HomeMy WebLinkAboutSmock - $18,054.68Disbursements of Loan Proceeds from the Borrower Loan Account to (or for the account of) Borrower in the
amount of the "Total Authorized Disbursement" line in the "Amount of Authorized Disbursement" column (see
form of notice below) shall be made in accordance with the terms and conditions of the Agreement, the other
Loan Documents, and the Disbursement Instructions promptly upon receipt by Lender of a notice in the
following form signed by the President, Vice President, Secretary, or Executive Director of CRC:
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, LLC as
per the Hanover Square Improvements installment
purchase contract
Application 5 (Smock) September 2011
$ 18,054.68
Total Authorized Disbursement
•$ 18,054.68
';
All terms used in these Disbursement Instructions without definition shall have the meanings
ascribed thereto in that certain Loan Agreement (Hanover Square Improvements), dated
May , 2011, by and between Lender and Village Financial, LLC.
Dated: 1 °/27 //
CITY OF CARMEL REDEVELOPMENT
COMMISSION
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 satisfactory inspection by CRC of the portions of the Hanover Square
Improvements to which the disbursement relates; and (b) receipt of customary submittals.
Application 1
Application 2
Application 3
Application 4
Application 5
Hanover Square Improvements
(Smock)
April 2011
Paid by Village Financial, LLC $ 85,007.92
June 2011
Paid by Village Financial, LLC $ 91,047.83
July 2011
Paid by Village Financial, LLC $ 67,792.72
August 2011
Paid by Village Financial, LLC $ 19,481.85
September 2011
Amount to be paid by Village Financial, LLC1.$ 1,8,054.68
AIA Type Document
Application and Certification for Payment
Page 1 of 2
TO (OWNER): VILLAGE FINANCIAL LLC
770 3RD AVENUE SW
CARMEL, IN 46032
FROM (CONTRACTOR): Smock Fansler Corporation
2910 W. Minnesota Street
Indianapolis, IN 46241
CONTRACT FOR:
PROJECT: HANOVER SQ FOUNT @ CITY CTR.
770 3RD AVENUE SW
CARMEL, IN 46032
VIA (ARCHITECT):
APPLICATION NO: 5
PERIOD TO:9/30/2011
ARCHITECT'S
PROJECT NO:
CONTRACT DATE:
DISTRIBUTION
TO:
_ OWNER
_ ARCHITECT
_ CONTRACTOR
CONTRACTOR'S APPLICATION FOR PAYMENT
Application is made for Payment, as shown below, in connection with the Contract.
Continuation Sheet, AIA Type Document is attached.
1. ORIGINAL CONTRACT SUM $
2. Net Change by Change Orders $
3. CONTRACT SUM TO DATE (Line 1 + 2) $
4. TOTAL COMPLETED AND STORED TO DATE $
331,500.00
0.00
331,500.00
312,650.00
5. RETAINAGE:
a. 10,00 % of Completed Work $ 31,265.00
b. 0.00 ° of Stored Material $ 0.00
Total retainage (Line 5a + 5b) $
31, 265.00
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) $ 50,115.00
281,385.00
263,330.32
18,054.68
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved in
previous months by Owner
0.00
0.00
Total approved this Month
0.00
0.00
TOTALS
0.00
0.00
NET CHANGES by Change Order
0.00
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 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.
CONTRACTOR: Smock Fansler Corporation
2910 W. Minnesota Street Indianapolis, IN 46241
By:
T.M. FANSLER
State of: IN
County of: MORGAN
Subscribed and Sworn to before me this
/ CEO
ixd
Date:
Notary Public: %' /J
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My Commission Expires : //736k6/6
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ARCHITECTS CERTIFICATE FOR PAYMENT
In Accordance with the Contract Documents, based on on -site observations and the data com-
prising the above application, the Architect certifies to owner that to the best of the Architect's
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 $ i&0S1•64
(Attach explanation if amount cert ed differs from the amount applied. Initial all figures on this
Application and on t Sheet that are changed to conform to the amount certified.)
ARCHITECT:
By:
Date: q /Aft AI
This Certificate is : gotiable. The AMOUNT CERTIFIED is
named herein. Issuance, Payment and acceptance of pay
rights of the Owner or Contractor under this Contract.
Cm.
C7-- aiak III
ayable only to the Contractor
re without prejudice to any
AIA Type Document
Application and Certification for Payment
Page 2 of 2
TO (OWNER): VILLAGE FINANCIAL LLC
770 3RD AVENUE SW
CARMEL, IN 46032
FROM (CONTRACTOR): Smock Fansler Corporation
2910 W. Minnesota Street
Indianapolis, IN 46241
CONTRACT FOR:
PROJECT: HANOVER SQ FOUNT @ CITY CTR.
770 3RD AVENUE SW
CARMEL, IN 46032
APPLICATION NO: 5
PERIOD TO:9/30/2011
VIA (ARCHITECT): ARCHITECT'S
PROJECT NO:
CONTRACT DATE:
DISTRIBUTION
TO:
OWNER
ARCHITECT
CONTRACTOR
SCHEDULE PREVIOUS COMPLETED STORED COMPLETED
ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED ado BALANCE RETAINAGE
1 FOUNTAIN EQUIPMENT 181,785.00 181,785.00 0.00 0.00 181,785.00 100.00 0.00 18,178.50
2 PIPING /PUMP 71,215.00 67,654.25 3,560.75 0.00 71,215.00 100.00 0.00 7,121.50
INSTALLATION /ELEC
3 GARAGE IMPROVEMENTS 23,500.00 21,150.00 0.00 0.00 21,150.00 90.00 2,350.00 2,115.00
4 PAVING AND SURFACE 55,000.00 22,000.00 16,500.00 0.00 38,500.00 70.00 16,500.00 3,850.00
EQUIPMENT
REPORT TOTALS $331,500.00 $292,589.25 $20,060.75 $0.00 $312,650.00 94.31 $18,850.00 $31,265.00
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: Village Financial LLC to furnish certain labor, materials, and /or services as
follows: Misc. Construction for a project known as: SFC #11 -023 Hanover Sq. Fountain Clay
Ctr. located at Carmel, IN and does hereby state on behalf of the aforementioned contractor:
(PARTIAL WAIVER) that there is due from the owner the sum of: ($18,054.68)
Eighteen Thousand Fifty Four Dollars and 68/100
[ ] receipt of which is hereby acknowledged; or
[X] the payment of which has been promised as the sole consderation 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 sung 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 rich 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 /21*
T.M. Fansler
Title CEO
WITNESS MY HAND AND NOTARIAL SEAL, this 20"' day of September , 2011.
Melissa J. Bishdp Notary frublic
My commission expires November 30, 2016
Residing in Morgan County
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