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HomeMy WebLinkAboutAll Pro Sound - $143,421.33Exhibit 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 Amounts to be paid by Village Financial as per the PAC Sound Equipment installment purchase contract Application 6 (All Pro Sound) June 2010 $ 59,628.63 Application 7 (All Pro Sound) July 2010 $ 83,792.70 Total Authorized Disbursement $ 143,421.33 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: /o /2 O CITY OF CARMEL REDEVELOPMENT COMMI N 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 Paid by Village Financial $ 21,172.50 May 2010 Paid by Village Financial $ 150,574.50 June 2010 Amount to be paid by Village Financial $ 59,628.63 July 2010 Amount to be paid by Village Financial ' $ 83;792.70 APPLICATION AND CERTIFICATE FOR PAYMEN1 AIA DOCUMENT G702 /CMa CONSTRUCTION MANAGER - ADVISER EDITION Page 1 or 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 # CONTRACT DATE: COST CODE: 6 6/16/2010 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 $ 54,770.70 (Column D + E on G703) b. 10% of Stored Material $ 3,240.40 (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column I 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 $ 1,581,970.00 (51,000.00) 1,530,970.00 580,111.03 58,011.10 522,099.93 462,471.30 59,628.63 1,008,870.07 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $51,000.00 Total approved this Month $0.00 TOTALS $51,000.00 NET CHANGES by Change Order $51,000.00 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: Date: 0 State of: r-1 002..; County of: Q'W- d4• -`660-- Subscribed and sworn to before me this (,t.e day of � .e X01 .o Notary Public: 1 My Commission expi 6-6 a/o �p,AY Pr%Ba� CREIGHTON E. JORDAN "r° t.\ NOTARY PUBLIC - STATE OFFLORIDA COMMIERIOPN* DD7051 93 CERTIFICATE FOR PAYMEN EXPIRES 9/21/2011 :eo \. . In accordance with the Contract Documents, based on on-sitett,strvations t Dd u 1888 NOTARYI 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 $ S %, 0 2 8 3 (Attach explanation if amount certified differs from e amo nt applied for. Initial all figures on this A. lication and on the C.' -tinuatii Sheet at changed to conform to the amount certified CO .iTRUT I1f .;``:� i ER: By ∎.i,7� :. %// .I, Date: 74 AR 'EC : 7 By: Date: 0(01 TO IC )O This Certificat• . negotiable. T e AMOUNT CERTIFIED is payable only to the Contractor n. • s erein. Issuance, payment and acceptance of payment are without prejudice to s . 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. APPLICA'T'ION NO: APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO: 6 06/16/10 06/16/10 A B C D E F G H 1 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 $ 152,365.00 $ 149,325.00 $ - $ - $ 149,325.00 98.00% $ 3,040.00 $ 14,932.50 2 Fabricated Steel $ 23,250.00 $ - $ 4,750.00 $ - $ 4,750.00 20.43% $ 18,500.00 $ 475.00 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 $ 184,872.00 $ - $ 32,404.03 $ 217,276.03 26.17% $ 612,940.97 5 21,727.60 5 Equipment Hardware $ 57,011.00 $ 7,850.00 $ - $ - $ 7,850.00 13.77% $ 49,161.00 $ 785.00 6 Labor $ 341,532.00 $ 113,900.00 $ 29,100.00 $ - $ 143,000.00 41.87% $ 198,532.00 $ 14,300.00 7 Bond $ 49,675.00 $ 49,675.00 $ - $ - $ 49,675.00 100.00% $ - $ 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 $ - $ - $ - $ - 0.00% $ 5,000.00 $ - 10 Software Allowance $ 1,500.00 $ - $ - $ - $ - 0.00% $ 1,500.00 $ - 11 Change Order #1 $ (51,000.00) $ - $ - $ - $ - 0.00% $ (51,000.00) $ - GRAND TOTALS $ 1,530,970.00 $ 513,857.00 $ 33,850.00 $ 32,404.03 $ 580,111.03 37.89% $ 950,858.97 $ 58,011.10 AIA DOCUMENT G7cUseesinnwatrtairEvandatton of tbisotttirtument by questing of the license a completed AIA Document 0401 - Certification of Document's Authenticity THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N W., WASHINGTON, D 20006 -5232 G703 -1992 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 Fifty -Nine Thousand Six Hundred Twenty -Eight Dollars and Sixty -Three Cents ($59,628.63), and to extent as billed on Pay Request #6 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 16th day of June, 2010 All Pro Sound, Inc. Signature Chad Edwardson, Design Sles Signature John Fug Signa Notary Public CREIGHiTON E. JORDAN NOTARY PUBLIC - STATE OF FLORIDA COMMISSION # DD705193 EXPIRES 9/21/2011 BONDED THRU 1- 888- NOTARYI DESIGN. IGN. D a PERFORM. L . 