERAL STEEL ERECTORS, INC. Page : 4 5230 E. 26TH STREET INDIANAPOLIS IN 46218 - CERTIFIED PAYROLL REGISTER For the pay period ending 06/09/2010 JOB EARN TOT EARN EMPLOYEE MINORITY HOURS WORKED EACH DAY THIS PAY PERIOD TAX EARN DEDUCS SOC SEC NUM 6/3 6/4 6/5 6/6 6/7 618 6/9 PAY BFT THIS JOB UNION/WCOMP TAXES NET SKILL LEV SEX TYP Thu Fri Sat Sun Mon Tue Wed TOTAL RATE RATE ADJUSTMENTS JOHNSON M.1 None Male S 15,00 0.00 0.00 0.00 0,00 0.00 OAO 16.00 27.500 DED 95.00 FIT 184.01 440.00 IRONWORKER BFT 784.17 SSMD 84.15 1,100.00 XXX -XX -0574 Journeyman BFTNET 0.00 Slate 37.40 1,100.00 Local 12.65 413.21 Other 0.00 686.79 KNOTTDAVID None Male c 15.00 0.00 0.00 0.00 0.00 0.00 0.00 16.00 30.250 IRONWORKER XXX -XX -4987 Journeyman DED 36.30 FIT 68.33 BFT 790.34 SSMD 92.56 BFTNET 0.00 Stale 41.14 Local 19.97 Other 0.00 Totals for Job 7509 Earnings - -- -Taxes Job 924.00 FIT 252.34 Gross 2,310.00 SSMD 176.71 Tax Gross 2,310.00 Slate 78.54 Net 1,638.49 Local 32.62 Hours 32.00 Other 0.00 484.00 1,210.00 1,210.00 258.30 951,70 PYCertPg.rpl Date June 10, 2010 Elaine A. Lee (Nana of Signatory Party) do hereby state; Sec/Treasurer (1) That I pay or supervise the payment of the persons employed by General Steel Fabricating Co Inc an the (Contractor or Subcontractor) Carmel Arts Center ; that during the payroll pedod commencing on the (Butiding or Work] rd 3 day of June 2010 and ending the 9th day of June , 2010 all persons employed on said project have been pald the full weekly wages earned, that no rebates have been or will be made either directly or Indirectly to or on behalf ohaald General Steel Fabricating Co Inc (Contractor or Subcontractor) from tho full weekly wages eamed by any person and that no deductions have been made either directly or Indirectly from the full wages eamed by any person, other than permissible deductions as defined In Regulations, Part 3 (29 CFR Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Start. 108, 72 Stet. 967; 78 Stat. 357; 40 U.S.C. 270c), and described. below: (2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complale; that the 'rage rates for laborers or mechanics contained therein are not less then the applicable wage rates contained In any wage determination Incorporated Into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3) That any apprentices employed In the above period are duly registered In a bona Ode apprenticeship program registered with a State apprenticeship agency recognized by the Bureau or Apprenticeship and Training, United States Department of Labor, of if no such recognized agency exists In a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor. (4) That: (a) WH ERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS !�t — In addition to the basic hourly wags rates paid to each laborer or mechanic listed In the above referenced payroll, payments of fringe benefits as listed In the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted In Section 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH ❑ — Each laborer or mechanic listed In the above referenced payroll has been paid, as indicated on the payroll, an amount not tees Than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed In the contract, except as noted In Section 4(c) below. (o) EXCEPTIONS EXCEPTION (CRAFT) EXPLANATION REMARft& NAME AND TITLE Elaine A. Lee, Sec/Treasurer SIGNATURE NAjJ� THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 10 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE, Payroll #14 Date: 05/28/2010 GENERAL STEEL ERECTORS, INC. Page : 4 Time : 9:45:56AM 5230 E. 28TH STREET INDIANAPOLIS IN 46218 - CERTIFIED PAYROLL REGISTER For the pay period ending 06/02/2010 Job : 7569 CARMEL REG PERF ARTS CTR - EREC EMPLOYEE MINORITY HOURS WORKED EACH DAY SOC SEC NUM 5/27 5128 5129 5130 5/31 611 512 PAY SKILL LEV SEX TYP Thu Fri Sat Sun Mon Tue Wed TOTAL RATE JOHNSON M.1 None Male S 15.00 0.00 0.00 0.00 0.00 0.00 0.00 16.00 27.500 xxx- xx -0674 IRONWORKER Journeyman JOB EARN TOT EARN TAX EARN THIS PAY PERIOD DEDUCS BFT THIS JOB UNIONIWCOMP TAXES NET RATE ADJUSTMENTS DED 75.20 FIT 44.34 440.00 EFT 313.67 SSMD 33.66 440.00 BFTNET 0.00 State 14.96 440.00 Local 5.00 173.22 Other 0.00 266.78 KNOTTDAVID None Male 16.00 0.00 0.00 0.00 0.00 0.00 0.00 16.00 30.250 DEB 25.35 FIT 20.60 484.00 XXX -XX -4987 IRONWORKER UT SSMD 72.30 32. 