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HomeMy WebLinkAboutGibraltar & Signature $61,206.97 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 3(Gibraltar) March 2011 $ 54,382.50 Application 3(Signature) March 2011 $ 6,824.47 Total Authorized Disbursement $ 61,206.97 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: 4 7 A CITY OF CARMEL REDEVELOPMENT COMMISSION 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. kil0 Document G7021CMa TM - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Signature Construction PROJECT: Plaza Parcel 5:Phase 1,Carmel City CenkFE1,StUf'C ItJ1 NO 3 Distribution to: One Pedcor Square-720 3rd Avenue SW PERIOD TO:. 3/23/11 OWNER ❑ Carmel,IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: Gibraltar Construction Corp VIA CONSTRUCTION MANAGER: CONTRACT DATE:4113110 ARCHITECT ❑ 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 certifie 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 Ap ication for Payment has been completed in accordance with the Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all an t have been paid by the Contractor for Work for which previous Certificates for Payment were i t d and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 253,613.00 payment shown herein is now 2. Net change by Change Orders $ 0.00 CONTRACTOR: Gibraltar Coo ru tion Corp 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 253,613.00 By /I A Date: _?---.7 --7/ 4.TOTAL COMPLETED 8,STORED TO DATE(Column G on G703) $ 135,768.00 State of ,2'it. ./��', 7 / ^tiYFr-/ BRIAN R, MCBf IDE 5.RETAINAGE: County of: � t a. %of Completed Work 13,576.80 Subscribed and sN�•rn to bef r, _,j� •1", RSS. o Hancock County (Column D+E on G703) $ me this O� day of ! My Comm, ice, 11-29.2017 b. %of Stored Material Notary Public: -"D I PN Commissicf't 01311862 (Column F on G703) $ My Commission expires: -//�"=" ice' Total Retainage(Lines 5a+5b or Total in Column I of 6703).. $ CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 122,191.20 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 (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 $ 67,808.70 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 54,382.50 AMOUNT CERTIFIED $ 5E1 278 t.50 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied Initial all figures on this 131,421.80 Application and on the Continuation Sheet that are changed to conform w r ith the amount cetified.) (Line 3 less Line 6) $ CONSTRUCTION MANA R. J By: _� �_ A Date: 3 /// CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Pe. .r Design •up,L t Total changes approved in previous months by Owner $ $ By: �`` 1 Date: Jr� Total approved;this Month $ $ This Certificate is not negotiable.U OUNT CERTIFIED is payable only to the Contractor TOTALS $• $ named herein, Issuance,payment al . ,ceptance of ayment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or Contractor under th tract. 3/af fC CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702/CMaTM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® 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. W/4 .PAIA Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® 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 AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION NO. : 3 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where APPLICATION DATE: 3/23/2011 variable retainage for line items may apply. PERIOD TO: 3/23/2011 ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE (D+E) D OR E) (D+E+F) (C-G) RATE) 1 Supervision $1,000.00 $320.00 $200.00 $520.00 52% 480.00 52.00 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'l $60,000.00 $36,000.00 $36,000.00 60% 24,000.00 3,600.00 5 Concrete Topping Slabs&Curbs Labor $69,213.00 $17,303.00 $24,225.00 $41,528.00 60% 27,685.00 4,152.80 6 Waterproofing& Expansion Joints $107,000.00 $42,800.00 $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 $75,343.00 $60,425.00 $0.00 $135,768.00 54% $117,845.00 $13,576.80 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 Fifty Four Thousand Three Hundred Eighty Two and 50/100 Dollars ($54,382.50) ❑ receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER)that the final balance due from the Owner is the sum of Dollars ( ) ❑ receipt of which is hereby acknowledged; or ❑ the payment of which has been promised as th sole consideration for'this Affidavit and Final Waiver of Lien which shall become effective upon rece p of such payment. THERFORE, the undersigned waives and releases unto the 0 ner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon ac ount of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions e,'•fes ed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work p,- orm6d or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By /At. Title President yr WITNESS MY HAND AND NOTORIAL SEAL ' 24th day of March, 2011. ,, '''"JET bi: ij •FOctikRiDE Res. of Hancock ounty \ JiMy Comm. E . 11-29-2017 DIANA su$CONTRACTOS ASSOCIATION INCOPORATD _ Commission # 611862 Unaulnot'Led Repooductton Prohrbjtad Rev P5 Motor Court (Gibraltar) January 2011 Application 1 Paid by Carmel Theater Development $ 47,936.70 February 2011 Application 2 Paid by Carmel Theater Development $ 19,872.00 March 2011 Application 3 Amount to be paid by Carmel Theater Development $ 54,382.50 _._ . ��%� TM _7 = Document G7021CMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PR ''IIFFCT: APPLICATION NO: Distribution to: Carmel Theatre Development Corporation,QCC Parcel 7B-Center for PeCfoming Arts 6 30 West Main Street,Suite 220 KKECEjVF� PERIOD T0. 3/23/11 OWNER ❑ Carmel,IN 46032 �AR 2 4 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION �@ ZQJf CONTRACT DATE: ARCHITECT ❑ Gibraltar Construction Corp ""��'/vq� 4/13/10 2932 N.Webster Ave. ENj CONSTRU PROJECT NOS: I I CONTRACTOR ❑ Indianapolis, IN 46219 VIA ARCHITECT: CTION FIELD ❑ CSO Architects,Inc. CONTRACT FOR: Sitework Package 1 ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor cer les 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 Continuation Sheet,AIA Document G703,is attached. Contract Documents,that all an unts have been paid by the Contractor for Work for which previous Certificates for Payment ere ssued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 1,046,700.00 payment shown herein is •1 d e. 2. Net change by Change Orders $ 0.00 CONTRACTOR:Gibralt Co struction Corp 3.CONTRACT SUM TO DATE(Line l ±2) $ 1,046,700.00 By: - Aia- Date: ,3-aC/i// 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 681,422.00 State of: �Au� 5.RETAINAGE: County of: iii/t ,,....• a. %of Completed Work Subscribed any sworn to b v P E` BRIAN R. MCBRIDE (Column D+E on G703) $ 52,335.00 me this a day of /' �' Res, of Hancock County b. %of Stored Material Notary P • • My Comm. Exp. 11-29-2017 (Column F on G703) $ My Commission expires. t e N mice' n # 611862 Total Retainage(Lines 5a+5b or Total in Column I of G703).. $ CERTIFICATE FOR PAYMENT 629,087.00 In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 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 $ 527,022.00 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. (Line 6 from prior Certificate) �` _� t�r w 15 8.CURRENT PAYMENT DUE $ 102,065.00 AMOUNT CERTIFIED $ )rC�O 01 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied. Initial all figures on this 417,613.00 Application and on the Continuation Sheet that are changed to conform with the amount certified.) (Line 3 less Line 6) $ CONSTRUCTIO • GER: By: Date: to CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC • r r: It cts Inc Total changes approved in previous months by Owner $ $ By: + ® Date: Cl.