HomeMy WebLinkAboutCertified Floorcovering - $113,789.79 The National Bank of Indianapolis 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 Camel Theater Development Company,LLC as per the
Limestone Material and Fabrication installment purchase contract,the Red Clay
Tile Roofing installment purchase contract,the Carpet,Tile and Access Flooring
installment purchase contract and the Wood Flooring installment purchase
contract
Apptl n 11(Homing Roofing) April 2010 $ 63,022.50
Application 13(Horning Rooting) $229,400.00
Application 22(Bybee Stone) August 2010
Application 2(Cincinnati Floor Company) August 2010 $ 89;228.7
Application 3(Cincinnati Floor Company) September 2010 $383,103.00
Application 5(Certified Floarcovering) August 2010 $ 10.977.75
placation 6(Certified Floorcovering) September 2010 $102,812.04
Total Authorized.Disbursement M888g9 ?}, sum=, =
All terms used in these Disbursement Instructions without definition shall have the meanings ascribed
thereto in that certain Loan Agreement(Equipment and Improvements), dated February 23, 2010, by and
between The National Bank of Indianapolis and Carmel Theater Development Company, LLC.
Dated: /�/ZG/l0 CITY OF CARMEL REDEVELOPMENT
! COMMISSION
By: ►.
Les S. Olds
Printed:
Executive Director
Title:
•
Draft
Carpet and Resilient Flooring
(Certified Floorcovering)
April 2010
Paid by Carmel Theater Development Company $ 4,320.00
May 2010
Paid by Carmel Theater Development Company $ 61,153.20
June 2010
Paid by Carmel Theater Development Company $ 75,598.80
July 2010
Paid by Carmel Theater Development.Company $ 14,248.56
August 2010
Amount to be paid by Carmel Theater Development Company $ 10,977.75
September 2010
Amount to be paid by Carmel Theater Development Company. $ 102,812.04
58
APPLICATION AND.CERTIFICATE FOR PAYMENT PAGE,ONE OF
Air\DCCUNIENT G792/CMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER,
To Contr: ' Project:
-Carmel Redevelopment Commission(Owner) Application#: 5 Distribution to:
One Civic Square
Carmel,IN 46032 Application Date: ,8/13/2010 OWNER
Attn: Les'Olds.AIA,Director of Redeveloprnent CONSTRUCTIO MGR
,
ARCHITECT
From:Contractor Period,Ending: '8/31/2010
. - _
Certified Floorcovering.Services,Inc VIA Construction-Manager: Shiel Sexton Co.,Inc. CONTRACTOR _
5150...West 84th-Street
Indianapolis,IN 46268 Via-Architect: CSO,Inc.
Contract For; Contract Date#: 07/29109
Carpet&Resilient Flooring-Contract#26955130
Pencil copy to Geoff Pratt(gpratt@shielseXton.com)by 15th of the month.'Billing due 20th of the month
CONTRACTOR'SAPPLICATION FOR PAYMENT The undersigned Contractor certifies than°thetest of the Contractor's knowledge,
Application is made for paYfnenl'as,shown below In connection with the Contract information and belief the Work covered bythis,application for payment,has.been
Continuation Sheet;'NIA Document 0703 attached 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
1.original:Contract Sum S449900.00 payments receiVed from‘the Owner arkithat currenlpayment shoWn is herein now due
2.Net Change by Change Orders 2;885.00 Contractor Certified.Floorcovering'Services,Inc
.arol 7. i 'Aii e *.ek:ir.): t.
3.Contract Sum To,Date 443,785.00 A ../ J, - /
By: - ./,'..r! - ....• . - - I ' . . DATE: August-13,2010
State of:' Irisiatia County Of:. Mariop ,.710,4.40/.....
4.Total Completed&Stored to Date 184,775.90 Notary Public. Sandra kl<hox Signed ayfd (I'
ce. .
