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HomeMy WebLinkAboutJ.R. Clancy - $302,430Exhibit 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 Amount to be paid by Village Financial, LLC as per the PAC Equipment installment purchase contract Application 16 (JR Clancy) August 2010 $ 140,058.83 Application 17 (JR Clancy) September 2010 $ 162,371.17 Total Authorized Disbursement $ 302,430.00 . 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 between Le der and Village Financial, LLC. Dated: / CITY OF CARMEL REDEVELOPMENT COMMISSION 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 Paid by Village Financial $ 613,487.55 July 2010 Paid by Village Financial $ 57,114.02 August 2010 Amount to be paid by Village Financial $ 140,058.83 September 2010 Amount to be paid by Village Financial $ - 162,371.17 - PPUCATOON <AND CE1=;TIFOCATE FOR PAYMENT CONSTRUCTION MANAGER- ADVISER EDITION AIA DOCUMENT G702 /CMa (Instructions on reverse side) To owNER[OYv e1 kef1k\JQtOpl'W Vcf- L.01)11144iG1�1 PROJECT ). (R • C1QYNU. 6ne C ('v '1 c_ m va r -e. Caravel, FROM CONTRACTOR) •I . Clar\c "1 o4 1 rev S+OL1 -k sC Cr1` P_C� CuSR, i\ 131.0 Cavwke\ 131\ 3"1-ha vw (SvJ Ceav rv�e ►, 632- 55 PAGE ()NE OF I'A(;E.s VIA CONSTRUCTION MANAGER: CONTRACT FOR yQ11��I�QQ� 1 pet ,w /6ns t�rQIAYRCIf1 "iEC7': CONTRACTOR'S APPUCATPON FO i ; PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. I. ORIGINAL CONTRACT SUM 5 2. Net Change By Change Orders 3. CONTRACT SUM TO DATE (Line 1 + 2) S 4. TOTAL COMPLETED & STORED TO DATE S 5 5 b_ (Column G on G702) 5. RETAINAGE: a. 'st, of Completed \X'ork (Columns D -r E on G703) 10,40.E s b. % of Stored Material S (Column F on G703) Total Retainage (Line 5a + 5b or Total in Column 1 of G703) S -J I 1 , ...c)2_ .0CJ s Sty l 2Cl • �sc� 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 5 gy ^) ' 6/ „2 .d 2- (Line 6 from prior Certificate) S I L �i! 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 less Line 6) S CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner aOC.. (525,i1,D/). a-) Total approved: this Month 0,00 0. TOTALS U.00 (SL —t _On QC1 ` ! NET CHANGES by Change Order ( C57,5 TI t.00-ejn APPLICATION NO.: 14 Distribution to: + PERIOD TO: 51.3(1 10 ❑ OWNER PROJECT NOS.; �.(((I n ❑ CONSTRUCTION Z.1.9 5- 61--ior MANAGER CONTRACT DATE:' I210q CI ARCHITECT ❑ CON'T'RACTOR 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 :Inc! pay- ments received from the Owner, and that current payment shown herein is now due. TRACTOR+.%• R . ,trt; A c M c , 13y• State of: tlq ' County of: Subscribed me this 'go :Zia .0-0- Ind,sworn to before day of Aftir_.0111%. Notary Public: My Commission expires: /3 Date: BRADLEY R. RIVERS ZGtftfeo)y Public, State of New York Qualified in Onondaga County No 0:111:3018349 o mission Expires 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 (Attach explanation if amount certified differs from the amount applied for initial all figures on Ibis Application and on the Cr innatinrt Sheet that changed to conform to the amount certified.) CONSTRUCTS MA'r'GER:', . 13y • 0, s Vie. - - Date: 0 g/2"7// ; AR . IITECT: By• .40/eaddlir Date: _! 31Z5* This Certif. is not negotiable. The AMOUNT CERTIFIED is payable only to the Con- tractor t ed 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 flit 1942 EDITION •,AIA° • ©1992'• THE AMERICAN INS'i'IT17TE OF ARCHITECTS. 