`A Total approved this Month $ $ This Certificate is not::negotiable. The AMOUNT CERTIFIED is payable only to th Contractor TOTALS $ $ named herein. Issuance`payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ the Owner or Contractor under this Contract. l CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. N . AIA Document G702/CMaTm—1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® 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. • =' ' Document G702/CMaTM _ 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a . constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. • D.Completing the G703 Form- Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. • Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. • Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect off AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA® 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 Page2of6 APPLICATION NO. : 6 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION DATE: 3/23/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 3/23/2011 ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE (D+E) D OR E) (D+E+F) (C-G) RATE) 1 Supervision $ 21,000 $9,870.00 $1,260.00 $11,130.00 53% 9,870.00 2 Allowance $ 70,000 $16,949.00 $16,949.00 24% 53,051.00 3 Bonds $ 15,315 $15,315.00 $15,315.00 100% - 4 Misc. General Conditions $ 20,985 $9,863.00 $1,260.00 $11,123.00 53% 9,862.00 5 Phase 1 6 Earthwork Material $ 27,000 $27,000.00 $27,000.00 100% - 7 Earthwork Labor $ 67,000 $67,000.00 $67,000.00 100% - 8 Underdrains Material $ 36,850 $35,008.00 $1,842.00 $36,850.00 100% - 9 Underdrains Labor $ 36,850 $18,425.00 $18,425.00 50% 18,425.00 10 Structural Soil Material $ 20,000 $20,000.00 $20,000.00 100% - 11 Structural Soil Labor $ 2,000 $2,000.00 $2,000.00 100% - 12 Plumbing Material $ 17,000 $12,750.00 $3,400.00 $16,150.00 95% 850.00 13 Plumbing Labor $ 10,000 $7,500.00 $2,000.00 $9,500.00 95% 500.00 14 Asphalt Paving Material $ 10,000 $10,000.00 $10,000.00 100% - 15 Asphalt Paving Labor $ 6,000 $6,000.00 $6,000.00 100% - 16 Concrete Curbs Material $ 5,500 $5,500.00 $5,500.00 100% - 17 Concrete Curbs Labor $ 30,000 $30,000.00 $30,000.00 100% - 18 Temporary Walk Material $ 2,000 $2,000.00 $2,000.00 100% - 19 Temporary Walk Labor $ 2,000 $2,000.00 $2,000.00 100% - 20 Joint Sealants Material $ 100 $0.00 0% 100.00 21 Joint Sealants Labor $ 100 $0.00 0% 100.00 22 Concrete Pavers Material $ 8,000 $8,000.00 $8,000.00 100% - 23 Concrete Pavers Labor $ 4,000 $4,000.00 $4,000.00 100% - 24 Permeable Pavers Material $ 100,000 $100,000.00 $100,000.00 100% - 52,335.00 25 Permeable Pavers Labor $ 26,000 $26,000.00 $26,000.00 100% - CONTINUATION SHEET Page 3 of 6 APPLICATION NO. : 6 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION DATE: 3/23/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 3/23/2011 ARCHITECT'S PROJECT NO. : A B C D E F G H I WORK COMPLETED MATERIALS ITEM FROM PREVIOUS TOTAL COMPLETED BALANCE TO DESCRIPTION OF WORK SCHEDULED VALUE PRESENTLY AND STORED TO % FINISH RETAINAGE NO. APPLICATION THIS PERIOD STORED(NOT IN (G/C) (IF VARIABLE RATE) (D+E) D OR E) DATE(D+E+F) (C-G) 26 Phase 1A 27 Earthwork Material $ 3,000 $3,000.00 $3,000.00 100% - 28 Earthwork Labor $ 5,000 $5,000.00 $5,000.00 100% - 29 Concrete Curbs