945.12 Journeyman 6FTNET 0.00 State 13 945.12 Local 15.60 176.96 Other 0.00 765.14 Totals for Job 7569 Earnings Taxes Job 924.00 FIT 72.94 Gross 1,385.12 SSMD 105.96 Tax Gross 1,385.12 Stale 47.09 Net 1,034.92 Local 20,66 Hours 32.00 Other 0.00 P`1*'CErtRrr rpi Hate June 2, 2010 Tom Robinson (Nemo of Signalnry Party) do hereby stale: Vice President (1) That I pay or supervise the payment of the persons employed by General Steel Fabricating Co Inc (idle) (Contractor or Subcontractor) Carmel Arts Center on the ; that during the payroll ported commencing on the (0ullding or Work) 2_71h day of May , 2010, and ending the 2nd day of June 2010 all persons employed-on said project have been pald the full weekly wages eamed, that no rebates have been or will be made either directly or Indirectly to or on behalf of Bald General Steel Fabricating Co Inc (Contractoror Bubcontinotar)" from the full moldy wages earned by any person and that no deductions have been made either directly or Indirectly from the full wages earned by any person, other than permissible deductions as defined in Regulations, Part 3 (29 CFR Subtitle A), issued by the Secretary of Lobar under the Copeland Act, as amended (48 Stat. 948, 63 Start. 100, 72 Stat. 967; 76 Slat, 357; 40 U.S.G. 276o), and described below: (2) That any payrolls otherwise under this contract required to be submitted for the above parted are correct and complete; that the wage rotes for laborers or mechanics contained therein are not less than the applicable wage rates contained In any wage determinallon Incorporated Into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work ha performed, (3) That any apprentices employed In the above period are duly registered In a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, of If no such recognized agency exists In a State, are registered with the Bureau of Appreettcoship and Training, United States Department of Labor. (4) That (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS Xi — In addition to the basic hourly wage rates pald to each laborer or mechanic listed In the above referenced payroll, payments of fringe beneflts as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted In Sacllon 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID IN CASH ❑ - Each laborer or mechanic listed In the above referenced payroll has been peld, as Indicated on the payroll, an amount not less than the sum of the applicable baste hourly wage rate plus the amount of the required, fringe benefits as listed In the contract, except as noted in Section 4(c) below. (c) EXCEPTIONS EXCEPTION (CRAFT) EXPLANATION REMARKS: NAME A140 11TLE Tom Robinson, Vice Preside SIGNATURE / ' -" --- THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 10 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE • Yayroli ifl.i Dale : 05/20/2010 GENERAL STEEL ERECTORS, INC. Page: 1 Time : 12:53:20PM 5230 E. 26TH STREET INDIANAPOLIS IN 46218 - CERTIFIED PAYROLL REGISTER For the pay period ending 05/2612010 Joh : 7569 CARMEL REG PERF ARTS CTR - EREC JOB EARN TOT EARN EMPLOYEE MINORITY HOURS WORKED EACH DAY THIS PAY PERIOD TAX EARN OEDUCS SOC SEC NUM 5120 5 /21 5/22 5/23 5/24 5125 5(26 PAY BFT THIS JOB UNION/VI/COMP TAXES NET SKILL LEV SEX TYP Thu Fri Sat Sun Mon Toe Wed TOTAL RATE RATE ADJUSTMENTS BRANDEN