17ii NEW YORK AVENUE. NW.. WASHINGTON, 4—:' D.C. 21)0 )6.529? • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal ,,;�•�� p PY g j prosecution. (;AI ITIrtAI• Vn,, ehnulrt „ea on nr,nmut AIA ranrnmant u.hirh hue thic nanfnn nrintav in rari An nrininal acm'rac that rhannac will not ha nhcrnrari ac maw nrrur ',than rtnrumantc ara ranrnriurarl. G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: Payment Application containing Contractor's signature is attached. J.R. Clancy 2695 -5170 Carmel PAC APPLICATION #: DATE OF APPLICATION: PERIOD THRU: PROJECT #s: J.R. 16 08/15/2010 08/31/2010 Clancy 2695 -5170 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 547,266.00 547,266.00 $0.00 S0.00 547,266.00 100% 50.00 2 Engineering /Project $415,534.00 $324,116.52 529,087.38 50.00 5353,203.90 85% 562,330.10 Management/Mobilization 3 Master Control System 5238,100.00 $214,290.00 50.00 50.00 5214,290.00 90% 523,810.00 4 Control System Electrical Work 533,750.00 532,062.50 50.00 50.00 532,062.50 95% 51,687.50 5 Control System Tum on and 568,900.00 $4,823.00 $0.00 50.00 54,823.00 7% $64,077.00 Testing 6 CYC, FOH, Lighting Truss Motorized Rigging $1,356,800.00 51,288,960.00 567,840.00 50.00 51,356,800.00 100% 50.00, 7 CYC, FOH, Lighting Truss 5514,200.00 5462,780.00 525,710.00 50.00 5488,490.00 95% 525,710.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels 51,301,000.00 $1,301,000.00 $0.00 50.00 $1;301,000.00 100% $0.00 9 Canopy Rigging and.Reel $348,800.00 5348,800.00 50.00 50.00 $348,800.00 100% 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 555,800.00 555,800.00 50.00 50.00 $55,800.00 100% 50.00 12 Variable Acoustic Curtains 5118,000.00 $0.00 S0.00 50.00 $0.00 0% $118,000.00 13 Curtain Installation 817,700.00 $0:00 50.00 $0.00 S0.00 0% 517,700.00 14 Variable Acoustic Tracks /Blocking 5426,000.00 5426,000.00 50.00 80.00 $426,000.00 100% 50.00 & Actuators 15 Track & Actuator Installation 5131,745.00 5125,157.75 $6,587.25 $0.00 $131,745.00 100% 50.00 16 Extension Lift & Railings $607,521.00 5577,144.95 50.00 50.00 5577,144.95 95% $30,376.05 SUB - TOTALS 55,997,316.00 55,524,400.72 5129,224.63 50.00 55,653,625.35 94% 5343,690.65 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 3 of 4 PROJECT: J.R. Clancy 2695 -5170 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: 16 DATE OF APPLICATION: 08/15/2010 PERIOD THRU: 08/31/2010 PROJECT #s: J.R. Clancy 2695 -5170 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 17 Lift Installation. 590,000.00 585,500.00 50.00 50.00 585,500.00 95% $4,500.00 18 Extension Lift Wagons $111,300.00 5105,735.00 55,565.00 50.00 5111,300.00 100% 50.00 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 $235,600.00 95% 512,400.00 21 House Mix Lift Installation 560,000.00 557,000.00 50.00 50.00 557,000.00 95% 53,000.00 22 House Mix Lift Wagons 570,000.00 S66,500.00 53,500.00 50.00 570,000.00 100% 50.00 23 House Mix Lift Wagon Installation S16,000.00 50.00 50.00 50.00 50.00 0% 516,000.00 24 Loudspeaker Wagon 535,384.00 533,614.80 51,769.20 50.00 $35,384.00 100% 50.00 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 50.00 50.00 50.00 0% 545,000.00 27 Demountable Riser Installation 54,800.00 50.00 50.00 $0.00 50.00 0% 54,800.00 28 Chorus Wagons 5189,000.00 537,800.00 50.00 50.00 537,800.00 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 $200,000.00 5152,124.00 50.00 50.00 5152,124.00 76% 547,876.00 31 Package 5190 Allowance 55,000.00 55,000.00 50.00 50.00 55,000.00 100% 50.00 32 CADAs - Builts 5170 &5180 520,000.00 510,000.00 50.00 50.00 510,000.00 50% 510,000.00 Allowance SUB - 1TOTALS 57,316,800,00 56,506,564.02 5140,058.83 50.00 $6,646,622.85 91% 5670,177.15 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 4 of 4 PROJECT: J.R. Clancy 2695 -5170 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: 16 DATE OF APPLICATION: 08/15/2010 PERIOD THRU: 08/31/2010 PROJECT #s: J.R. Clancy 2695 -5170 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 CAD As- Builts 5190 Allowance $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100% $0.00 34 Orchestra Risers $194,000.00 $0.00 $0.00 $0.00 $0.00 0% 5194,000.00 35 37 C/O #1 