Material $ 2,300 $2,300.00 $2,300.00 100% - 30 Concrete Curbs Labor $ 4,000 $4,000.00 . $4,000.00 100% - 31 Concrete Walks Material $ 6,250 $6,250.00 $6,250.00 100% - 32 Concrete Walks Labor $ 6,250 6,250 $6,250.00 100% - 33 Joint Sealants Material $ 100 $0.00 0% 100.00 34 Joint Sealants Labor $ 100 $0.00 0% 100.00 35 Concrete Pavers Material $ 3,700 3,700 $3,700.00 100% - 36 Concrete Pavers Labor $ 1,800 1,800 $1,800.00 100% - 37 Granite Pavers Material $ 20,000 20,000 $20,000.00 100% - 38 Granite Pavers Labor $ 7,000 7,000 $7,000.00 100% - 39 Phase 1B 40 Earthwork Material $ 2,500 $0.00 0% 2,500.00 41 Earthwork Labor $ 2,500 $0.00 0% 2,500.00 42 Concrete Curbs Material $ 1,000 $0.00 0% 1,000.00 43 Concrete Curbs Labor $ 3,000 $0.00 0% 3,000.00 44 Concrete Walks Material $ 2,650 $0.00 0% 2,650.00 45 Concrete Walks Labor $ 2,650 $0.00 0% 2,650.00 46 Joint Sealants Material $ 100 $0.00 0% 100.00 47 Joint Sealants Labor $ 100 $0.00 0% 100.00 48 Concrete Pavers Material $ 1,800 $0.00 0% 1,800.00 49 Concrete Pavers Labor $ 3,700 $0.00 0% 3,700.00 50 Permeable Pavers Material $ 4,000 $0.00 0% 4,000.00 CONTINUATION SHEET Page 4 of 6 APPLICATION NO. : 6 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION DATE: 3/23/2011 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts PERIOD TO: 3/23/2011 where variable retainage for line items may apply. ARCHITECT'S PROJECT NO. : A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE RATE) (D+E) DORE) (D+E+F) (C G) 51 Permeable Pavers Labor $ 1,000 - 0% 1,000 52 Phase 1C 53 Earthwork Material $ 1,200 1,200 1,200 100% - 54 Earthwork Labor $ 1,200 1,200 1,200 100% - 55 Topsoil Material $ 500 500 500 100% - 56 Topsoil Labor $ 500 500 500 100% - 57 Site Demolition Material $ 500 500 500 100% - 58 Site Demolition Labor $ 1,500 1,500 1,500 100% - 59 Concrete Curbs Material $ 2,400 2,400 2,400 100% - 60 Concrete Curbs Labor $ 6,000 6,000 6,000 100% - 61 Concrete Walks Material $ 12,500 12,500 12,500 100% - 62 Concrete Walks Labor $ 12,500 12,500 12,500 100% - 63 Joint Sealants Material $ 100 - 0% 100 64 Joint Sealants Labor $ 100 - 0% 100 65 Concrete Pavers Material $ 15,400 15,400 15,400 100% - 66 Concrete Pavers Labor $ 7,600 7,600 7,600 100% 67 Landscaping Material $ 100 - 0% 100 68 Landscaping Labor $ 100 - 0% 100 69 Phase 2 70 Earthwork Material $ 10,150 10,150 10,150 100% - 71 Earthwork Labor $ 10,150 10,150 10,150 100% - 72 Topsoil Material $ 16,250 - 0% 16,250 73 Topsoil Labor $ 16,250 - 0% 16,250 74 Concrete Walks Material $ 12,600 5,040 5,040 40% 7,560 75 Concrete Walks Labor $ 12,600 5,040 5,040 40% 7,560 CONTINUATION SHEET Page 5 of 6 . APPLICATION NO. : 6 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION DATE: 3/23/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 3/23/2011 ARCHITECT'S PROJECT NO. : A B C D I E F G H 1 WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE RATE)-G) ) . (D+E) DORE) (D+E+F) • 76 Joint Sealants Material $ 100 _ - 0% 100 77 Joint Sealants Labor $ 100 - 0% 100 78 Concrete Pavers Material $ 22,400 - 0% 22,400 79 Concrete Pavers Labor $ 11,100 - 0% 11,100 80 Granite Pavers Material $ 10,000 10,000 10,000 100% - 81 Granite Pavers Labor $ 5,000 - 0% 5,000 82 Pourous Pavers Material $ 60,000 60,000 60,000 100% - 83 Pourous Pavers Labor $ 15,000 15,000 15,000 100% - 84 Decomposed Granite Material $ 66,000 - 0% 66,000 85 Decomposed Granite Labor $ 25,000 _ - 0% 25,000 86 Landscaping Material $ 10,000 - 0% 10,000 87 Landscaping Labor $ 3,000 - 0% 3,000 88 Irrigation Material $ 3,500 - 0% 3,500 89 Irrigation Labor $ 5,000 - 0% 5,000 90 Phase 3 91 Earthwork Material $ 2,400 _ - 0% 2,400 92 Earthwork