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HomeMy WebLinkAboutAll Pro Sound - $171,747Exhibit 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 (April) $ 21,172.50 Amount to be paid by Village Financial (May) $ 150,574.50 Total Authorized Disbursement $ 171,747.00 All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (PAC Sound Equipment), dated , as of August 31, 2009, by and between Lender and Village Financial, LLC. Dated: G 1 ( o CITY OF CARMEL REDEVELOPMENT COMMISSION By. Printed Title Les S. Olds Executive Director Draft Sound Equipment All Pro Sound (Mercantile) January 2010 Amount paid by CRC $ 44,707.50 February 2010 Application 2 $ 207,699.30 February amount to be paid from PAC Sound Equipment $ 80,198.10 February amount to be paid from PAC Equipment $ 127,501.20 Paid by Village Financial $ 207,699.30 March 2010 Paid by Village Financial $ 38,317.50 April 2010 Amount to be paid by Village Financial $ -" :21,:1:72:50 May 2010 Amount to be paid by Village Financial: $_ 1.50;574:50 APPLICATION AND CERTIFICATE FOR PAYMEN1 AIA DOCUMENT G702 /CMa CONSTRUCTION MANAGER - ADVISER EDITION Page I of 2 TO OWNER: Carmel Redevelopment Comm issioi PROJECT: One Civic Square, Carmel, IN 46032 (Mail to Shiel Sexton) FROM CONTRACTOR: All Pro Sound 806 Beverly Parkway Pensacola, FL 32505 CONTRACT FOR: Production Sound and Co mmuications Parcel 7A, Regional Performing Carmel, IN. USA VIA ARCHITECT: CSO Architect Inc. ADDRESS: 280 East 96th St. Suite 100 Indianapolis, IN. 46240 APPLICATION NO: PERIOD TO: JOB NO: PROJECT #: AGREEMENT 4 CONTRACT DATE: COST CODE: 4 Revised 4/27/2010 830015 2695 2695 -6020 3/16/2009 27 41 16 Distribution to: x x x 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.± 2) 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) 5. RETAINAGE: a. 10% of Completed Work $ 13,487.50 (Column D + E on G703) b. 10% of Stored Material $ 21,167.70 (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column I of G703) 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 $ 1,581,970.00 (51,000.00) 1,530,970.00 346,552.00 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 CONTRACTOR: By: State of: /ewt ; 3✓� Subscribed and sworn to before me this Notary Public: My Commission e County of: • �t r .h? Date: D 1 ;7 620 /6 34,655.20 CERTIFICi4TE F R PAY t ENT ''°•" '/ 311,896.80 290,724.30 21,172.50 1,219,073.20 CI -IANGE ORDER SUMMARY ADDITIO)'M DEDUCTIONS Total changes approved in previous months by Ownet $51,000.00 Total approved this Month $0.00 TOTALS $51,000.00 NE I- CHANGES by Change Order $51,000.00 OT COMMISSION # DD705193 EXPIRES 9/21/2011 BONDED THRU 1- 888- NOTARY1 E. JORDAN ATE OF FLORIDA 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 (Attach explanation if amount certified differs figures on this Application and on the Con amount certified.) CO .TRU '',7 •�qj � i By: i /�. / Date: A P2' ' By: Date: the amount applied for. Initial all Sheet that changed to conform to the This Certificate is not negotiable. The AMOUNT CERTIFIED is payab c only to the Contractor named herein. Issuance, payment and acceptance of payment are withoul prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 /CMa APPLICATION AND CERTIFICATION FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION 1992 EDITION 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 2 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 4 Revised APPLICATION DATE: 04/27/10 PERIOD TO: 04/27/10 ARCHITECT'S PROJECT NO: A B C D E F C H I ITEM NO. DESCRIPTION OF WORK 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 - 0) RETAINAGF (IF VARIABLE RATE) FROM PREVIOUS APPI,ICATIOI\ (D + E) THIS PERIOD 1 Cable $ 152,365.00 $ - $ - $ 149,325.00 $ 149,325.00 98.00% $ 3,040.00 $ 14,932.50 2 Fabricated Steel $ 23,250.00 $ - $ - S - $ - 0.00% $ 23,250.00 $ - 3 Racks, Cases, and Carts $ 21,420.00 $ - $ - $ - $ - 0.00% $ 21,420.00 $ - 4 Equipment Electronics $ 830,217.00 $ - $ - $ 62,352.00 $ 62,352.00 7.51% $ 767,865.00 $ 6,235.20 5 Equipment Hardware $ 57,011.00 $ 7,850.00 $ - $ - $ 7,850.00 13.77% $ 49,161.00 $ 785.00 6 Labor $ 341,532.00 $ 53,825.00 $ 23,525.00 $ - $ 77,350.00 22.65% $ 330,282.00 $ 7,735.00 7 Bond $ 49,675.00 $ 49,675.00 S - $ - $ 49,675.00 100.00% $ - $ 4,967.50 8 Bid Package 6020 General Allowance 5 100,000.00 $ - 5 - $ - $ - 0.00% $ 100,000.00 $ - 9 Allowance No. 3 - CAD AS BUILTS $ 5,000.00 $ - $ - $ - $ - 0.00% $ 5,000.00 $ - 10 Software Allowance $ 1,500.00 $ - $ - $ - $ - 0.00% $ 1,500.00 $ - 11 Change Order #1 $ (51,000.00) S - $ - $ - S - 100.00% $ (51,000.00) $ - GRAND TOTALS $ 1,530,970.00 $ 111,350.00 $ 23,525.00 $ 211,677.00 $ 346,552.00 18.32% $ 1,250,518.00 $ 34,655.20 AIA DOCUMENT G7tlUsee■SimalyTadniailiVi a ld®fmvE ofstbilScd- ttijm t byaequesting 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.0 20006 -5232 G703 -1992 (;:7; !� .1 \; 4�1 AUDIO • VIDEO • LIGHTING SOLUTIONS WAIVER AND PARTIAL RELEASE OF LIEN UPON PROGRESS PAYMENT # 4 REVISED The undersigned lienor, for and in consideration of the sum of $21,172.50 hereby waives and Releases, its lien and right to claim a lien for labor, services, or materials furnished through April 27, 2010, to Shiel Sexton Co., Inc. on the job of City of Carmel Redevelopment Commission, For the following described property: City of Carmel Redevelopment Commission Parcel 7A, Regional Performing Arts Center 777 3rd Ave. SW. Carmel, IN. 46032 This waiver and release does not cover any retention of labor, services, or materials furnished after the date specified above. By: (Signature) Printed Name and Title: Chad Edwardson / Design Sales Dated on 27th day of April, 2010 For: All Pro Sound Inc. (Company Name) STATE OF FLORIDA COUNTY OF ESCAMBIA The foregoing instrument was acknowledged before me thiso?7 day of , 2010 By Chad Edwardson, who is personally known to me, or who has produced (type of identification) as identification and who did not take an oath. otary Signa ••••qY ....... CREIGHTON E. JORDAN \ f• t �` flint UMJSSIONN#DD7Q5 93A +r o .. EXPIRES 9/21/2011 (Serial Number DESIGN. BUILD. PERFORM. 806 Beverly Parkway • Pensacola, Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com LjDZIA\t/..D AUDIO • VIDEO • LIGHTING SOLUTIONS Bill Of Sale City of Carmel Redevelopment Commission Parcel 7A, Regional Performing Arts Center Carmel, IN.46032 FOR GOOD CONSIDERATION, and upon payment of Twenty -One Thousand One Hundred Seventy -Two Dollars and Fifty Cents ($21,172.50), and to extent as billed on Pay Request #4 Revised the undersigned, All Pro Sound Inc., 806 Beverly Parkway, Pensacola, FL. 32505 ( Seller) hereby sells and transfers to City of Carmel Redevelopment Commission( Buyer / Owner ), the following: See Breakdown Attached: Which are stored at: All Pro Sound Inc. Pre - Fabrication Building 602 West Michigan Avenue Pensacola, Florida 32505 Ph. (850)432 -5780 ext. 2075 Fax (850)432 -0844 The Seller warrants it has good title to said property, full authority to sell and transfer same, and that said property is sold free. of all liens, claims and encumbrances. Signed under seal this 27th day of April, 2010 All Pro Sound Inc. esign Sa Signature Chad Edwardson, Signature John Fuqu Signa Not Vice Presiden CREIGHTON E. ,DAN NOTARY PUBLIC - STATE OF FLORIDA COMMISSION # DD705193 EXPIRES 9/21/2011 BONDED THRU I.888.NOTARYI DESIGN. BAD. PERFORM. 