D M None Male S 40.00 0.00 0.00 0.00 0.00 0.00 0.00 40.00 25.200 DED 31.44 FIT 107.20 1,048.00 IRONWORKER s 1,D46.DD XXX -XX -9521 B 764.85 SMD 80.16 Journeyman BFTNET 0.00 State 35.63 1,048.00 Local 10.48 264.91 Other 0.00 783.09 JOHNSON M J None Mate S 40.00 0,00 0.00 0.00 0.00 0.00 0.00 40.00 26.200 DED 93.44 FIT 171.01 1,048.00 XXX -XX -0674 IRONWORKER BFT 764.85 SSMD 80.17 1,048.00 Journeyman BFTNET 0.00 State 35.63 1,048.00 Local 12.05 392.30 Other 0.00 555.70 I:NOTTDAVIO None Mate S 36.00 0.00 0.00 0.00 0.00 0.00 0.00 35.00 28.520 XXX-XX-4957 IRONWORKER Journeyman LUCAS J A XXX -XX -6753 None Male S 40.00 0.00 0.00 0.00 0.00 0.00 0.00 40.00 23.580 IRONWORKER Apprentice DED 31.13 FIT 42.46 1,037.52 BFT 693.66 SSMD 79.37 1,037.52 BFTNET 0.00 State 35.28 1,037.52 Local 17.12 205.38 Other 0.00 832.16 DED 173.30 FIT 109.72 943.20 BFT 758.96 SSMD 72.16 943.20 BFTNET 0,00 State 32.07 943.20 Local 21.41 408.66 Other 0.00 534.54 Date May 27, 2010 Donald Diilev Detailer (Name of Signatory Party) ruse) do hereby state: (1) That I pay or supervise the payment of the persons employed by General Steel Fabricating Co Inc ( Contractor or Subcontractor) Carmel Arts Center an the ; that during.the payroll period commencing on the (Building or Wort) 20ti' (joy of May 2010, and ending.the 26th duy of May , 2010 all persons employed on said pro)ect have been paid the full weekly wages earned, that no rebates have been or will be made either directly or Indirectly to or on behalf of Raid General Steel Fabricating Co Inc from the full (Contractor or Subcontractor) wooly wages earned by any person and that no deductions have been made either directly or indirectly irem the full wages eamad by any person, other than permissible deductions as defined In Regulations, Part 3 (29 CFR Subtitle A), Issued by the Secretory of tabor under the Copeland Act, as amended (40 Stat, 948, 63 Start. 106, 72 Stat. 967; 76 Slat. 357; 40 U.S., 270c), and described below • (2) That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination Incorporated into the contract; that the classifications set forth therein for each laborer or rnechanlo conform wlih the work he performed. (3) That any apprentices employed in the above period are duly registered In a bona fide apprenticeship program registered with a State npprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department ol.Lsbor, of If no such rocognized.agenoyexfsts In a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor. (4) That (a) WHERE FRINGE BENEFITS ARE'PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS rtia — In addition to the baslo hourly, wego rates paid to each laborer or mechanic listed In the above referenced payroll, payments of fringe benefits as listed In the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted In Section 4(c) below. (b) WHERE FRINGE BENEFITS ARE PAID iN CASH ❑ — Each laborer ar mechanic listed In the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basto.hourly wage rate plus the amount of the required fdnga benefits as tistoo In the contract, except as noted in Section 4(o) below. (c) EXCEPTIONS EXCEPTION (CRAFT) EXPLANATION REMARKS: NAME AND TiTLE Donald Dilley, Detailer • SIGNATURE c0171.1,akit-eam- THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE IS AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE • Date : 05/19/2010 Time : 2:36 :30PM Job : 7569 CARMEL REG PERT ARTS CTR - EREC Payroll #12 GENERAL STEEL ERECTORS, INC. Page -: 5 5230 E. 26TH STREET INDIANAPOLIS IN 45218 - CERTIFIED PAYROLL REGISTER For the pay period ending 05/19/2010 J013 EARN TOT EARN TAX EARN HOURS WORKED EACH DAY -- THIS PAY PERIOD EMPLOYEE MINORITY DEDUCS SOC SEC NUM 5/13 5/14 5115 5 /1G 5117 5118 5/19 PAY BFT THIS JOB UNIONIWCOMP TAXES NET SKILL LEV SEX TYP Thu Fri Sat Sun Mon Tue Wed TOTAL RATE