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HomeMy WebLinkAboutDisbursements - Contract Payments Previously made - $49,675Mercantile 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 Payment to Carmel Redevelopment Commission for reimbursement of Contract payments previously made 49,675.00 Total Authorized Disbursement }� r�� �v �; ii;�r�arr•:�r-� ss 7 ' �i 8` 1S, t'. y`r!k' P ratY $49:676;00 F{ H`a a b, A All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (Sound System), dated as of August 31, 2009, by and between Lender and Village Financial, LLC. Dated: December 15, 2009 CITY OF CARMEL REDEVELOPMENT COMMISSION By: Printed: Les Olds Title: Director of Redevelopment APPLICATION AND CERTIFICATE FOR PAYMEN1 AIA DOCUMENT G702 /CMa TO OWNER: Carmel Redevelopment Commissioi PROJECT: Parcel 7A, Regional Performing One Civic Square, Carmel, IN 46032 Carmel, IN. (Mail to Shiel Sexton) USA FROM CONTRACTOR: All Pro Sound 806 Beverly Parkway Pensacola, FL 32505 CONTRACT FOR: Production Sound and Co mmuications VIA ARCHITECT: CSO Architect Inc. ADDRESS: 280 East 96th St. Suite 100 Indianapolis, IN. 46240 CONSTRUCTION MANAGER - ADVISER EDITION Page 1 of 2 APPLICATION NO: PERIOD TO: JOB NO: PROJECT #: AGREEMENT # CONTRACT DATE: COST CODE: 1 5/19/2009 830015 2,695 2695 -6020 3/16/2009 27 41 16 Distribution to: OWNER MANAGER ARCHITECT CONTRACTOR CONTRACTOR'S APPLICATION FOR PAYMEN1 Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. 1. ORIGINAL CONTRACT SUM 2. Net change by Change Orders 3. CONTRACT SUM TO DATE (Line 1 f 2) 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) 5. RETA1NAGE: a. 10% of Completed Work (Column D + E on G703) b. 0% of Stored Material (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column 1 of 0703) 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 9. BALANCE TO FINISH, INCLUDING RETAINAGE $ (Line 3 less Line 6) $1 4,967.50 0.00 $ 1,581,970.00 1,581,970.00 $49,675.00 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 Contract Documents, that all amounts have been paic 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 CONTRA OR: By: State of: Subscribed an Notary Public• My Commissi me this Date: cS/9//2003 County of: C�7/%1— � —day of 1/1Z)5. expires: 4,967.50 CERTIFICATE FOR PAY 44,707.50 44,707.50 1,537,262.50 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner Total approved this Month TOTALS NET CHANGES by Change Ordei In accordance with the Contract Documents, comprising this application, the Construction Manager an ' rc 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 AMOUN4ERTIFIED JOHN D. FUQUA ColtimlSSlOn UU 666167 ,l+ Expires June 6, 2011 n- 9berrnvtR�S nrpia4d:40,110O AMOUNT CERTIFIED $ 11441777 ----- Lsr_ (Attach explanation if amount certified differs figures on this Application and on the Cont amount certif . CO STR( IN ). 1 AGE By: �►_.,!.'' `L�;�►.. �,.. A m the amount applied for. Initial all ion Sheet that changed to conform to the 13y: This Certificate is Contractor na prejudice to a Date: Date: egotiable. The AMOUNT CERTIFIED is payable only to the rein. Issuance, payment and acceptance of payment are without ghts of the Owner or Contractor under this Contract. AIA DOCUMENT G702 /CMa APPLICATION AND CERTIFICATION FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION . 1992 EDITIO AIA® © 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1745 NEW YORK AVE., N W., WASHINGTON, DC 20006 -529: Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity G702 /CMa -1992 CONTINUATION SHEET AIA DOCUMENT G703 PAGE 1 OF 2 PAGES AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO: 1 05/19/09 05/19/09 A B C D E F G H I ITEM NO. DESCRIPTION OF WORT{ SCHEDULED VALUE WORK COMPLETED MATERIALS PRESENTLY STORED (NOT IN D OR E) TOTAL COMPLETED AND STORED TO DATE (D +E +F) % (G — C) BALANCE TO FINISH (C - G) RETAINAGE (IF VARIABLE RATE) FROM PREVIOUS APPLICATION (D + E) THIS PERIOD 1 Cable $ 86,750.00 $ - $ - $ - $ - 0.00% $ 86,750.00 $ - 2 Fabricated Steel $ 23,250.00 $ - $ - $ - $ - 0.00% $ 23,250.00 $ - 3 Racks, Cases, and Carts $ 21,420.00 $ - $ - 5 - $ - 0.00% $ 21,420.00 $ - 4 Equipment Electronics $ 895,832.00 $ - $ - $ - $ - 0.00% $ 895,832.00 $ - 5 Equipment Hardware 5 57,011.00 $ - $ - $ - 5 - 0.00% 5 57,011.00 $ - 6 Labor $ 341,532.00 $ - $ - $ - $ - 0.00% $ 341,532.00 $ - 7 Bond 5 49,675.00 $ - 5 49,675.00 $ - $ 49,675.00 100.00% $ - $ 4,967.50 8 Bid Package 6020 General Allowance $ 100,000.00 $ - $ - 5 - $ - 0.00% $ 100,000.00 $ - 9 Allowance No. 3 - CAD AS BUILTS $ 5,000.00 $ - $ - $ - $ - 0.00% $ 5,000.00 5 - 10 Software Allowance $ 1,500.00 $ - $ - $ - $ - 0.00% $ 1,500.00 5 - GRAND TOTALS $ 1,581,970.00 $ - $ 49,675.00 $ - $ 49,675.00 3.14% $ 1,532,295.00 $ 4,967.50 AIA DOCUMENT G7CLIsetSIThtiVrOtitaitiEtt101096334of9ttliESCOtfitturnmt by9 questing of the license a completed AIA Document D401 - Certification of Document's Authenticity THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N W., WASHINGTON, D . 20006 -5232 G703 -1992