Labor $ 2,400 - 0% 2,400 93 Topsoil Material $ 1,000 - 0% 1,000 94 Topsoil Labor $ 2,000 - 0% 2,000 95 Site Demolition Material $ 1,000 - 0% 1,000 96 Site Demolition Labor $ 4,000 - 0% 4,000 97 Concrete Curbs Material $ 2,800 _ - 0% 2,800 98 Concrete Curbs Labor $ 4,000_ - 0% 4,000 99 Concrete Walks Material $ 7,500 - 0% 7,500 100 Concrete Walks Labor $ 7,500 - 0% 7,500 CONTINUATION SHEET Page 6 of 6 • APPLICATION NO. : 6 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 3/23/2011 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 3/23/2011 ARCHITECT'S PROJECT NO. : A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE RATE) (D+E) DORE) (D+E+F) (C G) 101 Joint Sealants Material $ 100 - 0% 100 102 Joint Sealants Labor $ 100 - 0% 100 103 Concrete Pavers Material $ 10,000 - 0% 10,000 104 Concrete Pavers Labor $ 3,200 - 0% 3,200 105 Landscaping Material $ 50 - 0% 50 106 Landscaping Labor $ 50 - 0% 50 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 $1,046,700.00 $585,580.00 $95,842.00 $0.00 $681,422.00 65% $365,278.00 $52,335.00 ISA Form#I-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 Parcel 7B, Center for Performing Arts, Sitework Package 1 and owned by Carmel Theatre Development Corporation, LLC. and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of One Hundred Two Thousand Sixty Five and No/100 Dollars ($102,065.00) ❑ receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER)that the final balance due from the Owner is the sum of Dollars ( ) ❑ receipt of which is hereby acknowledged; or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto t Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements there• account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions -e. ressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work p4 armed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By I Title President IT ! WITNESS MY HAND AND NOTORIAL SEAL, 4 2:11 <,ay of March, 2011. / (Notary Public) . 1979 ikb,aNA Su$GONTAACTOAS ASSOCIATION INCORPORATED y BRIAN R. MCBRIDE E npoh.„„ee Rape etkoh Pea+„n,t.e Ras. of Hancock County, , � �` * My Comm. Exp. 11-29-2017 ' yo o�. Commission # 611862 Draft Green Improvements (Gibraltar) October 2010 (application 1) Paid by the Carmel Theater Development Company $ 197,162.10 November 2010 (application 2) Paid by the Carmel Theater Development Company $ 198,245.70 December 2010 (application 3) Paid by the Carmel Theater Development Company $ 84,847.50 January 2011 (application 4) Paid by the Carmel Theater Development Company $ 18,270.70 February 2011 (application 5) Paid by the Carmel Theater Development Company $ 28,496.70 March 2011 (application 6) Amount to be paid by the Carmel Theater Development Company $ 102,065.00 • Gibraltar Construction Corp Check: 73 2932 N. Webster Ave. Date: 4/8/2011 Indianapolis, IN 46219 Vendor: GIBR1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2-6 102,065.00 102,065.00 0.00 0.00 102,065.00 Application 6 onP7B Sitework 4-3 54,382.50 54,382.50 0.00 0.00 54,382.50 Application 3 156,447.50 156,447.50 0.00 0.00 156,447.50 73 4/8/2011 ********156,447.50 THE SUM OF ONE HUNDRED FIFTY SIX THOUSAND FOUR HUNDRED FORTY SEVEN DOLLARS AND 50 CENTS Gibraltar Construction Corp 2932 N. Webster Ave. Indianapolis, IN 46219 Gibraltar Construction Corp Check: 73 2932 N. Webster Ave. Date: 4/8/2011 Indianapolis, IN 46219 Vendor: GIBR1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2-6 102,065.00 102,065.00 0.00 0.00 102,065.00 Application 6 onP7B Sitework 4-3 54,382.50 54,382.50 0.00 0.00 54,382.50 Application 3 156,447.50 156,447.50 0.00 0.00 156,447.50 • P5 Motor Court (Signature