RATE ADJUSTMENTS BRANDEN D M None Male S 40.00 0.00 0.00 0.00 0.00 0.00 0.00 40.00 26.200 DED 31.44 FIT 107.20 1,048.00 XXX XX 9521 IRONWORKER BFT 764.85 SSMD 80.18 1,048.00 Journeyman BFTNET 0.00 State 35.63 1,048.00 Local 10.46 264.93 Other 0.00 783.07 JOHNSON M J None XXX -XX -0674 Nlete 5 40.00 0.00 0.00 0.00 0.00 0.00 0,00 40.00 26.200 IRONWORKER Journeyman {NOTTDAVID None Male S 40.00 0.00 0.00 0.00 0.00 0.00 0.00 40.00 28.820 XXX -XX -4987 IRONWORKER Journeyman DED 93.44 FIT 171.01 1,048.00 BFT 764.85 SSMD 80.18 1,048.00 BFTNET 0.00 Slate 35.63 1,048.00 Local 12.05 392.31 Other 0.00 655,69 DED 34.58 FIT 59.75 1,152.80 BFT 770.73 SSMO 88.19 1,152.80 BFTNET 0.00 Stale 39.20 1,152:80 Local 19.02 240.74 Other 0.00 912.06 LUCAS J A None Male S 40.00 0.00 0.00 0.00 0.00 0.00 0.00 40.00 23.580 . DED 173.30 FIT 109.72 943.20 XXX -XX -6753 IRCINWORICER BFT 758.95 SSMD 72-15 943.20 Apprentice BFTNET 0.00 State 32.07 943.20 Local 21.41 408.65 Other 0.00 534.55 Date May 20, 2010 1, Elaine A. Lee Sec/Treasurer (Narno of Signatory Party) (rrtla) do hereby state: (1) That! pay or supervise the payment of the persons employed by General Steel Fabricating Co Inc (Contractor or Bubcanlractor) Carmel Arts Center (auliding or Work) 13th day of May , 2010 and ending the 1 0th day Of May 2010 all persons employed on said project have been paid the full weekly wages earned, that no rebates have been or will be made either directly or lndlrocUy to or on behalf of saki General Steel Fabricating Co Inc on the .; that during the payroll period commencing on the (Conhactorer eubcaniractor) from the full weekly wages earned by any person and that no deductions have been made either directly or Indirectly from the full wages earned by any person, other than permissible deductions as defined to Regulations,. Pert 3 (29 CFR subtitle A), Issued by the Secretary of Lebnr under the Copeland Act, as amended 148 Stat. 948, 63 Start. 108, 72 Stat, 967; 79 Slat. 357; 40 U.S.C. 276c), and described below. (2) That any payrolls otherwise under this contract required to be submitted for the above perlod are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rotes contained in any wage determination incorporated into the contract; that the classfficatlons set forth therein for ouch laborer ormechento conform with the work he periormed. (3) That any apprentices employed In the _above period are duly registered In a bona lido apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United Status Department of Labor, of If no such recognized agency exists In a Slate, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor. (4) Thal: (a) WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS in addition to the baste hourly wage rates paid to each laborer or mechanic listed In the above referenced payroll, payments of fringe benefits as listed In the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in Section 4(c) below, (b) WHERE FRINGE BENEFITS ARE PAID IN CASH Q — Each laborer or mechanic listed In the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate pius the amount of the required fringe benefits as listed In the contract, except au noted In Soctlon 4(c) below. (c) EXCEPTIONS EXCEPTION (CRAFT) EXPLANATION REMARKS: NAME AND TITLE Elaine A. Lee, Sec/Treasurer SiGNAATUURE y� THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE COM'nACTOn OR SUBCONTRACTOR 70 CIVIL OR CRIMINAL PROSECUTION. SEE aEOTiON 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. APPLE1C TEJON AND CELRTIIFIICATE FO PAYMENT CONSTRUCTION MANAGER- ADVISER EDITION AIA DOCUMENT G702 /CMa (Instructions on reverse .side) To OWNER: Ca V\J\ Qa9.V.Q {o 9Vv Q4tif- CU1Y1W1 &C.111 1 CT: S OneCI.V�C, uaYQ. Carlv,el /AC C if Irn e I , �U Cain 7— 1r 3�`{Avre� i�{ v.