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HomeMy WebLinkAboutHagerman Construction - Motor Court Stairs - $19,500Exhibit 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 Hagerman Construction Appl. #1 S18,525.00 Hagerman Construction Appl. #2 (Retainage) $ 975.00 Total Authorized Disbursement $19,50.0.00 All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (PAC Fixed Seating), dated, as of August 31, 2009, by and betwee Lender and Village Financial, LLC. Dated: 2/2o f 3 CITY OF CARMEL REDEVELOPMENT COMMISSION Printed L if S. OLDS Title 114-t• pMR74"` Document G702TM -1992 Application and Certificate for Payment TO OWNER: SIGNATURE CONSTRUCTION PROJECT: 720 3rd Ave. S.W. CARMEL, iN 46032 FROM CONTRACTOR: 'Hagerman Construction Corp P.O. Box 10690 Fort Wayne, IN 46853 -0690 CCC - P112 Motor Ct. Stairs VIA ARCHITECT: APPLICATION NO: APP. 4:00001 PERIOD TO: 1 1/30/2012 CONTRACT FOR: CONTRACT DATE: PROJECT NOS: 12- 3113 -4' INVOICE NO: 85567 Distribution to: OWNER ON ARCHITECT 0 CONTRACTOR 0 FIELD is OTHER 0 CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract, Alt. Document G7031-'1, Continuation Sheet, is attached. 1. ORIGINAL CONTRACT SUM S 2, NET CHANGE BY CHANGE ORDERS S 3. CONTRACT SUM TO DATE (Line 1 ± 7) - S 4. TOTAL COMPLETED & STORED TO DATE (Column (; on (1 703) 19,,500.00 5. RETA1NAGE: a. 5 00°'x' of Completed Work (Columns D + E on 6703) - -.. _.� 975.00 b. % of Stored Material (Column F on (1703) —.----_._..__- -- -_ -- -- Total Rctainage (Lutes 5a .l, 56. or Total iti C:'calunm 1 of G703). S 975.00 6, TOTAL EARNED LESS RETAINAGE S 18,525.00 (Lute 4 minus Line 5 Total) 7, LESS PREVIOUS CERTIFICATES FOR PAYMENT (i_irre 6 kont prior Cold-Mato 8. CURRENT PAYMENT DUE 9, BALANCE TO FINISH, INCLUDING RETAINAGE (Lute 3 memo- Lour 6) 19,500.00 (LI 0. 19. SQQSItL c 0.00 F. 18,525.0(1j 925,00 5...._. 925,00 FHANGE ORDER SUMMARY ADDITIONS 1)1 i)UC r1ONS Total changes approved in previous months by (honer $ S total approved this month S IS TOTAL S IS NET CHANGES by Change Order $ The undersigned Contractor cc:rti(1es 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 paid b} the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and Mat current pavement shown herein is now due. CONTRACTOR: i agerman Construction Corp B: l State of: t Count; of: Hamilton Subscribed and sworn to before me this r Indiana ff� i...54 14's clay of 41.(ttar J tai tmber el y 1. \4y commission expires: Pry 10/16/2019 Date: 11.:1 SEAL ARCHITECT'S CERTIFICATE FOR PAYMENT (-/E3 In accordance with the Contract Documents, based on on -site obscrv'a "I'•s1 '1'the c4a ti'. • sin this application, the Architect certifies to the Owner that to the best of .. ' 0 l ..l ledge, infisrmation and belief the Work has progressed as indicated. the cluaht, W° 1ork is in accordance with the Contract Documents. and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED 5 18,525.00 (Attach elp/ctna(uu7 if-amount certified (hfferti lirotx the amount applied. Initial tell figure8 un thtr .•11 ?pl)Catton and on the ( 07J..LI(7/1/0rr ,- -1Ce't that are cltctn,(0ot to c :oohtrnr with the amount certified) ARCHITECT: By: 2 Date: 1L- This ( ert.iticatt''.l not. )eg tiable. The ANIO1JNT CERTIFIED is payable only to ih Contractor named herein. issf311ce, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not he obscuret?. AIA Document G702'" - 1992, Copyright © 1953, 1963, 1965. 1971, 1978, 1983 and 1992 by The American institute of Architects. All rights reserved. WARNING: This AIA'` Document is protected by 11.5. Copyright taw and international Treaties. Unauthorized reproduction or distribution of this AtA' 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 taw. Purchasers are permitted to reproduce ten (10) copies of this document when compiotee To report copyright violations of ,AIA Contract Documents, e -mail The American Institute of Architects' legal counsel, copyright 4 aia.org. 0 Document G703TM - 1992 Continuation Sheet AlA Document: (i702TM- -1992, Application and Certificate for Payment, or 0732T/0-2009, Application and Certificate for Payment, Construction Manager as Adviser Edition, containing Contractor's signed certification is attached. [it tabulations below, amounts are in US dollars. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION NO: APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO: �„ 11/29/2012 €1 /30/2012 ITEM NO, II--i- ?'€UU_..`D-o'fii6t I l E � SCHEDULED VA[ -lit: .�`.— "t9�00:Od__._.,_---- T 1 MATERIALS PR1itiENTLV i srr)Rr[> (ko!in/)rrrEl - - - - _ j TOTAL Ct)�WIITEDAND sruRh[?Tt- r[).�Tt, (1) +'1;,lt -- 19,68:06- c,;, r, C.:/ = _, BA1.AN(. 1'iN'1, a.' ._�- ...__... DESCRIPTION OF WORK WORK CONI Pl. ETE1) l FROM 1 AMILK:ATtoN 1 tlr41f) I - -_.�_ { E � � l THISl'ERIOD — �I9;58Cr.08 -- 1 3 I i 1 I 1 !j I f tCO>i, Concrete, Flame; D--- � r�96�.44- ! Totals GRAND TOTAL 19,500.00 ---- i 19,500 -00 i 1 19,500,00 100.00 1 lf? RETAIN Ac;E fi r j /t:ru-tvl?le role! x.00 — 975.00 CAUTION: You should sign an original AIA Contract Document. on which this teat appears in RED. An original assures that changes will not he obscured AIA Document G703" – 1992. Copyright (?) 1963, 1965, 1966, 1967. 1970, 1978, 1983 and 1992 by The Amerio n Institute of Architects. All rights reserved_ WARNING: This AIA' Document is protected by 1).S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this A1A''Docurrtent• er arty portion of it, may result ut severe ctvit 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 counsei, copyn0ht @aia.org o:;•;.orti Document G702TM - 1992 Application and Certificate for Payment TO OWNER: SIGNATURE CONSTRUCTION 720 3rd Ave. S.W. CARMEL, IN 46032 FROM CONTRACTOR: Hagerman Construction Corp P.O. Box 10690 Fort Wayne, IN 46853 -0690 PROJECT: CCC - P112 Motor Ct. Stairs VIA ARCHITECT: APPLICATION NO: APP. #:00002 PERIOD TO: 11/30/2012 CONTRACT FOR: CONTRACT DATE: PROJECT NOS; 12- 3113 -4;' INVOICE NO: 85568 Distribution to; OWNER Glx ARCHITECT 0 CONTRACTOR 0 FIELD Cl OTHER 0 CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. AIA Document Gr703T", Continuation Sheet, is attached. 1. ORIGINAL CONTRACT SUM S 19,500.00 2. NET CHANGE BY CHANGE ORDERS 0.00 3. CONTRACT SUM TO DATE (Line. I A. 2) 1 ,5.0.0 QfL 4, TOTAL COMPLETED & STORED TO DATE (Column G ou G703) •`h 19,500.00 5. RETAINAGE: a. % of-Completed Work (C ohunns D l F, on G703) b, 'Co of Stored Material i(ottony F on G703) Total Retainage. (Lines 5a 4 56, or Total in Column 1 of G703)....,, s 0.00 6. TOTAL EARNED LESS RETAINAGE S (Line 4 minus Line 5 Twat) 7, LESS PREVIOUS CERTIFICATES FOR PAYMENT $ (Lune 6,Ihnn prior Ce'rnlicatc/ 8. CURRENT PAYMENT DUE 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Lane 3 minus Line 6) 18,525.00 I S 975.00 j ORDER SUMMARY ADDITIONS i DE.DUCI•IONS i IICI-IANCiE dotal changes approved in previous months by Owner Total approved iht5 month �--�,,_. � -- -.._•. `S {.._ ...--- - --- -- .- - --J ---- _._.____...-•-- - -._ -1 TOTAL $ IS NET CHANGES by Change Order S 1 The undersigned Contractor certifies that to the hest of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed to accordance with the Contract DOcume.nts, 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 Mat current payment shown herein is now due. CONTRACTOR; Hagerman Construction Corp.. 1;— B}: State of: County ()l': Indiana Hamilton Subscribed and sworn to before( ole this iitttttr ' t'trhit ICijilberley J. Spry ivly commission exptres: 10/16/2019 Date: day cif )+: (;) rh —.1 ARCHITECT'S CERTIFICATE FOR PAYMENT !1A A.0"..Erp_x\ SEAL In accordance with the Contract Documents. based on on -site observant this application. the Architect certifies to the Owner that to the hest of the ,nfot'niation and belief the Work has progressed as indicated. the duality R accordance with the Contract Documents, and the Contractor is entitled to AMOUNT CERTIFIED, 3 t t" .'tng t�Z PSI I .,�;r' e(tge. irk is in payment of the AMOUNT CERTIFIED S 975.00 (Attach evio cation 1/ amount cfftlfied di/7iws from the 0020xu(1 applied. mina) all figures on this ;lppliedlion and on the: nation .Sheer that are changed 0) conform with the amnion certified.) ARCHITECT: By: 1N f'hi5 Certificate ds not n. >otiable. -The AMOUNT C;F.R'f 11 lEU is payable only to The Contractor named herein. c , payment and acceptance of payment arc w,vtthout prejudice to any rights of the Owner or Contractor under this Contract. Date: CAUTION: You should sign an original AIA Contract Document, on which this text appears lt1 RED, An original assures that changes will not be obscurers. AIA Do. ocument G7021" - 1992. Copyright ce: 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects, All rights reserved. WARNING, This A1A'' Document la protected by U.S. Copyright Law and international Treaties. Unauthorized reproduction or distribution of this .A3A' Document, or any portion of it, may result in severe civic and criminal penalties, and will he prosecuted to the maximum extent possible under the levy. Purchasers are permitted to reproduce ton (101 copies of this document when completed. To report copyright violations of AIA Contract Documents, e•m0ii The American institute of Architects' legal counsel, copyright(caia.or9 IA Document G703" _ 1992 Continuation Sheet AL\ Document G7021m 1992, Application and Certificate for Payment, or G732rm -. 2009, Applic Mon and Ccrtiticate,for Payment, Construction Matta:el- as !Adviser Edition. coattail ing Contractor's signed certification is attached. In tabulations below, amounts are in US dollars. Use Column 1 on Contracts where variable retainage for line items may apply. —-- _— C A I3 c I ! r 1 I'I"EM ; NO. DESCRIPTION OF WORK APPLICATION NO: APP. #:00002 APPLICATION DATE: 11/29/2012 PERIOD TO: 11/30/2012 ARCHITECT'S PROJECT NO: SC'iiEDUL. &.0 VALUE LVORK COMPLETED r-- FROM PREVIOUS APPL.IC:ATi.ON (1) 7 G) rHIS PERIOD mATti9IA L$ PRESENTLY STOR (No/ ix t.) nr Tl TO'I'rA I. COMPLETED AND S'FOR11)1'r?i)A'TE j iG F.) ISALANCP. TO FiNI101 (C (0 RE7 AINACE 1; n,.irtrllie 1(21(1 CAUTION: 'You should sign an original ALA Contract Document, on which this text appears in RED, An original assures that changes will not be obsctt -ed. MA Document G703Tt' – 1992, Copyright Cs) 1963. 1965, 1966, 1967, 1970. 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AiA" Document is protected by U.B. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Ale Document, or any portion of 0, may result in severe civil and criminal penalties. and will Ue prosecuted to the maximum extent possible Under the taw. 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. emolittononcFete, came, u - - T9 50U.U0 19:507-00---1.— ' l 19,500100- 100170— 1- I I i 1 I t { I 1 i 1 I cIR ANh) TOTAL_ otals 19,500.00 19,500.00 � I i 19,500.00 100.00 1 CAUTION: 'You should sign an original ALA Contract Document, on which this text appears in RED, An original assures that changes will not be obsctt -ed. MA Document G703Tt' – 1992, Copyright Cs) 1963. 1965, 1966, 1967, 1970. 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. WARNING: This AiA" Document is protected by U.B. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this Ale Document, or any portion of 0, may result in severe civil and criminal penalties. and will Ue prosecuted to the maximum extent possible Under the taw. 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. December 12, 2012 Signature Construction 720 3rd Avenue SW Carmel, IN 46032 Fishers, IN 46038 ATTN: Jason Springer RE: PI 12 Motor Court Stair HCC Project No.:123113A extra - 03 Hagerman Construction Corporation Warranty To Whom It May Concern, Hagerman Construction Corporation does hereby guarantee all work performed under the scope of our Contract for a period done [1] year beginning at the Substantial Completion date. For claims call: Greg Delagrange Hagerman Construction Corporation 10315 Allisonville Road Fishers, IN 46038 -2017 Phone: 317-577-6836 If you have any questions regarding this warranty, please feel free to contact our office. Sincerely, HAGERMAN CONSTRUCTION CORPORATION Greg Delagrange Project Manager Hagerman Construction Corporation 10315 Airisonvilie Rd- = ss■er,, !N 4603H -2017 ph. 1317) 577 -6836 ix: [3171577-6841 www thehagerrnar•yro.irr.c.:rn