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Home My WebLink AboutSignature, Smock Fansler - $100,801.42 ti? 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(Smock) June 2011 $ 93,100.50 Application 2(Signature) June 2011 $ 7,700.92 Total Authorized Disbursement $100,801.42 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 Regi ons Bank and Carmel Theater Development Company, LLC. Dated: '7/?/t; /� 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. ti P5 Motor Court (Smock Fansler) April 2011 Application 1 Paid by Carmel Theater Development $ 55,530.00 May 2011 Application 2 Paid by Carmel Theater Development $ 36,052.20 June 2011 Application 3 Amount to be paid by Carmel Theater Development $ 93,100.50 AIA Type Document Application and Certification for Payment Page 1 of 2 TO(OWNER):CARMEL REDEVELOPMENT COMM. PROJECT:MOTOR COURT PAVING APPLICATION NO: 3 DISTRIBUTION 30 W.MAIN ST. TO: CARMEL, IN 46032 PERIOD 70:6/30/2011 _OWNER _ARCHITECT —CONTRACTOR FROM(CONTRACTOR):Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S 2910 W.Minnesota Street PROJECT NO: Indianapolis, IN 46241 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the work covered by this application for Payment has been completed in accordance with the Application is made for Payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Type Document is attached. Certificates for Payment were issued and payments received from the owner,and that current payment shown herein is now due. , ,,;;iiiiy,iif,�, 1.ORIGINAL CONTRACT SUM $ 268,590.00 '9c,, „:; ° 2.Net Change by Change Orders $ 0.00 CONTRACTOR: Smock Fansler Corporation ,• ' 2910 W.Minnesota Street Indianapolis, IN 46241 3.CONTRACT SUM TO DATE(Line 1 +2) $ 268,590.00 4.TOTAL COMPLETED AND STORED TO DATE $ 205,203.00 By: ,//'7/72-2/ /`, / - Date: ,:/. / CEO 5.RETAINAGE: State of:IN ,, S • ••�P a. 10.00%of Completed Work $ 20,520.30 County of: MORGAN //%,,,''yrE 0IF NO,,e'\ b. 0.00%of Stored Material $ 0.00 Subscribed and Sworn to before me this /2 -IL Day of ,I c j,1(' 20 / Notary Public: / ” , Total retainage(Line 5a+5b) $ 20,520.30 ' '---": • ," - 6,0� - My Commission Expires: // /c (/l:)(/ • / 6.TOTAL EARNED LESS RETAINAGE $ 184,682.70 (Line 4 less Line 5 Total) ARCHITECT'S CERTIFICATE FOR PAYMENT 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,based on on-site observations and the data corn- (Line the above application, the Architect certifies to owner that to the best of the Architect's (Line 6 from prior Certificate) $ 91,582.20 knowledge,information and belief the Work has progressed as indicated,the quality of the work 8.CURRENT PAYMENT DUE $ 93,100.50 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED. (Line 3 less Line 6) $ 83,907.30 4'Z IO1 �� AMOUNT CERTIFIED $ L (Attach explanation if amount certified differs from the amount applied. Initial all figures on this CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS _ Application and•• -_ on t uation Sheet that are changed to conform to the amount certified.) Total changes approved in ARCHITECT: previous months by Owner 0.00 0.00 By: �`L1 Date: )t V /a.4/ Total approved this Month 0.00 0.00 This CertAP).t negotiable. The AMOUNT CERTIFIED is payable only to . e Contractor �� named herein. ssuance, Payment and acceptance of payment are without• dice to y TOTALS 0.00 0.00 rights of the Owner or Contractor under this ntract. NET CHANGES by Change Order 0.00 CM V444/ 0*if AIA Type Document Application and Certification for Payment Page 2 of 2 TO(OWNER):CARMEL REDEVELOPMENT COMM. PROJECT:MOTOR COURT PAVING APPLICATION NO: 3 DISTRIBUTION 30 W.MAIN ST. TO: CARMEL,IN 46032 PERIOD TO:6/30/201I _OWNER _ARCHITECT —CONTRACTOR FROM(CONTRACTOR):Smock Fansler Corporation VIA(ARCHITECT): ARCHITECT'S 2910 W.Minnesota Street PROJECT NO: Indianapolis,IN 46241 CONTRACT FOR: CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE 1 MOBILIZATION/DEMOBILIZATION 13,200.00 6,600.00 3,300.00 0.00 9,900.00 75.00 3,300.00 990.00 2 ASPHALT BASE 55,100.00 55,100.00 0.00 0.00 55,100.00 100.00 0.00 5,510.00 3 UNIT PAVERS 200,290.00 40,058.00 100,145.00 0.00 140,203.00 70.00 60,087.00 14,020.30 REPORT TOTALS $268,590.00 $101,758.00 $103,445.00 $0.00 $205,203.00 76.40 $63,387.00 $20,520.30 AFFIDAVIT AND WAIVER OF LIEN [ ] Final [X] Partial [X] Payment to Follow State of Indiana County of Marion T. M. Fansler, being duly sworn states that he is the CEO of SMOCK FANSLER CORP. having contracted with: Carmel Redevelopment Commission to furnish certain labor, materials, and/or services as follows: Misc. Construction for a project known as: SFC#10-140 Carmel City Ctr.Motor Ct. & Fountains located at Indianapolis, IN and does hereby state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the owner the sum of: ($93,100.50) Ninety Three Thousand One Hundred Dollars and 50/100 [ ] receipt of which is hereby acknowledged;or [X] the payment of which has been promised as the sale 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($0.00) [ ] receipt of which is hereby acknowledged;or [ ] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon on account of Labor, Materials, and/or Services, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work performed, materials, or services furnished to the undersigned for said project, and within the scope of this affidavit and waiver. /� SMOCK FANSLER CORP. By �//? , /i e CEO T.M.Fansler ;" PAY. WITNESS MY HAND AND NOTARIAL SEAL,this 17th day of June,2011. - •:. Melissa J. Bishop Notary ublic .. My commission expires November 30,2016 Residing in Morgan County P5 Motor Court (Signature Construction - Smock) May 2011 Application 1 Paid by Carmel Theater Development $ 5,087.90 June 2011 Application 2 Amount to be paid by Carmel Theater Development $ 7,700.92 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENTG702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Carmel PROJECT: Motor Court APPLICATION NO Invoice#6-Smock 1 Distribution to: Carmel Indiana 46032 Signature costs OWNER ARCHITECT . PERIOD TO: 6/23/2011 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Cannel,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 0703,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. I. ORIGINAL CONTRACT SUM $ 26,859.00 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line 1±2) $ 26,859.00 4. TOTAL COMPLETED&STORED TO $ 12,788.82 / }r — C-----------: Date: Z // 5. RE•I'AINAGE: I homes Koontz,President / 0- a. 0%of Completed Work $ 0 Subscrib<1 d sworn to before me this 01./3 day of J U Nf !/ ( u n D+Eon 0703) '' LINDA BUCHANAN b. n F on 0703)Material $ ?•NOTARY'°? Hancock County /7(��n F on G7o3) s∎L My Commission Expires Total Ketainage(Lines aa+an or i- Total in Column lofG703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT) �`••'' Aug �t20,2011 6. TOTAL EARNED LESS RETAINAGE 8 12,788.82 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) $ 5,087.90 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE 8 7,700.92 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE 5 14,070.18 �j (Line 3 less Line 6) AMOUNT CERTIFIED S -110() -1 CHANGE ORDER UMMAK Y ADDI l IONS DEDUC I IONS (Attach explanation , certified(idlers from the amount applied.Initial all figures on this I otal changes approved Application and t 7 he on 1+ cation Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECT: Total approved this Month By: ( •1 Date: t,to 2'-t' )\ ffjj / TOTALS $0.00 $0.00 This Certi cate is no nrgotiabl: The AMOUNT CERTIFIED is payable only the ll) contractor h,meD n..el .issuance,payment anu acceptance or payment are wltnout NET CFIANGES by Change Order $0.00 prejudice to an ' is 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 Au icity from the �Licensee. `JVI .. 1fsofiP • SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Invoice # 6 - Smock 6/23/11 Motor Court - Smock 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 13,429.50 0.00 2,528.67 0.00 2,528.67 19% 10,900.83 2,528.67 Construction Management Fee 13,429.50 5,087.90 5,172.25 0.00 10,260.15 76% 3,169.35 10,260.15 26,859.00 5,087.90 7,700.92 0.00 12,788.82 48% 14,070.18 12,788.82 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 seven thousand seven hundred and ninty-two cents ($7,700.92) 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 ( /Subscribed and sworn to before me this: ,)l we 7 3 de,1/ Notary Public: 4.4-e--e.4.....1--- , i ' : LINDA BUCHANAN ! „ar Hancock County i SE My Commission Expires IL E9 A August 20,2011