806 Beverly Parkway • Pensacola, Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com ar 1 AUDIO • VIDEO • LIGHTING SOLUTIONS WAIVER AND PARTIAL RELEASE OF LIEN UPON PROGRESS PAYMENT # 6 The undersigned lienor, for and in consideration of the sum of $59,628.63 hereby waives and Releases, its lien and right to claim a lien for labor, services, or materials furnished through June 16, 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 16`h day of June, 2010 For: All Pro Sound Inc. (Company Name) STATE OF FLORIDA COUNTY OF ESCAMBIA /ay The foregoing instrument was acknowldged before me this of dam- , 2010 By Chad Edwardson, who is personally known to me, or who has pro (type of identification) as id- tificatio and who did not take an oath. f1 otary Signatur f1 ►) CREi HT•/ E. JORDAN -V: NOTARY PUBLIC- STATE OF FLORIDA Piinte 193 $ ;,14.,' 9`• EXPIRES 9/21/2 11 4:2LIN$' BONDED THRU1.888- NOTARYI (Serial Number) . SIGN. BUM. . PE 'O` . 806 Beverly Parkway • Pensacola, Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com 4:c Rb CERTIFICATE OF LIABILITY INSURANCE OP ID TM DATE (MM /DD/YYYY} 06/03/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hiles- McLeod Insurance Inc. PO Box 2747 Pensacola FL 32513 Phone:850 -432 -9912 Fax:850- 432 -3875 LUIV 1 AL. I NAME: PHONE FAX (A/c, No, Ext): (A/C, No): E-MAIL ADDRESS: CUSTO ,ER CUSTOMER ID*: ALLPR-1 INSURER(S) AFFORDING COVERAGE NAIC * INSURED All Pro Sound, Inc. 806 Beverly Parkway Pensacola FL 32505 INSURER A Everest national Insurance Co. X INSURER B : Cincinnati Insurance company 01209 INSURER C : 09/09/11 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS watt LTR TYPE OF INSURANCE ADDL 1NSR SUER WVD POLICY NUMBER PVLILY EI-r (MM /DD/YYYY) POLILY ExP (MM /DD/YYYY) LIMITS B GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR X CAP5173383 09/09/08 09/09/11 EACH OCCURRENCE $ 1,000,000 UAMAI�t IU RENItU PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER 7 POLICY X JECT PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00o $ B B B AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAA517 3383 CAA5173383 CAA5173383 09/09/09 09/09/09 09/09/09 09/09/10 09/09/10 09/09/10 COMBINED SINGLE LIMIT (Ea accldent) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CAP5173383 09/09/09 09/09/10 EACH OCCURRENCE $ 5,000,000 AGGREGATE $5,000,000 X DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDEDT (Mandatory in NH) If yes. descnbe under DESCRIPTION OF OPERATIONS below J / A 2700003375101 03/01/10 03/01/11 X WCSIATU- OM- TORY LIMITS ER E.L EACH ACCIDENT $ 1000000 E L DISEASE - EA EMPLOYEE $ 1000000 E.L DISEASE - POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 0 more space is required) Project: 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, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,,e% .Tif / q s1 1. J ACORD 25 (2009/09) ©1988 =2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AWR® 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. AGENCY PHONE 850- 432 -9912 A/C, No, Extl: Hiles- McLeod Insurance, Inc. PO Box 2747 Pensacola, FL 32513 Douglas V. Broxson FAX 850 - 432 -3875 (A/C, No): E -MAIL 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 / 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. NAME AND ADDRESS Sheil Sexton Co, Inc. and Carmel Redevelopment 902 N Capitol Ave Indianapolis, IN 46204 MORTGAGEE _ LOSS PAYEE X ADDITIONAL INSURED LOAN # AUTHORIZED REPRESENTATIVE 5.62.ea7r7[si wi 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 TO OWNER: Carmel Redevelopment CommissioiPROJECT: One Civic Square, Carmel, IN 46032 (Mail to Shiel Sexton) FROM CONTRACTOR: All Pro Sound VIA ARCHITECT: CSO Architect Inc. 806 Beverly Parkway ADDRESS: 280 East 96th St. Suite 100 Pensacola, FL 32505 Indianapolis, IN. 46240 CONTRACT FOR: Production Sound and Co mmuications CONSTRUCTION MANAGER - ADVISER EDITION Parcel 7A, Regional Performing Carmel, IN. USA APPLICATION NO: PERIOD TO: JOB NO: PROJECT #: AGREEMENT # CONTRACT DATE: COST CODE: Page 7 7/19/2010 830015 2695 2695 -6020 3/16/2009 27 41 16 1 of 2 Distribution to: OWNER MANAGER ARCHITECT CONTRACTOR x x x 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. L 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 $ 63,896.50 (Column D + E on G703) b. 10% of Stored Material $ 3,424.90 (Column F on G703) Total Retainage (Lines 5a + 5b or Total in Column I 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 $ 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 1,581,970.00 (51,000.00) CONTRACTOR: 1,530,970.00 673,214.03 By: Date: 07 State of: r �o rJ� County of: �''9�a --4: A-- Subscribed and savor to before me this day of -6,.,.,�� ao / -tom Notary Public: CREIGIfroN E. JORDAN My Commission xpires: Ar ".8.•. .( Jed TT :/ TAR1' PUBLIC -STATE OF FLORIDA 1' .� =``�( 1 CMvii,IISSIUN#uU /05193 $ 67,321.40 CERTIFICATE F'�R PAYM aura �• . +' e` °.' EXPIRES 9/21/2011 $ 605,892.63 In accordance with the Contract Documents, ba d on.tir. rt6 observl�y ,tlie comprising this application, the Construction Manager and Architect cer r to c1 OTARYI Owner that to the best of their knowledge, information and belief the Work has $ 522,099.93 progressed as indicated, the quality of the Work is in accordance with the Contract $ 83,792.70 Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED 925,077.37 ei `.impel 2� GT CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $51,000.00 Total approved this Month $0.00 TOTALS $51,000.0(1 NET CHANGES by Change Order $51,000.00 AMOUNT CERTIFIED (Attach explanation if amount certified diffe figures on this Application and on the Co amount certified.) CO TRUC \0 By: 1=111 R By: ,1 i/ - _ Date: A om the amount applied for. Initial all ion Sheet that changed to conform to the Date: 07 10 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable o ly to th Contractor named herein. Issuance, payment and acceptance of payment are withoui 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 NO: APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO: 7 07/19/10 07/19/10 A B C D E F G H f 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 $ 152,365.00 $ 149,325.00 $ - $ - $ 149,325.00 98.00% $ 3,040.00 $ 14,932.50 2 Fabricated Steel $ 23,250.00 $ 4,750.00 5 2,357.00 $ - $ 7,107.00 30.57% $ 16,143.00 $ 710.70 3 Racks, Cases, and Carts 5 21,420.00 $ 8,235.00 5 - 5 7,425.00 $ 15,660.00 73.11% $ 5,760.00 $ 1,566.00 4 Equipment Electronics $ 830,217.00 $ 217,276.03 $ 21,127.00 $ 22,596.00 5 260,999.03 31.44% $ 569,217.97 $ 26,099.90 5 Equipment Hardware $ 57,011.00 $ 7,850.00 $ 4,095.00 5 4,228.00 $ 16,173.00 28.37% $ 40,838.00 $ 1,617.30 6 Labor $ 341,532.00 $ 143,000.00 $ 31,275.00 $ - 5 174,275.00 51.03% $ 167,257.00 $ 17,427.50 7 Bond $ 49,675.00 $ 49,675.00 5 - $ - $ 49,675.00 100.00% $ - $ 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 - $ - 0.00% 5 5,000.00 $ - 10 Software Allowance $ 1,500.00 $ - $ - $ - $ - 0.00% 5 1,500.00 $ - 11 Change Order #1 $ (51,000.00) $ - $ - $ - $ - 0.00% 5 (51,000.00) $ - GRAND TOTALS $ 1,530,970.00 $ 580,111.03 $ 58,854.00 $ 34,249.00 $ 673,214.03 37.89% $ 857,755.97 $ 67,321.40 AIA DocuMENT G7cUseeslmafKtalttEealtdet1on ofsdaisoda, rumet byasiquesting 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.C. 20006 -5232 G703 -1992 NI) 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 Eighty -Three Thousand Seven Hundred Ninety -Two Dollars and Seventy Cents ($83,792.70), and to extent as billed on Pay Request #7 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 19th day of July, 2010 All Pro Sound, I Signatur Chad E Signature John Fuqu wardson, esign Sales Signatur Notary CREIGHTON E. JORDAN NOTARY PUBLIC . STATE OF FLORIDA COMMISSION* D0705193 EXPIRES 9/21/2011 BONDED THRU 1- 888.NOTARy1 DESIGN. BUILD. PE O . 