My Commission Exp 03/06/13
5.Retainage
--
a. 10.00%of Completed Work S18,477.59 ARCHITECT'S CERTIFICATION
b. 10.00%of Stored Material $000 Insccordancemith thecontract documents,based on on-site observations and the data
..
comprising this application;the Construction Manager and Architect certify..n the.Owner that
Tiatal Retalnage: 18,477.59 to the.best oftheir knowledge,infonnation end:belief the Work has progressed as indicated,the
quality of the work,ls in accordance with the Contract.Documents,and'the Contractor
6.Total Earned Less Retamage 166,298:31 is`entitled to'payment of the AMOUNT CERTIFIED:
7.S
56 -ri -
7.Less Previous Certificates for Payment 155,320.56 AMOUNT CERTIFIED. 1; I
8.Current Paymeht:Due $10,9771/5 (Attach explanation if amount certified differs'from'the amount applied for.
Initial all figures on this,application and,on Me'contis ration sheettha(are
9.Balance Due to Finish,including-Retainage $277:486169 changed,to conform to.the amount certified.)
I
Cc- STRUC .4- •,i, ER' /
Change Order-Summary Additions Deductions 5)2--7//
BY'11%•...--ka;_-.TA ... -Atf..)....... .41.'•----- Date: 49 ' . 0
4OP-.- ' 7,-•--
Total changes'spproved in
previous months by owner .2,885.00. •- ARCHITECT
_____ _ma jza
Total approved this month(August-10) - , - By. .Date: '
Totals 2.885.00 _
Net.changeby Change.Order: 2,885.00 -
This Certificate is not negotiable The amount certified is payable only to the
Contractornarned herein.Issuance,paymcnt&acceptance of payment are
without prejudice tO anY rights,of the'owneror contractor under this.contract.
appucATioN FOR:P)?sylsilpsiT-CONTINUATION,SHEET
A B C D E F G H I
.. .
(
APPLICATION AND PAGE ONE OF
AIA.D000MENTG702/CMa PARCEL.7A, REGIONAL PERFORMING ARTS CENTER
To,Contr: Project:
Carmel Redevelopment Commission(Owner) Application#: '5 Distribution to:
One Civic Square
Carmel,IN.46032 Application Date: 8/13/2010 OWNER _
Attn: Les,Olds,.AIA,Director-ot'Redevelopment CONSTRUCTIO MGR
From'Contractor: period.Ending: 8/31/2010 ARCHITECT
Certified,FloorcoveringServices;Inc VIA Construction Manager: ShieiSexton'Co:,Inc. CONTRACTOR
5150 West 84th''Street.
Indianapolis,I■=46268 Via Architect: CSO,.Inc.
