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HomeMy WebLinkAboutJ.R. Clancy - $39,952.34Exhibit 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 Application 21 (JR Clancy) January 2011 $ 4,155.34 Application 22 (JR Clancy) February 2011 $ 35,797.00 Total Authorized Disbursement $ 39,9'52.34 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 betwee Le der and Village Financial, LLC. Dated: CITY OF CARMEL REDEVELOPMENT COMMISSION By Printed Title Les S. Olds Executive Director pa/ 3 _36_d Here- 4 -'7 /A, 6 z7a3 -f— 2_0_0v lC% o Feve /0 JR Clancy (Mercantile) January 2010 Draft Theater Equipment 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 Paid by Village Financial $ 140,058.83 September 2010 Paid by Village Financial $ 162,371.17 October 2010 Paid by Village Financial $ 252,754.70 November 2010 Paid by Village Financial $ 187,006.02 December 2010 Paid by Village Financial $ 260.34 January 2011 Amount to be paid by Village Financial I $ 4,155.34 ' February 2011 Amount to be paid by Village Financial I $ 35,797.00 ' . APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION AIA DOCUMENT G702 /CMa (Instructions on reverse side) PAGE ONE OF PAGES TO OWNER: CL1YVV )eI VQ.019vvWf *-- O yyl,i Cne CivILS C 'v 'e_.L , �(TN tft ) z- `cSIFQ 'ECT: J .12 •CtQYI 2ciS -51-70 Co_vime.,( PAC, :1nC. -704 Cavw�e 1, IN FROM CONTRACTOR: 1, l�-ie +c _- (cuulck ^ I32..CA CONTRACT FOR: 911'C j 1A t P IC II II I VIA CONSTRUCTION MANAGER: • A • 'CHITECT: APPLICATION NO.: 21 PERIOD TO: 131 2011 PROJECT NOS.: J e (lavIc:L. CONTRACT DATE: 24 12 z.coci Distribution to: ❑ OWNER ❑ CONSTRUCTION MANAGER ❑ ARCHITECT ❑ CONTRACTOR CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection 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. % 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) with the Contract. $ 75)15, C.T_) . CC) $ (52,- 11oacxD $ tpi"Ict 0,04 .CO $ bi l3 (dirp $ $ $ 3 ` ,5-02._ .0 Lo, 5s1-1-,5i 0 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 $ Liiss3y 9. BALANCE TO FINISH, INCLUDING RETAINAGE T''3� (Line 3 less Line 6) $ 1-/-0 ) .`C CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner 0.00 `', I CCZS LOO L1()/ Total approved this Month C). 0_ CC.) TOTALS (:) ._CU ( -� tl C90-CO NET CHANGES by Change Order 7 (JL , `71 no _oh 1 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 duc. CO TR • CTOR: J• - Ckt- By: State of: N P.. ,,iae r/ County of: p„ I u, JO4 j - Subscribed and sworn to before me this Notary Public: My Commission expires: dS� 1p.o►Y 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 CERTIFIE . AMOUNT CERTIFIED $ 11 S5 (Attach explanation if amount certified differs from the amount applied for Initial all figures on this Application and on the Conlin on Sheet that changed to conform to the amount certified.) Date: 1 l 2.-q. 1 I MICHAEL JAY PARKIN Notary Public, State of New York Qualified in Onondaga County Reg. No. 01 PA4807278 My Commission Expires May 31, 20 /! C O NSTRUCTI II©MAN . ER: By A Date: Date: 01 By: This Certi fcaty I T.ot negotia„,c. The AMOUNT CERTIFIED is payable only to the Con- tractor r•a-v;d herein. Issuance, payment and acceptance of payment are without OPV prejudict 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. Director of Redevelopment /17/ 6o'c_2T G702 /CMa -1992 CONTINUATION PAGE Page 2 of 4 PROJECT: J.R. Clancy 2695 -5170 