Orchestra riser /slack line deletions, chairwagon - bronze, C/O #2 Allowance Reductions ($203,040.00) ($322,720.00) $0.00 ($320,000.00) $0.00 $0.00 $0.00 $0.00 $0.00 ($320,000.00) 0% 99% ($203,040.00) (52,720.00) 38 C/O #3 Work Directive $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $6,990,040.00 $6,191,564.02 $140,058.83 $0.00 $6,331,622.85 91% $658,417.15 CONTINUATION PAGE Quantum Software Solutions, Inc. Document COND@THONAL ",'AHVER AND RELEASE UPON P OGRESS P YG ENT Upon receipt by the undersigned of a chec from /t t,t en ( (Maker of Check) in the sum of $ I yOp13. 3 (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 Rf caV'vv .t r-\ trt'Y1 u ri Ayf CP11 -fir (Owner) located at Ali Av.Q Slit% yowl , ,IN 4110624 (Job Description) to the following extent. This release co rs a p gress payment for labor, services, equipment, or material furnished to Di 'Li�C'�p1�1 (Your Customer) through \) j- 3I 2(TIt (Date) only and does not cover any retentions retained bdfore 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: `vl2_3� )p J, R. CI cunnj, is. COMPANY NAME BOIL • Its ,, • ivy /, t fiGNIETIRCENIN (PRINT NAME AND TITLE) APIPLDCATOON Aid® CERTIFOCATE FOR PAYMENT CONSTRUCTION MANAGER- ADVISER EDITION S 5 AIA DOCUMENT G702 /CMa (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER:CUYYyjcI &LyeIoovte - .- LGAIrvllSSIor' PROjECT.I.-C-\.CU1Ul_ 2J 15--S1 -13 ale_ C i v i c Sci cL ► Q, Cap- m e t I C. Cavly t, IN (3L .1T1 3h'' A Qvwe 5\A/ CCTV hn C t ZN ii-14P52_' FROM CONTRACLORJ.12_C CtielLt J'X . I 109-1 .dl& let' Ct,4 CS /owl - -- SLjYdCU ', /.._\-J 132L$ j VIA CONSTRUCTION MANAGER: CONTRACT FOR: Yoe't �li,t �r,iGY(,l( �)x 1 uyj*l'tl fly A4 rc bitly_O ARCHITECT: CONTRACTOR'S APPUDCATDON FOR PAYMENT APPLICATION NO.: 11 Distribution to: PERIOD TO: 9 )Q1f0 ❑OWNE_R PROJECT NOS.:Ai IZ. C I (Lt ,' '- j ❑ CONSiRUCTION "L(.u4S-51-10 MANAGER CONTRACT DATE:2 1.12) 09 ❑ 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 s Net Change By Change Orders 3. CONTRACT SUM TO DATE (Line 1 ± 2) 4. TOTAL COMPLETED & STORED TO DATE (Column G on G702) RETAINAGE: "f. of Completed Work (Columns D + E on G703) h. ,f, of Stored Material (Column F on G703) 'natal Rclainage (Line 5a + 5b or Total in Column I of G703) C L Lo 1 I JO ).CO 0, i 31 cc114 -. UZ_ 5 6. TOTAL EARNED LESS RETAINAGE (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) S 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAI (Line 3 less Line 6) 5 Co, 144-, 7..02, 5, c1 %Z,1 ?��,8s 5 )W231) 1 ] NAG 'L-7 98 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner a co (Cj ;-Npo.od 0 .00 7htal approved this Month 0_00 TOTALS 0. 0 0 (sic; : i l -00.00 NET CHANGES by Change Order (c?�-) 71 l na 60 ) The undersigned Contractor certifies that to the hest of the Contractors 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`' RACTORJ -(Z •C By: State of: /Vzw y�,;.k County Of: C.icir /a Subscribed and stiyorn to before me this ,20 � day of Notary Public;/ My Commission expires: Date. 41/G•�' /fG BRADLEY R. RIVERS Notary Public. State of New York cl /j) Qualified In Jncnt :3q3 County No. 01R15018349 _ Rission E, pues September 17 'A/3 3 tln CEF'TDFDCATE 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 s 11 ke, ;iy •�i (Attach explanation if amount certified differs from the amount applied fni: Initial all /H'ir'es on this Application and on the Continuation .Sheet that chanted to cnulfn•nl 10 the amount certified.) C BV: ARC By: STRUCTIO N� AGER: 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 G7D21CMa • APPLICATION AND CERTIFICATE FOR PAYMENT • CONSTRUCTION MANAGER-ADVISER IinrrloN 1992 EDI'T'ION • AIA' • ©1992 • THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVENUE. N.W. WASHINGTON, D.C. 211006-5292 21)2 • WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. G702 /CMa -1992 r•AIITInvi• Vnn chnnld ,,ca an nrininal AIA rinrmmwnt u,hirh hat this ra„tinn nrintari In rari An nrininal nccnrac that rhannac will not hn nhcrnrad ae may nrrl.r wham rinrumantc am ranrnrti,rad CONTINUATION PAGE Page 2 of 4 PROJECT: J.R. Clancy 2695 -5170 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: 17 DATE OF APPLICATION: 09/15/2010 PERIOD THRU: 09/30/2010 PROJECT #s: J.R. Clancy 2695 -5170 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 $47,266.00 547,266.00 50.00 50.00 547,266.00 100% 50.00 2 Engineering /Project $415,534.00 5353,203.90 520,776.70 50.00 5373,980.60 90% 541,553.40 Management/Mobilization 3 Master Control System 5238,100.00 5214,290.00 50.00 50.00 5214,290.00 90% 523,810.00 4 Control System Electrical Work 533,750.00 $32,062.50 51,687.50 50.00 533,750.00 100% 50.00 5 Control System Tum on and $68,900.00 54,823.00 S5,512.00 50.00 $10,335.00 15% $58,565.00 Testing 6 CYC,.FOH, Lighting Truss 51,356,800.00 51,356,800.00 50.00 50.00 51,356,800.00 100% 50.00 Motorized Rigging 7 CYC, FOH, Lighting Truss 5514,200.00 5488,490.00 525,710.00 50.00 5514,200.00 100% 50.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels 51,301,000.00 51,301,000.00 50.00 50.00 $1,301,000.00 100% S0.00 9 Canopy Rigging and Reel 5348,800.00 5348,800.00 50.00 50.00 5348,800.00 100% S0.00 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 S55,800.00 555,800.00 50.00 $0.00 555,800.00 100% S0.00 12 Variable Acoustic Curtains 5118,000.00 50.00 50.00 S0.00 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 $426,000.00 5426,000.00 50.00 $0.00 S426,000.00 100% 50.00 & Actuators 15 Track & Actuator Installation 5131,745.00 5131,745.00 50.00 S0.00 5131,745.00 100% S0.00 16' Extension Lift & Railings 5607,521.00 5577,144.95 S30,376.05 $0.00 $607,521.00 100% 50.00 SUB - TOTALS 55,997,316.00 55,653,625.35 584,062.25 50.00 55,737,687.60 96% $259,628.40 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 3 of 4 PROJECT: J.R. Clancy 2695 -5170 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: 17 DATE OF APPLICATION: 09/15/2010 PERIOD THRU: 09/30/2010 PROJECT #s: J.R. Clancy 2695 -5170 A 6 C D E F G H 1 ITEM # WORK DESCRIPTION COMPLETED WORK STORED MATERIALS (NOT IN 0 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 590,000.00 585,500.00 54,500.00 50.00 590,000.00 100% 50.00 18 Extension Lift Wagons 5111,300.00 5111,300.00 50.00 50.00 5111,300.00 100% 50.00 19 Extension Lift Wagon Installation 518,000.00 50.00 54,500.00 50.00 54,500.00 25% 513,500.00 20 House Mix Lift & Railings 5248,000.00 5235,600.00 512,400.00 50.00 5248,000.00 100% 50.00 21 House Mix Lift Installation 560,000.00 557,000.00 53,000.00 50.00 560,000.00 100% 50.00 22 House Mix Lift Wagons S70,000.00 570,000.00 50.00 50.00 570,000.00 100% 50.00 23 House Mix Lift Wagon Installation 516,000.00 50.00 54,000.00 50.00 54,000.00 25% 512,000.00 24 Loudspeaker Wagon 535,384.00 535,384.00 50.00 50.00 535,384.00 100% 50.00 25 Loudspearker Wagon Installation 57,000.00 50.00 $1,750.00 50.00 51,750.00 25% 55,250.00 26 Demountable Risers $45,000.00 50.00 545,000.00 50.00 545,000.00 100% 50.00 27 Demountable Riser Installation 54,800.00 50.00. S3,600.00 50.00 53,600.00 75% 51,200.00 28 Chorus Wagons 5189,000.00 537,800.00 50.00 50.00 537,800.00 20% 5151,200.00 29 Package 5170 Allowance $200,000.00 5193,289.50 (59,643.08) 50.00 5183,646.42 92% 516,353.58 30 Package 5180 Allowance 5200,000.00 5152,124.00 59,202.00 50.00 5161,326.00 81% 538,674.00 31 Package 5190 Allowance 55,000.00 55,000.00 50.00 50.00 55,000.00 100% 50.00 32 CAD As- Buiits 5170 & 5180 520,000.00 510,000.00 50.00 50.00 510,000.00 50% 510,000.00 Allowance SUB - TOTALS 57,316,800.00 56,646,622.85 5162,371.17 50.00 