Contract For: Contract Date#i 07/29/09
Carpet A'Resilient Flooring,Contract#2695-5130
ITEM SCHEDULED. PREVIOUS, COMPLETED STORED TOTAL-CP& % BALANCE TO RETAINAGE
NO. .DESCRIPTION OF'WORK. -VALUE WORK THIS PERIOD MATERIALS STORED TO DATE (G/C) 'FINISH'(C-G) 10.00%
1 BASEMENT 0.00 0.00 0:00 0.00 0.00' 0.00% 0:00 0.00.
2 Resilient Material 5,500.00 4;950.00 550.00 0.00 5,500.00 100:00% 0.00 550.00
.3 Resilient Labor 3,000:00 0.00 0.00 0.00 0:00. 0.00% 3,000:00 0.00
• 4 Carpet,Material 17,000:00 2;550.00 0.00 0.00. 2,550.00 15.00% 14,450.00 255.00
5 Carpet Labor .3,100.00' 0:00 0.00 0.00 ;0.00 0.00°°/ 3,100:00 .0.00,
6 Grout System Material '0.00 0.00 0:00 0.00. 0.00 100.00% 0:00 0.00
7 GroutSystem'Labor 0.00. 0:00 0.00 .0.00; 0.00; 100.00% 0`.00 0:00
'8 PLENUM 0.00 0:00 0.00 0.00 0.00 0.00% 0.00 0.00,
9 Resilient Material '2,400:00. . 2,160.00 240.00 0:00 2,400.00 100.00% 0.00 .240.00'
10 Resilient Labor 1,300.00 0.00 0.00 0.00 '0.00 0.00% 1;300.00 0.00'
11 Carpet Material 29,000:00 0.00 0.00 0.00. 0.00 0.00% 29;000:00 0.00
12 Carpet Labor .6,100.00 0.00 0.00 0.00 :0.00. 0.00% 6,100.00 0.00
13 Grout System Material 4,680:00, 4,212.00 468.00 0.00 .4,680.00 100.00% 0:00 468.00
14 Grout System Labor 3,600:00 3,240.00 0.00 0.00 3,240.00 90.00% 360:00 324.00
15 ORCHESTRA LOW .0.00 0.00 0.00 0.00 0':00 0.00% 0.00 0.00
16 Resilient Material 8;500.00' 7,650.00 850.00 0.00 8,500.00 100.00% 0.00 850.00
17 Resilient Labor 4,400.00 0.00 0.00 0.00' 0.00 0.00%d 4;400:00 0.00
18 Carpet Material 12,000.00 4,800.00 0.00 0.00 1,800.00: 15.00% 10,200.00 180.00
19 Carpet Labor .2,100.00 0.00 0:00 0.00 0.00 0.00% 2,100.00 0.00
20 Grout System,Material 2,600.00 2;340.00 260.00 0.00 2;600.00 100.00% 0.00 260.00;
21 Grout System Labor 2,000.00 1;800.00 0.00 0.00 1',800,00: 90.00% 200.00 180.00
22 ORCHESTRA HIGH :0.00 0:00 0:00 0.00 .0.0O 0;00% 0.00 0.00
23 Resilient Material '900.00 810.00 90.00 0.00 900.00' 100.00% 0`.00 90.00
24 Resilient Labor 400.00 0.00 0:00 0.00' 0.00' 0.00% 400.00 0.00
25. Carpet Material 36,000.00 0.00 0.00 0.00 0::00 0.00% 36000.00 .0.00
26 Carpet Labor 6:300.00 0:00 0.00 0.00. o:00, 0.00% 6:300.00 .0.00.
27' Giout.System'Material 3;510.00 3;159.00 351,00 0.00 3.510.00, 100.00% o:oo 351.00:.
28 Grout System.Labor 2,700.00 2;430:00 0.00 0.00 2,430.00; 90.00% 270.00 243.00'
29 BOX TIER 0.00 0.00 ,0.00: .0.00 0.00% 0.00 0.00:
30 Resilient Material 5;100.00 4,590.00 510.00 0.00 5,100.00' 100.00% 0:00 510.00
31' Resilient Labor 2,900:00 0:00 0.00 0.00, '0:00: .0.00% 2,900.00 0.00:
32 Carpet Material 56,000.00. 8,400:00 0.00 0.00 8;400:00 15.00% 47,600,00 840:00,
33 Carpet Labor. 10:500:00. 0.00 0.00 •0.00 0.00' 0.00% 10,500.00 0.00
34. Grout System Material 42,770.00 38,493.00 4,277.00 '0.00 42,770.00' 100.00% 0.00 ;4,277.00.
APPLICATION FOR PAYMENT-CONTINUATION SHEET
A. B' 'C' D E F G H
;ITEM SCHEDULED' PREVIOUS; COMPLETED. STORED TOTAL-CP& % BALANCE TO .RETAINAGE
APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE,OF
AIA DOCUMENT G702JCMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER
To Contra: Project:
Carmel:Redevelopment;Commission(Owner) Application#: 5': Distribution to:
One Civic Square
Carmel;IN.46032 Application;Date: 8/13/2010 OWNER _
Attn:'Les'Olds,AIA';Director.of Redevelopment! CONSTRUCTIO MGR. ._
From"Contractor Period Ending: 8/31/2010 ARCHITECT` -
,Certified,Floorcoyering Services,anc VIA Construction Manager'..Shiel Sexton Co.,Inc. CONTRACTOR;
5150 West 84th Street
Indianapolis,IN:46268 Via Architect:'CSO:Inc..