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: 21 DATE OF APPLICATION: 01/15/2011 PERIOD THRU: 01/31/2011 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 $47,266.00 $0.00 $0.00 $47,266.00 100% $0.00 2 Engineering /Project $415,534.00 $411,378.66 $4,155.34 $0.00 $415,534.00 100% $0.00 Management/Mobilization 3 Master Control System $238,100.00 $238,100.00 $0.00 $0.00 $238,100.00 100% $0.00 4 Control System Electrical Work $33,750.00 $33,750.00 $0.00 $0.00 $33,750.00 100% $0.00 5 Control System Turn on and $68,900.00 $68,900.00 $0.00 $0.00 $68,900.00 100% $0.00 Testing 6 CYC, FOH, Lighting Truss $1,356,800.00 $1,356,800.00 $0.00 $0.00 $1,356,800.00 100% $0.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $514,200.00 $0.00 $0.00 $514,200.00 100% $0.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,000.00 $1,301,000.00 $0.00 $0.00 $1,301,000.00 100% $0.00 9 Canopy Rigging and Reel $348,800.00 $348,800.00 $0.00 $0.00 $348,800.00 100% $0.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $316,200.00 $0.00 $0.00 $316,200.00 100% - $0.00 11 Loudspeaker Rigging Installation $55,800.00 $55,800.00 $0.00 $0.00 $55,800.00 100% $0.00 12 Variable Acoustic Curtains $118,000.00 $118,000.00 $0.00 $0.00 $118,000.00 100% $0.00 . 13 Curtain Installation $17,700.00 $17,700.00 $0.00 $0.00 $17,700.00 100% $0.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $426,000.00 $0.00 $0.00 $426,000.00 100% $0.00 & Actuators 15 Track & Actuator Installation $131,745.00 $131,745.00 $0.00 $0.00 $131,745.00 100% $0.00 16 Extension Lift & Railings $607,521.00 $607,521.00 $0.00 $0.00 $607,521.00 100% $0.00 SUB - TOTALS $5,997,316.00 $5,993,160.66 $4,155.34 $0.00 $5,997,316.00 100% $0.00 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 #: 21 DATE OF APPLICATION: 01/15/2011 PERIOD THRU: 01/31/2011 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 17 Lift Installation $90,000.00 $90,000.00 $0.00 $0.00 $90,000.00 100% $0.00 18 Extension Lift Wagons $111,300.00 $111,300.00 $0.00 $0.00 $111,300.00 100% $0.00 19 Extension Lift Wagon Installation $18,000.00 $18,000.00 $0.00 $0.00 $18,000.00 100% $0.00 20 House Mix Lift & Railings $248,000.00 $248,000.00 $0.00 $0.00 $248,000.00 100% $0.00 21 House Mix Lift Installation $60,000.00 $60,000.00 $0.00 $0.00 $60,000.00 100% $0.00 22 House Mix Lift Wagons $70,000.00 $70,000.00 $0.00 $0.00 $70,000.00 100% $0.00 23 House Mix Lift Wagon Installation $16,000.00 $16,000.00 $0.00 $0.00 $16,000.00 100% $0.00 24 Loudspeaker Wagon $35,384.00 $35,384.00 $0.00 $0.00 $35,384.00 100% $0.00 25 Loudspeaker Wagon Installation $7,000.00 $7,000.00 $0.00 $0.00 $7,000.00 100% $0.00 26 Demountable Risers $45,000.00 $45,000.00 $0.00 $0.00 $45,000.00 100% $0.00 27 Demountable Riser Installation $4,800.00 $4,800.00 $0.00 $0.00 $4,800.00 100% $0.00 28 Chorus Wagons $189,000.00 $189,000.00 $0.00 $0.00 $189,000.00 100% $0.00 29 Package 5170 Allowance $200,000.00 $185,307.42 $0.00 $0.00 $185,307.42 93% $14,692.58 30 Package 5180 Allowance $200,000.00 $170,103.00 $0.00 $0.00 $170,103.00 85% $29,897.00 31 Package 5190 Allowance $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100% $0.