Construction) January 2011 Application 1 Paid by Carmel Theater Development $ 2,663.15 February 2011 Application 2 Paid by Carmel Theater Development $ 5,414.43 March 2011 Application 3 Amount to be paid by Carmel Theater Development $ 6,824.47 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Cannel PROJECT: Motor Court APPLICATION NO Invoice ii 3 1 Distribution to: Carmel Indiana 46032 Signature costs OWNER ARCHITECT PERIOD TO: 3/25/201 I 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 front 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 I ±2) $ 25,361.30 4. TOTAL COMPLETED&STORED TO $ 14,902.05 1 2 B '� Date: X15 //( 5. RETAINAGE: Thomas Koontz,President a. 0 %of Completed Work $ 0 subscribed y,d sworn to before me this 'T_ day of 3/// r"."'",.;, :i;,,,„(Column D+Eon G703) LINDA BUCHANAN b. %of Stored Material $ Hancock County NG ARY'.(Column F on G703) . SEAL : My Commission Expires z; Total Rctainage(Lines 5a+5b or lN°:''_ August 20,2011 Total in Column I of 0703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT' 6. TOTAL EARNED LESS RETAINAGE $ 14,902.05 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 front prior Certificate) $ 8,077.58 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 6,824.47 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 10,459.25 (Line 3 less Line 6) AMOUNT CERTIFIED $ to eZ447 I CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ' (Attach explanation(([amount certified differs from the amount applied.Initial all figures on this Total changes approved Application and and• _•ntinuation heel that r han t nfonn pith 1e amount certified.) in previous months by Owner ARCHITECT: �� 43(ia Total approved this Month By: Date: e3�Z 5 1 TOTALS $0.00 $0.00 This Certifi ate is lot negotiable. The AMOUNT CERTIFIED is payable only to he Contractor na a Herein.issuance,payment and acceptance or payment are without NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702.APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 01992 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/lq/46V SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 3 3/25/11 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 4,310.43 3,803.22 0.00 8,113.65 64% 4,567.00 8,113.65 Construction Management Fee 12,680.65 3,767.15 3,021.25 0.00 6,788.40 54% 5,892.25 6,788.40 25,361.30 8,077.58 6,824.47 0.00 14,902.05 59% 10,459.25 14,902.05 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 six thousand eight hundred twenty-four dollars and forty-seven cents ($6,824.47) 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 Thomas E. K ntz, President / Subscribed and sworn to before me this: ,13/� Notary Public: ,!')2.r XX/ ����' �• LINDABUCHANAN �'NOTPAY'. Hancock County J se. .;` My Commission Expires •••.'FO,,N�;•• August 20,2011 Signature Construction, LLC Check: 74 720 3rd Ave., SW Date: 4/8/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4-3 6,824.47 6,824.47 0.00 0.00 6,824.47 Application 3 10-2 775.44 775.44 0.00 0.00 775.44 Application 2 11-2 2,084.93 2,084.93 0.00 0.00 2,084.93 Application 2 on P73 Fountains 9,684.84 9,684.84 0.00 0.00 9,684.84 74 4/8/2011 ***********9,684.84 THE SUM OF NINE THOUSAND SIX HUNDRED EIGHTY FOUR DOLLARS AND 84 CENTS ************ Signature Construction, LLC 720 3rd Ave., SW Carmel, IN 46032 Signature Construction, LLC Check: 74 720 3rd Ave., SW Date: 4/8/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4-3 6,824.47 6,824.47 0.00 0.00 6,824.47 Application 3 10-2 775.44 775.44 0.00 0.00 775.44 Application 2 11-2 2,084.93 2,084.93 0.00 0.00 2,084.93 Application 2 on P73 Fountains 9,684.84 9,684.84 0.00 0.00 9,684.84