Contract For: Contract Date#: 07i29/09
Carpet&Resilient Flooring-Contract#2695-5130
NO. DESCRIPTION;OF=.WORK VALUE WORK THIS PERIOD MATERIALS STORED TO DATE (G/C) FINISH(C-G); 10%o
35 'Grout System,Labor .31,056.00 27,950.40; 0:00 0.00 27,950.40 _90:00%` 3,105.60, 2,795.04
36 BALCONY LOW
37 Resilient.Material 1,500.00 1,350:00: 150:00 0:00 1;500.00 100.00% 0.00 150.00
38 Resilient.Labor 800.00 0:00 0.00 0.00 0.00 0.00% 800.00 0:00
39 Carpet•Material 19 800.00 0:00. 0:00 0.00 0.00 000%, 19.800:00; 0:00
40 Carpet Labor. 4,600.00 0.00 0 00 0.00 0.00 0.00%. 4,000:00. 0.00
41 Grout,System_Material 7,800.00 7020.00; 780.00 0.00 7,800.00 100:00%: 0:00' 780.00
42 Grout System Labor 6,000.00 5,400:00: 0.00, 0:00 5,400.00 90.00%, 600.00 540.00
43 BALCONY.;HIGH 0.00; 0:00; 0.00 0.00 0:00% `0:00' 0.00
44 Resilient Material 1,300.00 . 1,170.00; 130:00 0:00 .1,300:00 100.00%, ;0;00. 130:00
45 Resilient Labor, 800.00 0.00, 0:00 0.00 0.00 0.00% 800.00 0.00
46 Carpet"Material 26,800.00 800;00 0.00 ,0.00 0.00 0.00 0.00%. 26,800.00 0.00
47. Carpet Labor 5,200.00 0.00 0:00- 0`.00 0.00 0.00%. 5,200.00, 0.00
48 Grout.SystemtMalerial '26,384:00 18,345.00 2,039.00 0:00 .20,384.00 100.00% 0:00, 2,038.40
49 Grout System Labor 14,100.00 12,690.00 0.00 0.00 12,690.00 90.00% 1,410`.00- 1,269:00
50 ATTIC' 0.00 0:00 0'.00 0:00 0.00% 0:00 0.00
51 Resilient,Material. 600.00 540.00 60.00 0.00 600':00 100.00% `0.00 60',00
52 Grout System Labor 400.00 0.00 0.00 0.00 0.00 0,00% 400.00 0':00
53 ALLOWANCE#5` 15,000:00 41729.00; 'o ao 0.00 4,729.00 31153% 10 271:00 472`:90
54 ALLOWANCE#6`CAD"DRAWINGS 5000:00 0.00 0:00 0:00 0.00 0:00% '5,000.00 0:00
55 BOND/SUBMITTALSICLOSEOUT" 6:000.00 •4,800:00 o:oo 0.00 4,600.00 80.00% 1,200.00: 480.00
56 CO#1'RCP PAC 006'Changes 2,885:00 0:00' 1,442:50` 0:00 1,442 50 50:00%; 1,442.50` 144.25
0.00. '0:00 0.00
TOTALS: $443,785:00 $172,578.40 $12197.50 $0.00 $184;775`90 $0.00 $259,009.10 $18,477.59
AFFIDAVIT AND WAIVER.OF.LIENS
o Final X Partial o Payment to Follow
State of Indiana,
SS
CauritY of Marion •
. .