806 Beverly Parkway • Pensacola, Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com TRANSFER OF TITLE 4LL /MO 5490Na J '' e - ( "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 /PA /4. , 7 , 20 /D and (ii) in the "Amount of this Request" section of that Affidavit executed by the Contractor on /97;2/4 , _27 , 20 /D. "CONTRACTOR" By (Li Printed: `AAA. ?dts-rJsci Title: /Dcs(4. ACRD CERTIFICATE OF LIABILITY INSURANCE OP ID JR ALLPR- 1 DATE (MMIDD/YYYY) 02/04/10 PRODUCER Hiles- McLeod Insurance, Inc. PO Box 2747 Pensacola FL 32513 Phone:850- 432 -9912 Fax:850- 432 -3875 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED All Pro Sound, Inc. 806 Beverly Parkway Pensacola FL 32505 INSURER A. Everest National Insurance Co. INSURER B: Cincinnati Insurance Company 01209 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR AUU1 INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY)_ POLICY EXPIRATION DATE (MMIDD/YYYY) LIMITS B X GENERAL X UABIUTY COMMERCIAL GENERAL LIABIUTY CAP5173383 09/09/08 0 9/ 0 9/ 11 EACH OCCURRENCE $1,000,000 UAMACat I U RtN I MU PREMISES (Ea occurence) $100,000 CLAIMS MADE X OCCUR MED EXP (My one person) $5,000 PERSONAL P. ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER 7 POLICY PRO LOC JECT PRODUCTS - COMP /OP AGG $ 2 , 0 0 0 , 0 0 0 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAA5173383 09/09/09 09/09/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE UABILITY ANY AUTO AUTO ONLY EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESS X X / UMBRELLA UABIUTY OCCUR CLAIMSMADE DEDUCTIBLE RETENTION $ CAP5173383 09/09/09 09/09/10 EACH OCCURRENCE • $5,000,000 AGGREGATE $5,000,000 $ $ $ A WORKERS AND EMPLOYERS' ANY PROPRIETOR OFFICER/MEMBER (Mandatory If yes, describe SPECIAL COMPENSATION UABIUTY y / N 2700003375091 03/01/09 03/01/10 WC STATll- 01 H- TORY LIMITS ER E.LEACHACCIDENT $ 1000000 /PARTNER/EXECUTIVr EXCLUDED? in NH) under PROVISIONS below E.L DISEASE - EA EMPLOYEE $ 1000000 EL DISEASE - POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Prject: Parcel 7A Regional Performing Arts Center 777 3rd Ave SW Carmel, IN 46032 Sheil Sexton Co., Inc. is an additional insured with regards to General Liability. CERTIFICATE HOLDER CANCELLATION Sheil Sexton Co., Inc. 902 N Capitol Ave. (Indianapolis IN 46204 SHEILSE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTH /O EDRi.� A / S7_.CM / /fl ^g p V i t/--� ACORD 25 (2009/01) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AWRD EVIDENCE OF PROPERTY INSURANCE OP ID: JK DATE (MM /DD /YYYY) 02/04/2010 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE 850- 432 -9912 INC , No, Extl: AGENCY Hiles- McLeod Insurance, Inc. PO Box 2747 Pensacola, FL 32513 Douglas V. Broxson FAX 850 - 432 -3875 (A/C, No): EMAIL ADDRESS: CODE: 09010 SUB CODE; AGENCY ALLPR -1 CUSTOMER ID #: COMPANY Cincinnati Insurance Company PO Box 145496 Cincinnati, OH 45272 INSURED All Pro Sound, Inc. 806 Beverly Parkway Pensacola, FL 32505 LOAN NUMBER POLICY NUMBER CAP5173383 EFFECTIVE DATE 09/09/08 EXPIRATION DATE 09/09/11 CONTINUED UNTIL TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION /DESCRIPTION 806 Beverly Pkwy Pensacola„ FL 32505 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE I PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE Installation /Builders Risk Stored Materials 1500000 500 REMARKS (Including Special Conditions) Project: Parcel 7A Regional Performing Arts Center 777 3rd Ave SW Carmel, IN 46302 Carmel Redevelopment, One Civic Square, Carmel, IN 46032 is also listed as certificate holder. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. IONAL IN NAME AND ADDRESS Sheil Sexton Co, Inc. and Carmel Redevelopment 902 N Capitol Ave Indianapolis, IN 46204 MORTGAGEE LOSS PAYEE ADDITIONAL INSURED X LOAN # AUTHORIZED REPRESENTATIVE ACORD 27 (2006/07) © ACORD CORPORATION 1993 -2006. All rights reserved. The ACORD name and logo are registered marks of ACORD APPLICATION AND CERTIFICATE FOR PAYMEN1 AIA- DOCUMENT G702 /CMa CONSTRUCTION MANAGER - ADVISER EDITION Page I or 2 S� TO OWNER: Carmel Redevelopment Commissiol PROJECT: One Civic Square, Carmel, IN 46032 (Mail to Shiel Sexton) FROM CONTRACTOR: All Pro Sound 806 Beverly Parkway Pensacola, FL 32505 CONTRACT FOR: Production Sound and Co Parcel 7A, Regional Performing Carmel, IN. USA VIA ARCHITECT: CSO Architect Inc. ADDRESS: 280 East 96th St. Suite 100 Indianapolis, IN. 46240 mmuications APPLICATION NO: PERIOD TO: JOB NO: PROJECT 4: AGREEMENT CONTRACT DATE: COST CODE: 5 5/17/2010 830015 2695 2695 -6020 3/16/2009 27 41 16 Distribution to: x x OWNER MANAGER ARCHITECT CONTRACTOR CONTRACTOR'S APPLICATION FOR PAYMEN1 Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, A1A 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 G703) 5. RETAINAGE: a. 10% of Completed Work $ (Column D + E on G703) b. 10% of Stored Material $ (Column F on G703) Total Retainage (Lines 5a + 5b or $1$ 48,135.70 1,581,970.00 (51,000.00) 1,530,970.00 513,857.00 3,250.00 Total in Column I of G703) 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) 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 CONTRACTOR: State of: Ft'o.c. rJ AO- Subscribed and swo n to before me this Notary Public: MyCommissisI expires: Date: County of: I'+0—• -f I day I' t C5I� �1 E. JORDAN • •O1PRY PUB( •• 7 r ¢ • NOTARYPU LIC -STATE OF FLORIDA ,� ►,� i COMMISSION # DD705193 11 BONDED THRU 1. 888- NOTARY1 51,385.70 CERTIFICATE R PAYM 4.21. 462,471.30 311,896.8(1 150,574.50 1,068,498.70 CI -TANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Ownet $51,000.00 Total approved this Month $0.00 TOTALS $51,000.00 NET CHANGES by Change Ordei $51,000.00 • • ill In accordance with the Contract Documents, bases 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 (Attach explanation if amount certified differs from the amount applied for. Initial all figures on this Application and on the Conti ion Sheet that changed to conform to the amount certifi C STRUM ivies NAGS . BY • Date: /10 A • ( :rem. /ry By: [ ip. ". '� �---�. Date: 5.24T • ( This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to tht Contractor 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 CERTIFICATION FOR PAYMENT CONSTRUCTION MANAGER - ADVISER EDITION 1992 EDITION AIA® © 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1745 NEW YORK AVE., N , 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 2 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 NO: APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO: 5 05/17/10 05/17/10 A B C I) E F G H I ITEM NO. DESCRIPTION OF WORK 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 S 152,365.00 $ 149,325.00 $ - $ - 5 149,325.00 98.00% 5 3,040.00 $ 14,932.50 2 Fabricated Steel $ 23,250.00 5 - $ - $ - S - 0.00% $ 23,250.00 $ - 3 Racks, Cases, and Carts $ 21,420.00 $ - $ - $ 8,235.00 $ 8,235.00 38.45% $ 13,185.00 $ 823.50 4 Equipment Electronics $ 830,217.00 $ 62,352.00 $ 98,255.00 $ 24,265.00 $ 