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $10,000.00 $0.00 $0.00 $10,000.00 50% $10,000.00 Allowance SUB - TOTALS $7,316,800.00 $7,258,055.08 $4,155.34 $0.00 $7,262,210.42 99% $54,589.58 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 #: 21 DATE OF APPLICATION: 01/15/2011 PERIOD THRU: 01/31/2011 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 $194,000.00 $0.00 $0.00 $194,000.00 100% $0.00 35 37 C/O #1 Orchestra riser /slack line deletions, chairwagon - bronze, C/O #2 Allowance Reductions ($203,040.00) ($322,720.00) ($203,040.00) ($320,000.00) $0.00 $0.00 $0.00 $0.00 ($203,040.00) ($320,000.00) 100% 99% $0.00 ($2,720.00) 38 C/O #3 Work Directive $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $6,990,040.00 $6,934,015.08 $4,155.34 $0.00 $6,938,170.42 99% $51,869.58 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from -R-clear Cm pcul:ies (Maker of Check) in the sum of $ 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 se any meha ic's lien, stop notice, or bond right the undersigned hasun the job pf cY me Jtr i / 1 ' ' ' , i (Owner) located at TT7 Av.Q Svi 41-rnP I LPCi62— (Job Description) to the following extent. This release cows a p gres payment for labor, services, equipment, or material fumi hed to D I I t i CXTolri (Your Customer) through Jft y U(,l V L I, 215 I I (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: 1 / 2-j)) J, R. C(ahj, �c . 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 $ 252_ 0 for labor, services, equipment, or material furnished to �► (Your Customer) on the job FA i'[ i / a 1 r (Owner) located at ��'� S w rme (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 prog ss payment for labor, services, equipment, or materials furnished to `. l I I) j 7) i/ (Your Customer) through f<-h-rr ;31,2010 (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 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: 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 • I)toeti 4 i , 2 3 , 20 / 0, and (ii) in the "Amount of this Request" section of that Affidavit executed by the Contractor on TCQ„� bey' , 22) , 2010 . "CONTRACTOR" dL � Vc'i NctidiaL Printed: ` -C �'1 n Title: CCO if � �(, Ma.4a c,r APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION AIA DOCUMENT G702 /CMa (Instructions on reverse side) TO OWNERCQrIMe.. 02dIV.Q,lolr1j -tAt COn'1VVi (SC 1 OJECT:J .CtCtV CU ZIJ�aS- Go eve C� v 1 Srfi ;�a. riL Carmel PAL J C rvvve i , '03�' 1-6' Av SV FROM CONTRACTOR J.�C!a�CL. Znc . 1a+1 a-y rs+ kid (cl. S YaC'v_, 1,7)W VIA CONSTRUCTION MANAGER: CONTRACT FOR i \rL j '�� 1r ,bye_ _u fv miv \s p., 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 I. ORIGINAL CONTRACT SUM $ �t Jl St �W �l 2. Net Change By Change Orders �5, l�iv. �� J, 3. CONTRACT SUM TO DATE (Line 1 ± 2) $ ,C190/ 016-00 $ bic113,007g2- 4. TOTAL COMPLETED & STORED TO DATE (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) $ $ ,, 6. TOTAL EARNED LESS RETAINAGE $ t D,102q;L+LL5. '7Z (Line 4 less Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT (Line 6 from prior Certificate) $ 8. CURRENT PAYMENT DUE L9,SW, LD uS1 4/Z ic1-7. ld_J 9. BALANCE TO FINISH, INCLUDING RETAI$ N A9 L r • G `"(Line 3 less Line 6) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner C CO (52.5:"7 a) Total approved this Month 0.00 0.60N TOTALS ID.�j (S �-Aso N), (G25.100.60 11 NET CHANGES by Change Order MANAGER - ADVISER EDITION ,C 5- PAGE ONE OF PAGES APPLICATION NO.: 2-2_. PERIOD TO: 2I21/(l PROJECT NOS. dr -kit l U 29gs -51 -7 Distribution to: ❑ OWNER ❑ CONSTRUCTION MANAGER CONTRACT DATE: 2112109 ❑ ARCHITECT El 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. C• T• CTOR: J. 