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HomeMy WebLinkAboutGibraltar, Signature - $25,286.43 Regions Bank hereby is instructed to make a disbursement of Loan Proceeds from the Borrower Loan Account to (or for the account of) Borrower in: (a) the amount of the "Total Authorized Disbursement" line in the "Amount of Authorized Disbursement" column below; and (b) accordance with the terms and conditions of the Agreement, the other Loan Documents, and the Disbursement Instructions. Purpose of Authorized Disbursement Amount of Authorized Disbursement Amount to be paid by Carmel Theater Development Company as per the Motor Court Improvements installment purchase contract Application 2(Gibraltar) February 2011 $ 19,872.00 Application 2(Signature)February 2011 $ 5,414.43 Total Authorized Disbursement :,'k.2P,;-FPARX4,914,"*VIICV4V11"$'25 All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (Equipment and Improvements), dated July 22, 2010, by and between Regions Bank and Carmel Theater Development Company, LLC. Dated: 34/ 6f CITY OF CARMEL REDEVELOPMENT COM SION By: Les S. Olds Printed: Executive Director Title: It is acknowledged and agreed by the parties that CRC has reserved the right to require, as a condition of authorizing disbursement of Loan Proceeds from the Borrower Loan Account to (or for the account of) Borrower: (a) completion of a satisfactory inspection by CRC of the portions of the Equipment and/or the Improvements to which the disbursement relates; and (b) receipt of customary submittals. P5 Motor Court (Signature Construction) January 2011 Application 1 Paid by Carmel Theater Development $ 2,663.15 February 2011 Application 2 Amount to be paid by Carmel Theater Development, $ 5,414.43: APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENTG702 PAGE ONE OF 2 PAGES2 TO OWNER CRC at City of Carmel PROJECT:Motor Court APPLICATION NO Invoice ii 2 1 Distribution to: Carmel Indiana 46032 Signature costs OWNER • ARCHITECT PERIOD TO: 02/22/2011 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT:Pedcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Carmel,Indiana 46032 CONTRACT FOR: CONTRACT DATE: , CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,AIA Document G703,is attached. 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 payments received from the Owner,and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM $ 25,361.30 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1±2) $ 25,361.30 4. TOTAL COMPLETED&STORED TO $ 8,077.58 r By / Date: 2 L Z.//i 5. RETAINAGE: homas E. oontz,Pre tdent a. 0 %of Completed Work $ 0 Subs ribed and om to before me this day of Fe'6 • D 1/ (Column D+Eon G703) .F4U LINDA BUCHANAN b. %of Stored Material $ 11,A;;;TA.f;',-:`:%-: Hancock County (Column F on G703) I'.K. My Commission Expires Total Retainagc(Lines 5a+5b or 'I '' :`:,..:O:'• August 20,2011 Total in Column 1 of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT''—'" '""'"""''''*"''- 6. TOTAL EARNED LESS RETAINAGE $ 8,077.58 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 2,663.15 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 5,414.43 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 17,283.72 ,1� (Line 3 less Line 6) AMOUNT CERTIFIED $ St-{i�•.43___ . CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certifi: differs from the amount applied Initial all figures on this Total changes approved Application an to on • '•n eet that a` hanged to with the amount certified.) in previous months by Owner ARCHITECT: 41 l /ZIP' Total approved this Month By: ��,,/ A Date: Z pP �,►_�.