Carol S. Milli being duly sworn states that the•is-sthe Vice President of Certified Floorcovering Services,
Incorporated having contracted with-Carmel Redevelopment Commission-to furnish certain materials and/or labor
as follows: FLOORING for a project known as Parcel 7A„Repional Performino.Arts Centerand-oWned by
Carmel Redevelopment Commission and does hereby further state on behalf of the aforementioned
SUOCOntraCtOrlaupplier:
,
(PARTIAL WAIVER)that there is due from the contractor suer'of Ten Thousand Nine Hundred Seventy Seven
and 75/100($16077.75).
Kreceipt of which is hereby acknowledged;.or
( I the payMent of which has been promised asIthe,sble.cenSideration-01 this Affidavit and Partial Waiver of
Lien which is given safely with respect to said amount and which Waitrershail be eitectiveonlyupan
receipt Of payinent thereof 14y the Undersigned;
(FINAL WAIVER)that the final balance due from the contractor is the sum of
($: )
[ tredeiptof WhiCh is hereby adknowledged; or
I the Pyrnent of which has been promised as the sole consideration of this Affidavit and Final Waiver of
Lien which shall become effective upon receipt of such payment,
THEREFORE,the undersigned waives and releases unto the Owner of said premises,any and alt lien or claim
whatsoever on the abovedescribed,,property and improvements thereon on account of LABOR or Material or
both furnished by the undersigned thereto subject to limitations or tOriditiO4 expressed herein, if any and
further certifies that no ether party has any claim or right tea lien on account of anstwork performed or material
furnished to the undersigned for said project and within the scope of this affidavit andwaiver,
Certified Floorcovering Service Incorporated By Carol S.Milli Vicerp5ident.
Signed:. a.„w.,41 •
Carol S. iCe-Pretiderit
WITNESS MY HAND AND NOTARIAL SEAL, this 13th day of, Audiist ,-20 16 ;
MyCornrriisSiOn Expires:03:.'062013 Sandra-A;f‹nox
rc"6siditig in:Niarlon County'
•
APPLICATION AND CERTIFICATE FOR PAYMENT PAGE ONE OF 158
ALA DOCUMENT G702/CMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER
To Contr: Project:
Carmel Redevelopment Commission(Owner) Application#: 6 Distribution to:
One Civic Square
Carmel,IN 46032 Application Date: 9/14/2010 OWNER _
Attn: Les Olds,AIA,Director of Redevelopment CONSTRUCTIO MGR _
From Contractor. Period Ending: 9/30/2010 ARCHITECT
Certified Floorcovering Services,Inc VIA Construction Manager. Shiel Sexton Co.,Inc. CONTRACTOR
5150 West 84th Street
Indianapolis.IN 46268 Via Architect: CSO,Inc.
Contract For: Contract Date#: 07/29/09
•
Carpet&Resilient Flooring=Contract#2695-5130
Pencil copy to Geoff Pratt(gprattlshielsexton.com)by 15th of the month. Billing due 20th of the month
One original to the project site.
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment as shown below,in connection with the Contract information and belief the Work covered by this application for payment has been
Continuation Sheet,AIA Document G703 attached. 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
1.Original Contract Sum $440,900.00 payments received from the Owner and that current payment shown is herein now due
2.Net Change by Change Orders 2,885.00 Contractor. Certified oorcovering Services,Inc
Ha I P ig9/nt.
3.Contract Sum To Date •443,785.00 By: DATE: September 14,2010
State of d' S County Of: Marion
4.Total Completed&Stored to Date 299,011.50 Notary Public: C arol A �`S.Milli' Signed:
My Commission Exp 04/17/17
5.Retainage
a. 10.00%of Completed Work $29,901.15 ARCHITECT'S CERTIFICATION
b. 10.00%of Stored Material $0.00 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
Total Retainage: 29,901.15 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
6.Total Earned Less Retainage 269,110.35 is entitled to payment of the AMOUNT CERTIFIED.
7.Less Previous Certificates for Payment 166,298.31 AMOUNT CERTIFIED )Q
t►��iZ Z.