� sv i FROM CONTRACTORS- i��lain Tvc - CCLV VIIei /a) 03% 114 1 ferS k -1S land Q-a- Su) v-c, 4,R N■ (710 � `` Jp /� VIA CONSTRUCTION M CONTRACT FOR &Val 1t"• 1L, A�vafryl �S ICI i ITECT: CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document 15703, is attached. j �,/� 1. ORIGINAL CONTRACT SUM S 7, 51 J / $W . Qnn/O\\ 2. Net Change By Change Orders ( 525 1LV. W) 3. CONTRACT SUM TO DATE (Line 1 ± 2) � C ,cic��, 6J��/`�J 4. TOTAL COMPLETED & STORED TO DATE 5 1_0 t 1C 1 t 0 [-.V2_ 5 5 (Column G on G702) 5. RETAINAGE: a. % of Completed Work (Columns D + E on 6703) b. % of Stored (Material (Column F on 6703) Total Retainage (Line 5a + 5b or Total in Column 1 of G703) 5 $ 5 6. TOTAL EARNED LESS RETAINAGE 5 (Line 4 less Line 5 Total) 3 c 7 a 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 5 J)101, G1 (Line 6 from prior Certificate) R. CURRENT PAYMENT DUE 5f I I 1 t--(- , 02_ 9. BALANCE TO FINISH, INCLUDING RETAINAGE' (Line 3 Tess Linc 6) 5 11 y-1 i 1 1`10 CI-IANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 0,Cyj (G29 - )(o(.(a Q CC..)` Total approved this Month O. CO TOTALS O -� (c (9O UU 1 NET CHANGES by Change Order (S7 11 n1) w t ANAGER: PAGE ONE UI: PAGES APPLICATION NO.: ) 3 PERIOD TO: 1311ID PROJECT NOS.: Z,(yeLS CONTRACT DATE �2-1U9 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 \Vork for which previous Certificates for Payment Were issued :Ind pay- ments received from the Owner, and that current payment shown here_irl is now due. CONTRACTO By: State of:/1/ County ore JOyJD c q Subscribed and sworn to before me this tp i S•T day car TL,/ L :E/ C . Not :try Public: 11�L My Commission expires: / 1( 01 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. Date :) u 1:2t^ i n MICHAEL JAY PARKIN Notary Public, State of New York Qualified in Onondaga County Reg. No. 01PA4807278 My Commission Expires May 31, 20i` AMOUNT CERTIFIED (Attach explanation if amount certified differs front the amount applied. for Initial all figures on II.Iis Application and on th 'Continuation .Sheet that chanl{ed to conform to the amount certified.) CONSTRUCT,] N MANAGE By: ' ►:,l: i, - . 4Lat-_.■111 I �� Date: 6.1 0 A CHI ±'if i `` 1 By: 1_` v -- D to • PA3Utira 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. A 1' AIA DOCUMENT G702JCMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION \]ANAGER - ADVISER iil)IT t)N VIE: 1992 EDITION • AIAr' • ©1992 • Tlili AMERICAN INSTITUTE OF AIRCIITI'EcTS. 1735 NEV YORK AVENUE, N.W., W.1Sh11NGToN. Ip., D.C. 201)06.5292 • WARNING: Unlicensed photocopying violates U.S. copyright taws and will subject the violator to legal prosecution. CAI tTIfm• Vnn chnnlrl nea an nrininal AIA rInrnmant whirh hoe thin rantlnn nrintarl in rarl An nrinlnal accnrac that rhannac will not ha nhernrari ac mast nrrnr whan rinntnnantc ara ranrnrtueort. 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: 15 07/15/2010 07/31/2010 2695 A 8 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 (0 + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (if Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 1 Bond 547,266.00 $47,266.00 50.00 50.00 547,266.00 100% 50.00 2 Engineering /Project $415,534.00 5311,650.50 512,466.02 50.00 $324,116.52 78% 591,417.48 Management/Mobilization 3 Master Control System 5238,100.00 5214,290.00 S0.00 50.00 5214,290.00 90% 523,810.00 4 Control System Electrical Work 533,750.00. 525,312.50 56,750.00 50.00 532,062.50 95% 51,687.50 5 Control System Turn on and 568,900,00 53;445.00 51,378.00 50:00 54,823.00 7% 564,077.00 Testing 6 CYC, FOH, Lighting Truss 51,356,800.00 S1,288,960.00 50.00 50.00 $1,288;960.00 95°A 567,840.00 Motorized Rigging 7 CYC, FOH, Lighting Truss 5514,200.00 5462,780:00 50.00 50.00 5462,78000 90% 551,420.