806 Beverly Parkway • Pensacola, Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com y, ryl jJ, AUDIO • VIDEO • LIGHTING SOLUTIONS WAIVER AND PARTIAL RELEASE OF LIEN UPON PROGRESS PAYMENT # 7 The undersigned lienor, for and in consideration of the sum of $83,792.70 hereby waives and Releases, its lien and right to claim a lien for labor, services, or materials furnished through July 19, 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 ed on 19th day of July, 2010 For: All Pro Sound Inc. (Company Name) STATE OF FLORIDA COUNTY OF ESCAMBIA The foregoing instrument was acknowledged before me this rl day of By Chad Edwardson, who is personally known to me, or who has produced ll(type of identification) as identification i d who did not take an oath. Q tary Signature) %P ..a.... CREIGHTON ON • JORDAN •o-- PB� OF FI ORIDA :;,p ,%. NOTARY fUBLIC STATEO need Utittilililiggagni0705193 ° EXPIRES 9/21 /2011 BONDED THRU 1488- NOTARYI , 2010 (Serial Number) DESIGN. BUILD. PERFORM. ,f = 806 Beverly Parkway • Pensacola, Florida 32505 • Phone 850.432.5780 • Fax 850.469.9780 • www.allprosound.com Rt'® CERTIFICATE OF LIABILITY INSURANCE OP ID TM DATE (MM03 /10 06/03/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hiles- McLeod Insurance, Inc. PO Box 2747 Pensacola FL 32513 Phone:850- 432 -9912 Fax:850- 432 -3875 Lvim IAL I NAME: • PHONE • FAX (A/C, No, Ext): (A/C, No): b -MAIL ADDRESS: PRUUULVH CUSTOMER ID #: ALLPR-1 INSURER(S) 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 : EACH OCCURRENCE INSURER 0 : PREMISES (Ea occurrence) INSURER E : INSURER F : X OCCUR CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS 1N5t( LTR TYPE OF INSURANCE A•DL INSR SUBR WVD POLICY NUMBER ruLiCY t:rr f MM /DD /YYYY ) POLICY Exr (MM /DD/YYW) LIMITS B GENERAL GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X CAP517 338 3 09/09/08 09/09/11 EACH OCCURRENCE $ 1 , 0 00 , 0 0 0 PREMISES (Ea occurrence) $ 100 , 000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5 , 0 0 0 GEN'L PERSONAL. &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 AGGREGATE LIMIT APPLIES PER' PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X jEa LOC $ B B B AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAA.5173383 CAA5173383 CAA5173383 09/09/09 09/09/09 09/09/09 09/09/10 09/09/10 09/09/10 COMBINED SINGLE LIMIT accident) $1,000,000 BODILY BODIld INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B ^J UMBRELLALIAB EXCESS LIAB X .^ OCCUR CLAIMS -MADE CAP5173383 00/09/09 09/09/10 EACH OCCURRENCE $S,000,000 AGGREGATE $ 5, 000 , 000 X DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 2700003375101 03/01/10 03/01/11 X WLSIAIU- OIH- TORY LIMITS ER E L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 10 0 0 0 0 0 E.L. DISEASE - POLICY LIMIT $ 10 0 0 0 0 0 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, f more space Is required) Project: 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. DER CANCELLATION SHEILSE Sheil Sexton Co., Inc. 902 N Capitol Ave. Indianapolis IN 46204 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPO V TION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD 4WRL EVIDENCE OF PROPERTY INSURANCE OP ID: JK DATE (MM /Db /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, Extl: AGENCY Hiles- McLeod Insurance, Inc. PO Box 2747 Pensacola, FL 32513 Douglas V. Broxson FAx IA/C, N.)850-432-3875 E -MAIL 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 INFORMATION 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 f--s ' J © ACORD CORPORATION 1993 -2006. All rights reserved. The ACORD name and logo are registered marks of ACORD