8.Current.Payment Due 5102,812:04 (Attach explanation if amount certified differs from the amount applied for.
Initial all figures on this application and on the continuation sheet that are
9.Balance Due to Finish,Including Retainage $174,674.65 changed to conform to the amount certifi-.
NSTR •�J. N•GER A,. _
� ��
Change Order Summary Additions Deductions By:�_Q�Qi��!; Date: � .r 0
Total changes approved In
previous months by owner 2,885.00 - ARCHI �II1 I zoti aer
Total approved this month(September-10) _ - - By: 1..,£�_ Date:
Totals 2,885.00 - I
Net change by Change Order. 2,885.00.
This certificate is not negotiable The amount certified is payable only to the
Contractor named herein.Issuance,payment&acceptance of payment are
without prejudice to any rights of the owner or contractor under this contract.
APPLICATION FOR PAYMENT-CONTINUATION SHEET
A B C D E F G H I
APPLICATION'AND CERTIFICATE FOR PAYMENT PAGE ONE OF
AIA;DOCUMENT G702ICMa' PARCEL 7A, REGIONAL PERFORMINGARTS:CENTER
To.Contr Project:.
Carmel'Redevelopment•Commission(Owner) Application#: 6 Distribution,to:
One Civic Square
Carmel:IN 46032 Application Date:: 9/14/2010 OWNER
Attn::.Les'`Olds,AIA;Oirector.of:Redevelopment' CONSTRUCTIO'MGR
FromContractor: Period Ending. 9/30/2010 ARCHITECT
Certified;Floorcovering'Services,;Inc VIA Construction;Manager Shiel.Sexton Co.,Inc. CONTRACTOR _
5150 West 84th Street
Indianapolis',IN.46268 Via Architect: CSO,Inc.
Contract:For. Contract Date#: 07129/09
Carpet.&;Resilient Flooring-Contract#2695-5130 .
