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Gibraltar - Motor Court Exterior Wall - $4,417.50
Regions 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 Carmel Theater Development Company as per the Motor Court Exterior Wall installment purchase contract Application 4(Gibraltar) April 2012 $ 4,417.50 Total Authorized Disbursement $ 4,417.50 All terms used in these Disbursement Instructions without definition shall have the meanings ascribed thereto in that certain Loan Agreement (Equipment and Improvements), dated July 22, 2010, by and between Regions Bank and Carmel Theater Development Company, LLC. Dated: 7 !� ^� CITY OF CARMEL REDEVELOPMENT COMMISSION By: 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 a satisfactory inspection by CRC of the portions of the Equipment and/or the Improvements to which the disbursement relates; and (b) receipt of customary submittals. Motor Court Exterior Wall (Gibraltar Construction) October 2011 Application 1 Paid by Carmel Theater Development $ 39,645.00 November 2011 Application 2 Paid by Carmel Theater Development $ 99,005.00 • January 2012 Application 3 Paid by Carmel Theater Development $ 16,542.50 April 2012 Application 4 Amount to be paid by Carmel Theater Development $ 4,417.50 +�_„_. TM 3� ;f Document G732 - 2009 Application and Certificate for Payment, Construction Manager as Adviser Edition TO OWNER: Carmel Theater Development Company PROJECT: Motor Court P112 Veneer APPLICATION NO: 4 j�`" DISTRIBUTION TO: _ 11711 North Pennsylvania Street,Suite 200 ;, OWNER Carmel, IN 46032 PERIOD TO — 4/30/12 CONSTRUCTION MANAGER _ FROM Gibraltar Construction Corp VIA CONSTRUCTION CONTRACT DATE: 7/5/11 ARCHITECT _ CONTRACTOR 2932 N.Webster Ave. MANAGER: PROJECT NOS: / / CONTRACTOR Indianapolis, IN 46219 FIELD __ CONTRACT FOR: Motor Court P112 VIA ARCHITECT: Pedcor Design Group OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the Work covered • his Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,tha;l I mounts have been paid by the Contractor for Work for which previous AIA Document G703TM,Continuation Sheet,is attached. Certificates for Payment li. r• ssued and payments received from the Owner,and that current payment 1.ORIGINAL CONTRACT SUM $ 201,000.00 shown herein is now du I' 2.NET CHANGES IN THE WORK $ 0.00 CONTRACTOR: Gi 9 :r !onstruction Corp 3.CONTRACT SUM TO DATE(Line I±2) $ 201,000.00 By: /1 A Date: y�,J �� 4.TOTAL COMPLETED AND STORED TO DATE(Column G on G703) $ 173,300.00 State of 77/4 .5.RETAINAGE: County of • ' y BRIAN R. MCBRIDE a. �J" %of Completed Work Subscribed ands s /o befor `" °�4 ,, /2.,. /-4_ Res, of Hancock County (Column D+Eon G703) .' $ 13,690.00 me this , day of b. %of Stored Material Notary My Comm. EP. 11-2g-2017 (Columrr:Fou G703) $ My Commission expires %fi?�.j 7 DawA Commission # 611862 Total Retainage(Lines 50+56,or Total in Column Ion G703) $ - CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 159,610.00 In accordance with the Contract Documents,based on evaluations of the Work and the data comprising (Line 4 minus Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT 155,192.50 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in (Line 6 fr om prior Certificate) accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT 8.CURRENT PAYMENT DUE $ CERTIFIED. 4,417.50 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ 5-0 (Attach explanation if amount certified differs from the amount applied. ritual a l figures on this (Line 3 minus Line 6) $ 41,390.00 Application and on the Continuation Sheet that are changed to conform with the amount certified.) CONSTRUCTION MANAU14nature Construction LLC fl BY: Air --4"r'--.-..w Date: SAO 4)- SUMMARY OF CHANGES IN THE WORK ADDITIONS DEDUCTIONS ARCHITECT.\('V/ i ultiple Prime Contraetors are responsible for peuformating portions of the Total changes approved in previous months by Owner $ $ Project, the +r •hitect's*i t ication is not required) Total approved this month including Construction Change By ,( 1 �L Date: ✓ C w. Directives $ $ This Certifica ^i-not neb'tiablc.The AMOUNT CERTIFIED is payable my tb the Contractor named TOTALS $ $ herein! Issuan e,payment and acceptance of payment are without prejudice to any rights of the Owner NET CHANGES IN THE WORK $ or Cont . to nder 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 be obscured. AIA Document G732T"—2009(formerly G702T"CMa—1992).Copyright©1992 and 2009 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe • a 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 ntract ocu . --mail The American Institute of Architects'legal counsel,copyright @aia.org. it" 1 \�mlf�o tukt:rgAI 0 Document G732TM - 2009 Instructions Application and Certificate for Payment, Construction Manager as Adviser Edition GENERAL INFORMATION Purpose.ALA Document G732-2009,Application and Certificate for Payment,Construction Manager as Adviser Edition,is to be used in conjunction with AIA Document G703T"'-1992,Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor. Procedures for their use are covered in AlA Document A232TM-2009,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. Related Documents.AIA Document G703-1992. Use of Current Documents. Prior to using any ALA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G732-2009,but only for use in connection with a particular project.The ALA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the ALA. Rights to reproduce the document may vary for users of ALA software. Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects' legal counsel,copyright@aia.org. USING G732-2009 After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G732-2009,Application and Certificate for Payment,Construction Manager as Adviser Edition.The Contractor should sign G732,have it notarized and submit it,together with G703,to the Construction Manager and Architect.The Construction Manager and Architect should review G732 and G703 and, if they are acceptable,complete the Certificate for Payment on G732.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A232TM-2009.They should then initial all figures on G732 and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G732 and G703 should be forwarded to the Owner. . COMPLETING G703 Heading.This information should be completed to be consistent with similar information on ALA Document G732-2009,Application and Certificate for Payment,Construction Manager as Adviser Edition. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project. Multiple pages should be used when required. Column C.Should be subtotaled at the bottom when more than one page is used and totaled on the last page: Initially,this total %;• should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column.E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials ir.7,, previously stored which are not yet incorporated into the Project. Mere payment by the Owner for stored materials does not result in a 'I_t deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period)., Column C.Enter here the total of columns D, E and F.Calculate the percentage completed by dividing column G by column C. Column H. Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts Where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders and Construction Change Directives.The amount of the original contract,adjusted by Change Orders and amounts authorized for Construction Change Directives as reflected in line 2,is to be entered on line 3 of the G732 form. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AlA Document G732-2009,Application and Certificate for P.ayiment,Construction Manager as Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G732. AIA Document G732TM—2009(formerly G702TMCMa—1992).Copyright©1992 and 2009 by The American Institute of Architects.All rights reserved. WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®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 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 counsel,copyright @aia.org. CONTINUATION SHEET Page 2 of 2 • APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION NO. : 4 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where APPLICATION DATE: 4/27/2012 variable retainage for line items may apply. PERIOD TO: 4/30/2012 ARCHITECT'S PROJECT NO. : A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK SCHEDULED VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G/C) FINISH (IF VARIABLE RATE) - (D+E) DORE) (D+E+F) (C G) Base Bid 1 Allowance $25,000.00 $0.00 0% 25,000.00 2 Mobilization $8,500.00 $8,500.00 $8,500.00 100% - 3 Submittals- Base Bid $13,550.00 $13,550.00 $13,550.00 100% - 4 Earth Moving $3,000.00 $2,000.00 $2,000.00 67% 1,000.00 5 Lawns and Grasses $1,100.00 $0.00 0% 1,100.00 6 Masonry $124,500.00 $124,500.00 $124,500.00 100% - 13,690.00 7 Electrical $18,850.00 $18,850.00 $18,850.00 100% - 8 Joint Sealants/Waterproofing _ $6,500.00 $3,250.00 $2,650.00 $5,900.00 91% 600.00 $201,000.00 $168,650.00 $4,650.00 $0.00 $173,300.00 86% $27,700.00 $13,690.00 • ISA Form # 1-402 Al AFFIDAVIT AND WAIVER OF LIEN ❑ FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Motor Court P112 Veneer and owned by Carmel Theater Development Company and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of Four Thousand Four Hundred Seventeen 50/100 Dollars ($4,417.50) ❑ receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration 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 sum of Dollars () n receipt of which is hereby acknowledged; or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto the wner of said premises, any and all lien or claim whatsoever on the above-described property and improvements there iin ccount of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions - •-pr sed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work p=4 or ed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. r Gibraltar Construction Corp By :J, A Title President WITNESS MY HAND AND NOTORIAL SEAL, th'. /0' • 2012. (Notary Public) 6 1979 itt©1ANA Su9CONTRACTORS ASSOCIA71QN INCORPOR4IED Unsulnor.t. PapioduCt1Pn P,on,bitid Rev BM O •