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels 51,301,000.00 51,301,000.00 50.00 $O.00 $1,301,000.00 100% 50.00 9. Canopy Rigging and Reel $348,800.00 5331,360.00 517,440.00 50.00 5348,800.00 100% 50.00 Installation 10 Loudspeaker Motorized Rigging 5316;200.00 5316,200.00 50.00 50.00 5316,200.00 100% 50.00 11 Loudspeaker Rigging Installation 555,800.00 550,220.00 55,580.00 50.00 555;800.00 100% 50.00 12 Variable Acoustic Curtains 5118,000.00 S0.00 50.00 50.00 50.00 0% 5118,000.00 13 Curtain Installation 517.700.00 50.00 50.00 S0.00 50.00 0% 517,700.00 14 Variable Acoustic Tracks /Blocking 5426,000.00 5426,000.00 50.00 50.00 5426,000.00 100% 50.00 & Actuators 15 Track & Actuator Installation 5131,745.00 S125,157.75 S0.00 50.00 5125,157.75 95% 56,587.25 16 Extension Lift & Railings 5607,521.00 5577,144.95 50.00 50.00 5577,144.95 95% 530,376.05 SUB - TOTALS 55,997,316.00 S5,480,786.70 543,614.02 50.00 55,524,400.72 92% 5472,915.28 CONTINUATION PAGE Quantum Software Solutions, 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: 15 07/15/2010 07/31/2010 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 (0 + E + F) % COMP. (G / C) BALANCE TO COMPLETION (C -G) RETAINAGE (If Variable) AMOUNT PREVIOUS PERIODS AMOUNT THIS PERIOD 17 Lift Installation 590,000.00 581,000.00 54,500.00 50.00 585,500.00 95% 54,500.00 18 Extension Lift Wagons 5111,300.00 5105,735.00 S0.00 50.00 5105,735.00 95% 55,565.00 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 5235,600.00 50.00 50.00 5235,600.00 95% 512,400.00 21 House Mix Lift Installation 560,000.00 548,000.00 59,000.00 50.00 557,000.00 95% 53,000.00 22 House Mix Lift Wagons 570,000:00 566,500.00 S0.00 50.00 566,500.00 95% 53,500.00 23 House Mix Lift Wagon Installation 516,000.00 50.00 S0.00 50.00 50.00 0% 516,000.00 24 Loudspeaker Wagon $35,384.00 $33,614.80 50.00 50.00 533,614.80 95% 51,769.20 25 Loudspearker Wagon Installation 57,000.00 $0.00 50.00 50:00 $0.00 0% $7,000.00 26 Demountable Risers 545,000.00 50.00 50.00 50.00 50.00 0% 545,000.00 27 Demountable Riser Installation $4,800.00 50.00 50.00 50.00 50:00 0% 54,800.00 28 Chorus Wagons 5189,000.00 537,800.00 50.00 50.00 537,800.00 20% $151,200.00 29 Package 5170 Allowance 5200,000.00 5193,289.50 50.00 50.00 5193,289.50 97% $6,710.50 30 Package 5180 Allowance 5200,000.00 $152,124.00 50.00 50.00 $152,124.00 76% $47,876.00 31 Package 5190 Allowance $5,000.00 55,000.00 50.00 50.00 55,000.00 100% S0.00 32 CAD As- Builts 5170 & 5180 $20,000.00 510,000.00 $0.00 50.00 510,000.00 50% 510,000.00 Allowance SUB - TOTALS 57,316,800.00 56,449,450.00 557,114.02 50.00 56,506,564.02 89% 5810,235.98 CONTINUATION PAGE Quantum Software Solutions, 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: 15 07/15/2010 07/31/2010 2695 A B C D E F G H 1 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 CAD As- Builts 5190 Allowance 55,000.00 55,000.00 50.00 50.00 55,000.00 100% 50.00 34 Orchestra Risers 5194,000.00 50.00 50.00 50.00 $0.00 0% $194,000.00 35 37 CIO #1 Orchestra riser /slack line deletions, chairwagon - bronze, CIO #2 Allowance Reductions ($203,040.00) ($322,720.00) $0.00 (5320,000.00) S0.00 $0.00 50.00 50.00 $0.00 (5320,000.00) 0% 99% ($203,040.00) (52,720.00) 38 CIO #3 Work Directive S0.00 $0.00 S0.00 50.00 50.00 50.00 TOTALS $6,990,040.00 56,134,450.00 $57,114.02 50.00 56,191,564.02 89% $798,475.98 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONDMONAL WADVER AND RELEASE UPON PROGRESS PAYMENT T Upon receipt by the undersigned of a check from p,c6C oi- (Maker of Check) in the sum of $ 5, I 1 C 2-- (Amount of Check) payable to (Payee or Payees of Check) and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to rel ase any m hapic's lien stop notice, or bond right the undersigned has pn the job Y ry\e. Y-rot't1l n Ayk C' 't (Owner) located at 71 AV.Q SW y ra (Job Description) to the following extent. This release co rs p gress payment for labor, services, equipment, or material fumished to D a. `) j IXOV\ (Your Customer) through 1, -2711 201 (Date) only and does not cover any retentions retained beforb or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract rights including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that furnished labor, services equipment, or material was not compensated by the progress payment. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned. Dated: fl 12-I l 7 0 J, R. CI auto, COMPANY NAME By Its LLu l;lettL • AA /, I o -' REMERNIN (PRINT NAME AND TITLE) UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT The undersigned has been paid and has received a progress payment in the sum of $ 3 •02, for labor, services-, equipment, or material furnished to ,• (Your Customer) on the job gt _ r► (Owner) located at —]1] A\/ S W (Job Description) and does hereby release any mechanic's lien, stop notice, or bond right that the undersigned has on the above referenced job to the following extent. This release covers q pro g ss payment for labor, services, equipment, or materials furnished to -)C (Your Customer) through pt-i 1 , 2010 (Date) only and does not cover any retentions retained before or after the release date; extras famished before the release date for which payment has not been received; extras or items furnished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that furnished labor, services, equipment, or material was not compensated by the progress payment. Dated: U H,2())0 LJ.R.C1&JIC T c COMPANY NAME' (Print Name and Title) NOTICE: THIS DOCUMENT WAIVES RIGHTS UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GMNG UP THOSE RIG SIGN THIS DOCUMENT HAVE I�S ENFORCEABLE ' AG tNST YOU IF YOU SIGN I ! , EVEN IF YOU 1 AVE NOT BEEN PAID. IF YOU HAVE NOT BEEN PAID, USE A CONDITIONAL RELEASE FORM. r.r .- •r r TRANSFER OF TITLE J.R. Clancy, Inc. ( "Contractor ") transfers to Village Financial, LLC any and all right, title and/or interest that Contractor has in any labor and /or materials described in (i) that Affidavit of Waiver of Lien executed by the Contractor on U I , , , 20d) , and (ii) in t le "Amount of this Request" section of that Aff d it executed by the Contractor on , 20 /0. "CONTRACTOR" Printed: j-(°n {a 1 -f�t V \Q b1 16,L _ ; C , Title: A- C(h)kyhI73 tJfal 9er UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT The undersigned has been paid and has received a progress payment in the sum of 30`) C 12- I,) for labor, services, equipment, or material furnished to (Your Customer) on the job ofi (Owner) located at ri'v'e 1f( 0.2 -- (Job Description) and does hereby release any mechanic's lien, stop notice, or bond right that the undersigned has on the above referenced job to the following extent This release cows progess payment for labor, services, equipment, or materials furnished to Ur\ I � I''1 (Your Customer) I l , vr through / . g 24/ (Date) e) only and does not cover any retentions retained beford or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that fumished labor, services, equipment, or material was not compensated by the progress payment. DatedJL) J l./ )2-O/D J. R . C n( .� J COMPANY NAM (Print Name and Title) NOTICE: THIS DOCUMENT WAIVES RIGHTS UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS, THIS DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF YOU HAVE NOT BEEN PAID, USE A CONDITIONAL RELEASE FORM. TRANSFER OF TITLE J.R. Clancy, Inc. ( "Contractor ") transfers to Village Financial, LLC any and all right, title and/or interest that Contractor has in any labor and /or materials described in (i) that Affidavit of Waiver of Lien executed by the Contractor on ,,J v i u 1 aj , 20)0, and (ii) in the "Amount of this Request" section of that Affida its executed by the Contractor on j UJ L( , ) 3 , 20J. "CONTRACTOR" B Printed: \ 1t?v Title: cnti Y \IraV\ d C1L� Mann r