56,808,994.02 93% 5507,805.98 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONTINUATION PAGE Page 4 of 4 PROJECT: J.R. Clancy 2695 -5170 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: 17 DATE OF APPLICATION: 09/15/2010 PERIOD THRU: 09/30/2010 PROJECT #s: J,R. Clancy 2695 -5170 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 CAD As- Builts 5190 Allowance 55,000.00 $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% 5194,000.00 35 37 C/0 #1 Orchestra riser /slack line deletions, chairwagon - bronze, C/O #2 Allowance Reductions (5203,040.00) (5322,720,00) 50.00 ($320,000.00) 50.00 $0.00 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 S0.00 S0.00 50.00 50.00 50.00 TOTALS 56,990,040.00 56,331,622.85 5162,371.17 $0.00 56,493,994.02 93% 5496,045.98 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CO DMOI AL V/AWER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from 1- dCO V (Maker of Check) in the sum of $ Ilv2,31) . 17 (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 rellpase any mechanic's lien, stop notice, or bond right the undersigned has n the job f lti ��Q. r ir i A -er (Owner) located at -77 Av.Q Sw ? 1 -NIP L(�(3�� (Job Description) to the following extent. This release coyers a ppgresp payment for labor, services, equipment, or material furnished to al it + XTOV (Your Customer) through 9 )3L> 1 (0 (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 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: Cj I 20 I ID J, R. CI a t , COMPANY NAME (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 $ i]. for labor, services, equipment, or material furnished to (Your Customer) on the job (Owner) located at fame f . (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 covs q progceess payment for labor, services, equipment, or materials furnished ed to x (Your Customer) through l 0 1 3() ja _ (Date) only and does not cover any retentions retained before or aver 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. Dated: D J.R.0 C COMPANY NAM D It *AIM is • 11f.. r!'.i'' (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 AGAENST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF YOU HAVE NOT BEEN PAID, USE A CO f DITION L RELEASE FORM, nr- , ,.. 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 'VA hpy- , Z) , 2010 , and (ii) in the "Amount of this Request" section of that A idavit executed by the Contractor ong) 1J(Arthe,v , /p , 20[ O . "CONTRACTOR" Printed ht 1-('' Y1 Ain /Cf / C/(..) Title: A( (° () U )11.111'? C J AA C/ ' Y^ UNCONDITIONAL t lAWER AND RELEASE UPON PROGRESS PAYMENT The undersigned has been paid and has received a progress payment in the sum of $5.7,1(L-4.02— for labor, services, equipment, or material furnished to (Your Customer) on the job o (Owner) located at X111 3 ,Lve S w Q '52-- (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 prow ss payment for labor, services, equipment, or materials furnished to l 1 ` (r1 (Your Customer) through 1 +3i 10 (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 fumished after the release date. Rights based upon work performed or items fumished under a writ-ten 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: 9 1201 1 o J•R.0 .Y1 7"AC COMPANY NAM (Print Name and Title) NOTICE: THIS DOCUMENT WAIVES RIGHTS UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GMNG UP THOSE RIGHTS, THIS DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU SIDS' IT, EVEN IF YOU HAVE NOT BEEN PAIDc 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 onC pAh.P.v. , 2J , 20 10, and (ii) the "Amount of this Request" section of that A 'davit executed by the Contractor on 291( 4 o_P), -- , 7L1, 20 in. "CONTRACTOR" Printed: Je.1/1 1/1 Via (( C. ... Title: /~ .COU ifrhi1l5 Iuto_nroSe l