184,872.00 22.27% $ 645,345.00 $ 18,487.20 5 Equipment Hardware $ 57,011.00 $ 7,850.00 $ - $ - $ 7,850.00 13.77% 5 49,161.00 $ 785.00 6 Labor 5 341,532.00 $ 77,350.00 $ 36,550.00 $ - $ 113,900.00 33.35% $ 227,632.00 $ 11,390.00 7 Bond $ 49,675.00 5 49,675.00 $ - $ - $ 49,675.00 100.00% $ - 5 4,967.50 8 Bid Package 6020 General Allowance $ 100,000.00 $ - $ - $ - $ - 0.00% $ 100,000.00 $ - 9 Allowance No. 3 - CAD AS BUILTS $ 5,000.00 5 - 5 - $ - $ - 0.00% $ 5,000.00 $ - 10 Software Allowance $ 1,500.00 $ - $ - $ - $ - 0.00% $ 1,500.00 5 - 11 Change Order #1 $ (51,000.00) $ - $ - $ - $ - 0.00% S (51,000.00) 5 - GRAND TOTALS $ 1,530,970.00 $ 346,552.00 $ 134,805.00 $ 32,500.00 $ 513,857.00 35.18% $ 1,017,113.00 5 51,385.70 AIA DOCUMENT G7diseesrmeivelataitratanclatton ofstlaisotteatrument byanquesting of the license a completed AIA Document D401 - Certification of Document's Authenticity G703 -1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.0 20006 -5232 AUDIO • VIDEO • LIGHTING SOLUTIONS Bill Of Sale City of Carmel Redevelopment Commission Parcel 7A, Regional Performing Arts Center Carmel, IN.46032 FOR GOOD CONSIDERATION, and upon payment of One Hundred Fifty Thousand Five Hundred Seventy -Four Dollars and Fifty. Cents ($150,574.50), and to extent as billed on Pay Request #5 the undersigned, All Pro Sound Inc., 806 Beverly Parkway, Pensacola, FL. 32505 ( Seller) hereby sells and transfers to City of Carmel Redevelopment Commission( Buyer / Owner ), the following: See Breakdown Attached: Which are stored at: All Pro Sound Inc. Pre - Fabrication Building 602 West Michigan Avenue Pensacola, Florida 32505 Ph. (850)432 -5780 ext. 2075 Fax (850)432 -0844 The Seller warrants it has good title to said property, full authority to sell and transfer same, and that said property is sold free of all liens, claims and encumbrances. Signed under seal this 17th day of May, 2010 All Pro Sound, Inc. esig Signature L Chad Edwardso Signature John Fuqu Signatur Notary Public , Vice Preside CREIGHTON E. JORDAN NOTARY PUBLIC - STATE OF FLORIDA COMMISSION # DD705193 EXPIRES 9/21 /2011 BONDED THRU 1 -888-NOTARY1 DESIGN. BUILD. LD. P= - . O11 ., 806 Beverly Parkway • Pensacola, Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com AUDIO • VIDEO • LIGHTING SOLUTIONS WAIVER AND PARTIAL RELEASE OF LIEN UPON PROGRESS PAYMENT # 5 The undersigned lienor, for and in consideration of the sum of $150,574.50 hereby waives and Releases, its lien and right to claim a lien for labor, services, or materials furnished through May..17,_2010, to Shiel Sexton Co., Inc. on the job of City of Carmel Redevelopment Commission, For the following described property: City of Carmel Redevelopment Commission Parcel 7A, Regional Performing Arts Center 777 3rd Ave. SW. Carmel, IN. 46032 This waiver and release does not cover any retention of labor, services, or materials furnished after the date specified above. Dated on 17th day of May, 2010 (Signature) Printed Name and Title: Chad Edwardson / Design Sales For: All Pro Sound Inc. (Company Name) STATE OF FLORIDA COUNTY OF ESCAMBIA The foregoing instrument was acknowledged before me this' day of / 1 , 2010 By Chad Edwardson, who is personally known to me, or who has produced ��o� >J (type of identification) as identifica did not take an oath. d who (Notar Signature) CREIGHTON E. JORDAN 1�11�Ik`>fE OF FLORIDA • COMMISSION # 00705193 . * EXPIRES 9/21/2011 ''forl`-r' (� e'ri a l N u rrT THRU 1.888•NOTARY1 .DESIGN. MUD. PERFORM. 806 Beverly Parkway • Pensacola. Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com ACORD CERTIFICATE 0 F LIABILITY INSURANCE DATE(MMIDD/YYYY) ALLPR -1 02/04/10 PRODUCER Hiles- McLeod Insurance, Inc. PO Box 2747 Pensacola FL 32513 Phone:850- 432 -9912 Fax:850- 432 -3875 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED All Pro Sound, Inc. 806 Beverly Parkway Pensacola FL 32505 INSURER A Everest National Insurance Co. INSURER B: Cincinnati Insurance Company 01209 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR AUU'L INSRC TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS B X GENERAL X UABILJTY COMMERCIAL GENERAL LIABIUTY CAP5173383 09/09/08 09/09/11 EACH OCCURRENCE $1,000,000 PREMISES (Ea occurence) $100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GENL 7 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY n PRO- JECT LOC B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAA5173383 09/09/09 09/09/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ GARAGE UABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESS X X I UMBRELLA LIABILITY OCCUR CLAIMSMADE DEDUCTIBLE RETENTION $ CAP5173383 09/09/09 09/09/10 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 $ $ A WORKERS AND EMPLOYERS' ANYPROPRIETOR OFFICER/MEMBER (Mandatory If yes, describe SPECIAL COMPENSATION UABIUTY Y I N 2700003375091 03/01/09 03/01/10 WCSTAFU- OrH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1000000 IPARTNER/EXECUTIVFy EXCLUDED? EL DISEASE - EA EMPLOYEE $ 10 0 0 0 0 0 in NH) under PROVISIONS below E.L DISEASE - POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Prject: Parcel 7A Regional Performing Arts Center 777 3rd Ave SW Carmel, IN 46032 Sheil Sexton Co., Inc. is an additional insured with regards to General Liability. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009/01) ©1988 =2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION SHEILSE DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR- LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Sheil Sexton Co., Inc. 902 N Capitol REPRESENTATIVES. Indianapolis IN 46204 IN 4 I AUTHO / D `l`"REPRESENTATIVE ',f- /1 ctegoliN%1 IN--1 ACORD 25 (2009/01) ©1988 =2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC®R® EVIDENCE OF PROPERTY INSURANCE OP ID: JK DATE (MM /DD/YYYY) 02/04/2010 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE 850- 432 -9912 A/C. No, Ext): AGENCY Hiles- McLeod Insurance, Inc. PO Box 2747 Pensacola, FL 32513 Douglas V. Broxson (A/C, No):850- 432 -3875 I E-MAIL DRESS: CODE: 09010 SUB CODE: AGENCY ALLPR -1 CUSTOMER ID #: COMPANY Cincinnati Insurance Company PO Box 145496 Cincinnati, OH 45272 INSURED All Pro Sound, Inc. 806 Beverly Parkway Pensacola, FL 32505 LOAN NUMBER POLICY NUMBER CAP5173383 EFFECTIVE DATE 09/09/08 EXPIRATION DATE 09/09/11 CONTINUED UNTIL TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION /DESCRIPTION 806 Beverly Pkwy Pensacola„ FL 32505 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE Installation /Builders Risk Stored Materials 1500000 500 REMARKS (Including Special Conditions) Project: Parcel 7A Regional Performing Arts Center 777 3rd Ave SW Carmel, IN 46302 Carmel Redevelopment, One Civic Square, Carmel, IN 46032 is also listed as certificate holder. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ADDITIONAL INTEREST NAME AND ADDRESS - Sheil Sexton Co, Inc. and Carmel Redevelopment 902 N Capitol Ave Indianapolis, IN 46204 MORTGAGEE LOSS PAYEE ADDITIONAL INSURED X LOAN # AUTHORIZED REPRESENTATIVE ,e4r,-1l s 1 N---, ACORD 27 (2006/07) © ACORD CORPORATION 1993 -2006. All rights reserved. The ACORD name and logo are registered marks of ACORD