�- Z '711 TOTALS $0.00 $0.00 This Ce .ficate is n It negotiable. The • ""OUNT CERTIFIED is payabl only the Lontracto amen n rein.Issuance,payment ano acceptance of payment are wit ut NET CHANGES by Change Order $0.00 prejudice to a 'lilts of the Owner or Contractor under this Contract. AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT•1992 EDITION•AIA •©1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. Director of Redevelopment /y1{60 c' SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 2 __ - 2/22/11 _ ._ Motor Court - Gibraltor • Carmel, Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO Committed NO. WORK VALUE APPLICATIONS PERIOD STORED STORED TO DATE % FINISH Cost General Requirements: Site Supervision 12,680.65 0.00 4,310.43 0.00 4,310.43 34% 8,370.22 4,310.43 Construction Management Fee 12,680.65 2,663.15 1,104.00 0.00 3,767.15 30% 8,913.50 3,767.15 25,361.30 2,663.15 5,414.43 0.00 8,077.58 32% 17,283.72 8,077.58 CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and /or labor as follows: Construction Management Services for a project known as Motor Court, located at Carmel, Indiana and owned by the Carmel Redevelopment Commission and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of five thousand four hundred fourteen dollars and forty-three cents ($5,414.43) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC AIM { - T imas E. 400ntz, President Subscribed and sworn to before me this: /'eA da ;° / Notary Public: ' LINDA BUCHANAN c: = oTAA • : Hancock County SEAL..:„. My Commission Expires August 20,2011 Signature Construction, LLC Check: 63 720 3rd Ave., SW Date: 3/22/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 5-1 2,681.70 2,681.70 0.00 0.00 2,681.70 App 1 P 73 fountains 9-2 5,414.43 5,414.43 0.00 0.00 5,414.43 App 2 on Motor Court 8,096.13 8,096.13 0.00 0.00 8,096.13 63 3/22/2011 ***********8,096.13 THE SUM OF EIGHT THOUSAND NINETY SIX DOLLARS AND 13 CENTS ******************************** Signature Construction, LLC 720 3rd Ave., SW Carmel, IN 46032 Signature Construction, LLC Check: 63 720 3rd Ave., SW Date: 3/22/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 5-1 2,681.70 2,681.70 0.00 0.00 2,681.70 App 1 P 73 fountains 9-2 5,414.43 5,414.43 0.00 0.00 5,414.43 App 2 on Motor Court 8,096.13 8,096.13 0.00 0.00 8,096.13 P5 Motor Court (Gibraltar) January 2011 Application 1 Paid by Carmel Theater Development $ 47,936.70 February 2011 Application 2 Amount to be paid by Carmel Theater Development $ 19,872.00 A . AI .cri .....„,.._. A Document 1 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION NO: Distribution to: Signature Construction Plaza Parcel 5;Phase 1,Carmel City Center-Motor Court 2 One Pedcor Square-720 3rd Avenue SW PERIOD TO: 2118/11 OWNER ❑ Carmel,IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ Gibraltar Construction Corp 4/13/10 2932 N.Webster Ave. PROJECT NOS: / I CONTRACTOR ❑ Indianapolis,IN 46219 VIA ARCHITECT: FIELD ❑ Pedcor Design Group,LLC ❑ CONTRACT FOR: Waterproofing and Paving Components CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor cert...,tes that to the best of the Contractor's knowledge,information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this •pplication for Payment has been completed in accordance with the Pp P Y Contract Documents,that . I ,;unts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment l e/j( sued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 25.q l 13 on payment shown herein is 1.;�f• 2. Net change by Change Orders $ 0.00 CONTRACTOR:Gibralt•/I",f -'+uction Corp . 3.CONTRACT SUM TO DATE(Line l ±2) $ 253.613.00 By: fk Date:O3107 I�"// 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 75,343.00 State of:r�h� //5! T 5.RETAINAGE: ♦ o.c�YPJe BRIAN R. MCBRIDE County ofd ir? �/� _ Res, of Hancock Cou-`7 a, %of Completed Work Subscribed and r to be ¢ � �� >> My Comm. 11-2c' }17 7,534.30 me this y day f eAc-m Y (Column D+Eon G703) $ y J ✓p I Ate Commission 062 b. %of Stored Material Notary Public: -# '' (Column F on G703) $ My Commission expires: / —,�49_/ 7' Total Retainage(Lines 5a+5b or Total in Column I of 0703). $ CERTIFICATE FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 67,808.70 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 47,936.70 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. (Line 6 from prior Certificate) 8.CURRENT PAYMENT DUE $ 19.872.00 1 AMOUNT CERTIFIED $ i°t Sel)% 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ 185,804.30 CONSTRUCTIONiANA`•: By: , �.