'f C q CEJIJ1..1' IC- By: Date: _ L-'J State of: County of:t(L�tC�� Subscribed and sw rn to before me this 2. ' day of Notary Public:/ My Commission expires: P. ' RIVERS R. R, I Notary ,'uy;c. ?a:e „f Nevi York O airf �„ 1ounty Commission `xpire ;?inri,b'r 27, N 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 $ 3S 1,'') ctl (Attach explanation if amount certified di • from the amount applied for Initial all figures on this Application and on the inuation Sheet that changed to conform to the amount certified.) Date Datc: 04-142,161 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, NW., 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: J.R. Clancy 2695 -5170 Carmel PAC Payment Application containing Contractor's signature is attached. APPLICATION #: 22 DATE OF APPLICATION: 02/15/2011 PERIOD THRU: 02/28/2011 PROJECT #s: J.R. Clancy 2695 -5170 A B C D I 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 $415,534.00 $0.00 $0.00 $415,534.00 100% $0.00 ManagemenUMobilization 3 Master Control System $238,100.00 $238,100.00 $0.00 $0.00 $238,100.00 100% $0.00 4 Control System Electrical Work $33,750.00 $33,750.00 $0.00 $0.00 $33,750.00 100% $0.00 5 Control System Turn on and $68,900.00 $68,900.00 $0.00 $0.00 $68,900.00 100% $0.00 Testing 6 CYC, FOH, Lighting Truss $1,356,800.00 $1,356,800.00 $0.00 $0.00 $1,356,800.00 100% $0.00 Motorized Rigging 7 CYC, FOH, Lighting Truss $514,200.00 $514,200.00 $0.00 $0.00 $514,200.00 100% $0.00 Motorized Rigging Installation 8 Canopy Rigging and Cable Reels $1,301,000.00 $1,301,000.00 $0.00 $0.00 $1,301,000.00 100% $0.00 9 Canopy Rigging and Reel $348,800.00 $348,800.00 $0.00 $0.00 $348,800.00 100% $0.00 Installation 10 Loudspeaker Motorized Rigging $316,200.00 $316,200.00 $0.00 $0.00 $316,200.00 100% $0.00 11 Loudspeaker Rigging Installation $55,800.00 $55,800.00 $0.00 $0.00 $55,800.00 100% $0.00 12 Variable Acoustic Curtains $118,000.00 $118,000.00 $0.00 $0.00 $118,000.00 100% $0.00 13 Curtain Installation $17,700.00 $17,700.00 $0.00 $0.00 $17,700.00 100% $0.00 14 Variable Acoustic Tracks /Blocking $426,000.00 $426,000.00 $0.00 $0.00 $426,000.00 100% $0.00 & Actuators 15 Track & Actuator Installation $131,745.00 $131,745.00 $0.00 $0.00 $131,745.00 100% $0.00 16 Extension Lift & Railings $607,521.00 $607,521.00 $0.00 $0.00 $607,521.00 100% $0.00 SUB - TOTALS $5,997,316.00 $5,997,316.00 $0.00 $0.00 $5,997,316.00 100% $0.00 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 #: 22 DATE OF APPLICATION: 02/15/2011 PERIOD THRU: 02/28/2011 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 17 Lift Installation $90,000.00 $90,000.00 $0.00 $0.00 $90,000.00 100% $0.00 18 Extension Lift Wagons $111,300.00 $111,300.00 $0.00 $0.00 $111,300.00 100% $0.00 19 Extension Lift Wagon Installation $18,000.00 $18,000.00 $0.00 $0.00 $18,000.00 100% $0.00 20 House Mix Lift & Railings $248,000.00 $248,000.00 $0.00 $0.00 $248,000.00 100% $0.00 21 House Mix Lift Installation $60,000.00 $60,000.00 $0.00 $0.00 $60,000.00 100% $0.00 22 House Mix Lift Wagons $70,000.00 $70,000.00 $0.00 $0.00 $70,000.00 100% $0.00 23 House Mix Lift Wagon Installation $16,000.00 $16,000.00 $0.00 $0.00 $16,000.00 100% $0.00 24 Loudspeaker Wagon $35,384.00 $35,384.00 $0.00 $0.00 $35,384.00 100% $0.00 25 Loudspeaker Wagon Installation $7,000.00 $7,000.00 $0.00 $0.00 $7,000.00 100% $0.00 26 Demountable Risers $45,000.00 $45,000.00 $0.00 $0.00 $45,000.00 100% $0.00 27 Demountable Riser Installation $4,800.00 $4,800.00 $0.00 $0.00 $4,800.00 100% $0.00 28 Chorus Wagons $189,000.00 $189,000.00 $0.00 $0.00 $189,000.00 100% $0.00 29 Package 5170 Allowance $200,000.00 $185,307.42 $6,561.00 $0.00 $191,868.42 96% $8,131.58 30 Package 5180 Allowance $200,000.00 $170,103.00 $29,236.00 $0.00 $199,339.00 99% $661.00 31 Package 5190 Allowance $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100% $0.00 32 CAD As- Builts 5170 & 5180 $20,000.00 $10,000.00 $0.00 $0.00 $10,000.00 50% $10,000.00 Allowance SUB - TOTALS $7,316,800.00 $7,262,210.42 $35,797.00 $0.00 $7,298,007.42 99% $18,792.58 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 #: 22 DATE OF APPLICATION: 02/15/2011 PERIOD THRU: 02/28/2011 PROJECT #s: J.R. Clancy 2695 -5170 A B C D I E F G H I COMPLETED WORK STORED TOTAL % BALANCE ITEM # WORK DESCRIPTION SCHEDULED AMOUNT AMOUNT PREVIOUS AMOUNT THIS PERIOD MATERIALS (NOT IN D OR E) COMPLETED AND STORED COMP. (G / C) TO COMPLETION RETAINAGE (If Variable) PERIODS (D + E + F) (C -G) 33 CAD As- Builts 5190 Allowance $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 1100% $0.00 34 Orchestra Risers $194,000.00 8194,000.00 $0.00 $0.00 $194,000.00 100% $0.00 35 37 0/0 #1 Orchestra riser /slack line deletions, chairwagon - bronze, 0/0 #2 Allowance Reductions ($203,040.00) ($322,720.00) ($203,040.00) ($320,000.00) $0.00 $0.00 $0.00 $0.00 ($203,040.00) ($320,000.00) 100% 99% $0.00 ($2,720.00) 38 0/0 #3 Work Directive $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $6,990,040.00 $6,938,170.42 $35,797.00 $0.00 $6,973,967.42 99% $16,072.58 CONTINUATION PAGE Quantum Software Solutions, Inc. Document CONDITIONAL WAVER AND RELEASE UPON PROGRESS PAYMENT Upon receipt by the undersigned of a check from ifacor (3v t vu S (Maker of Check) in the sum of $ 35,1C11.00 (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 relpase any mercha ic's lien, stop notice, or bond right the undersigned has n the job f CallY one ft r-tt e i ►i ' Ay-t- Ce h --fr (Owner) located at "7 fl /*v.Q SW ?Iva I' ,TN i- i -liC? (Job Description) to the following extent. This release co rs a p gresp" payment for labor, services, equipment, or material fumishe to D') it IJCTDtVI (Your Customer) through 11 25r1 1 I (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: '�26 ) 1 I J, R. C(a.vo, . COMPANY NAME 'r( U%t-hoi AA/ hni ►v- &4k.A 4 J (PRINT NAME AND TITLE) J R Clancy, Inc. 7041 Interstate Island Road Syracuse, NY 13209 Invoice 21 22 Application 21 App 22 P7A Check: 10 Date: 3/29/2011 Vendor: J R CLA1 Prior P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 55 4,155.34 4,155.34 0.00 0.00 4,155.34 55 35,797.00 35,797.00 0.00 0.00 35,797.00 39,952.34 39,952.34 0.00 0.00 39,952.34 10 3/29/2011 * * * * * * * ** *39,952.34 THE SUM OF THIRTY NINE THOUSAND NINE HUNDRED FIFTY TWO DOLLARS AND 34 CENTS * * ** J R Clancy, Inc. 7041 Interstate Island Road Syracuse, NY 13209 J R Clancy, Inc. 7041 Interstate Island Road Syracuse, NY 13209 Invoice 21 22 Application 21 App 22 P7A Check: 10 Date: 3/29/2011 Vendor: J R CLA1 Prior P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 55 4,155.34 4,155.34 0.00 0.00 4,155.34 55 35,797.00 35,797.00 0.00 0.00 35,797.00 39,952.34 39,952.34 0.00 0.00 39,952.34