� ���� Date: 4>4.-1/1 f CHANGE ORDER SUMMARY ADDITIONS DEDUC(IONS ARCNITEC �,�ifi � (� P.,,., __ •,•11 %_,... _ _ �L ,- 2. 23 1c Total changes approved in previous months by Owner $ $ By: �,St _ Date: Total approved this Month $ $ This Ce • cate is not ne•.liable. The A AUNT CERTIFIED is payable ly t the Contractor TOTALS $ $ named here . Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ y the Owner or . or under this Contract. . — Director of Redeveiopmen/y./d o 7 141r- CAUTION:You should sign an original AlA Contract Document,on which this text appears in RED.An original assures that changes wilt not be obscured. AIA Document G7Q2/CMa7N—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.W ARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAe'Document,or any portion of It,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. CONTINUATION SHEET Page 2 of 2 APPLICATION NO.: 2 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification,is APPLICATION DATE: 2/18/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where PERIOD TO: 2/18/2011 variable retainage for line items may apply. ARCHITECT'S PROJECT NO. A B C D 1 E P G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO RETAINAGE PRESENTLY COMPLETED AND °A ITEM FROM PREVIOUS FINISH (IF VARIABLE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN .STORED TO DATE (G 1 C) (C-G) RATE) (D+E) DORE) (D+E+F) 1 Supervision $1,000.00 $210.00 $110.00 $320.00 32% 680.00 32.00 2 Trench Drain Material $7,500.00 $7,500.00 $7,500.00 100% - , 750.00 3 Trench Drain Labor $1,500.00 $1,500.00 $1,500.00 100% - 150.00 4 Concrete Topping Slabs&Curbs Mt'I $60,000.00 $0.00 0% 60,000.00 - 5 Concrete Topping Slabs&Curbs Labor $69,213.00 $17,303.00 $17,303.00 25% 51,910.00 1,730.30 6 Waterproofing&Expansion Joints $107,000.00 $26,750.00 $16,050.00 $42,800.00 40% 64,200.00 4,280.00 7 Plumbing $7,400.00 $5,920.00 $5,920.00 80% 1,480.00 '592.00 $253,613.00 $53,263.00 $22,080.00 $0.00 $75,343.00 30% $178,270.00 $7,534.30 • ISA Form#1-402 AFFIDAVIT AND WAIVER OF LIEN ❑ FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Carmel City Cntr-P111 -Waterproofing and Paving Components-Motor Court and owned by Carmel Theater Development Company. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of Nineteen Thousand Eight Hundred Seventy Two and No/100--_--- Dollars ($19,872.00) ❑ receipt of which is hereby acknowledged;or ® the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER)that the final balance due from the Owner is the sum of Dollars ( ) ❑ receipt of which is hereby acknowledged;or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE,the undersigned waives and releases unto th 1 Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements there•1 account of LABOR or material or both,furnished by the undersigned thereto,subject to limitations of condition- =x� essed herein, if any and further certifies that no other party has any claim or right to a lien on account of any w.rk rfT rmed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. • Gibraltar Construction Corp By !A4 ' Title President WITNESS MY HAND AND NOTORIAL S /• //J 1st •-y of February,2011. (Notary Public) Pie BRIAN R. MCBRIDE a jV9 +N i©1AKA SUSCONTAACTOfS ASSOCIATION INC01000AiATED . e.,,,, Res, Of Hancock County 1.1R6YIhOr•X4A Neplticaa(;tpR PI 4IoilrlOtl * * My Comm. Exp 11-29-2017 RSV xG D,PN Commission # 611862