ITEM. SCHEDULED PREVIOUS COMPLETED STORED; TOTAL CP:& %d BALANCE TO •RETAINAGE
NO. DESCRIPTION OF WORK VALUE: WORK THIS'PERIOD MATERIALS STORED TO DATE 1G/C)' FINISH(C-G) 10:00%
1 BASEMENT 0.00 0.00 0.00 0:00` ;0.00, 0.00% ;0.00 0.00
2 'Resilient Material 5:500.00 5;500.00 0.00 0:00 5,500.00:. 100;00% 0.00 550.00
3 Resilient„Labor 3,000:00 0 00 300.00 0.00 ;300.00: 10:00% 2;700.00' 30.00
4 CarpetMatenal> 17,000:00 2,550:00 8,000.00 ,0:00 10;550.00' 62.06°/0 6,450.00 1,055:00
5 Carpet'.Labor". 3,100:00 0.00 310.00 '0:00: 310:00; 10:00% 2,790.00. =31.00
6 Grout System Material 0.00 0.00 0.00 0 0, 0.00 0:00% 0.00:. 0.00
7 Grout Systern.Labor 0:00 Q 00 0:00 0:00 0.00• '0.00% 0.00. 0.00
8; PLENUM` 0:00 0.00 0.00 0:00 o::oo 0:00% 0.00' 0.00
9 Resilient Material 2,400.00 2,400.00 0.00 0.00 2,400:00 100.00%0 0.00 240.00
10 Resilient Labor 1;300.00. 0.00 130.00 0.00 130:00 10.00% 1,170.00 13:00
11 Carpet Material 29,000.00- 0.00 0.00 0.00 '0:00 0.00% 29,000.00 0.00
12 Carp 'Labor: 6,100.00 0.00 0:00 0.00 0.00. .0.00% 6,100.00 0.00
13 Grout System,Material 4,680:00 4,680.00 0.00 0.00 4,680.00. 100.00% 0.00 468.00
14 Grout System;Labor 3,600.00 3,240.00 36.0:00 0.00 3,600.00 100.00% 0.00 360.00'
15 ORCHESTRA LOW 600' 0.00 0.00 0.00 '0.00 0.00% 0.00 0.00
16 Resilient;Material 8,500.00 8,500.00 0,00 0.00 .8,500.00 100.00% 0.00 850:00
1.7 Resilient Labor 4,400.00 0.00 440:00 0.00 440.00 10.00% 3,980:00 44:00.
18 Carpet Material 12,000.00. 1;800.00 10,200.00 0.00, 12,000.00 100.00% 0.00 1,200:00
19 Carpet Labor 2100.00 0:00 210.00 0:00 210.00 10.00% 1,890.00 21.00
20 Grout'System Material 2,600:00 2,600.00 0.00 0.00 2,600.00 100.00% 0.00 260.00
21 Grout'System'L-abor 2,000.00 1,600.00 0.00 0:00 1,800.00 90.00% 200.00 180.00
22 ORCHESTRA HIGH 0.00 0;00 0:oo 0.00 0.00 0.00% 0.00 0.00
23 Resilient Material. 900:00 900.00 0.00 0.00 900.00 100.00% 0:00 90.00:
24 Resilient Labor 400.00 0.00 0`.00 0:00 0.00 0.00% 400.00 0.00,
25 Carpet Material 36,000.00, 0.00 36,000:00 0:00 36,000:00 100:00% 0100 3,600:00;
26 Carpet Labor 6,300.00 0.00 0:00 0:00 0.00 0.00% 6;300.00 0.00
27 GroutSystem:Matenal 3,510.00;. 3;510.00 0.00 0.00 3,510.00 100.00% 0.00 ,351:00
28 Grout System Labor :2,700.00, 2,430:00 0:00 0:00 2,430.00 '90.00% 270.00 243.00;.
29 BOX,,TIER 0.00" 0.00 0.00 • 0.00 0.00% o:00 0:00'.
30 Resilient Mate'nat 5,1,00100. 5;100.00 .0:00 0:00 5,100.00 100:00% 0.00 510.00
31 Resilient Labor 2,900.00. 0:00' 290:00 0.00 290.00 10.00% 2,610.00 29.00,
32 Carpet Material 56,000.00 8 '8:106.0o 20,000.00 0100 28,400:00 50 71%• 27";600 00 2;840:00
33 Carpet Labor 10,500.00. 0001 0.00 0.00 0.00 0.00% 10;500.00 0.00
34 Grout System;Material 42,770.00 42,770.00 0.00 0.00 42,770.00 100.00% 0.00 4,277,00
APPLICATION FOR PAYMENT-:CONTINUATION SHEET
A B C D E F G H' I
ITEM SCHEDULED PREVIOUS COMPLETED STORED TOTAL:CP"& %: BALANCE:TO
RETAINAGE
APPLICATION.AND CERTIFICATE FOR PAYMENT PAGE ONE OF
AIA'DOCUMENTG702/CMa PARCEL 7A, REGIONAL PERFORMING ARTS CENTER
ToContr. =Project:
Carmel.Redevelopment Commission(Owner) Application#: 6 Distribution to
One,Civic Square
Carmel:IN'46032 Application Date: 9/14/2010 OWNER
Attn:•Les.Olds,AIA,Director of,Redevelopment CONSTRUCTIO.MGR
From'Contractor. • Period Ending: 9/30/2010 .ARCHITECT'
Certified•Floorcovering Services,Inc; VIA;Construction:Manager Shiet;Sexton Co.,Inc. CONTRACTOR
5150';West84th Street
IndianapolisIN 46268 Via Architect: CSO;Inc.
Contract For. Contract;Date#: 07/29/09
Carpet&.Resilient Flooring-Contract#2695-5130
NOT DESCRIPTION OF WORK VALUE WORK THIS PERIOD MATERIALS: STORED:TO,DATE (G/C) FINISH(C-G);. 10%
35 Grout System Labor 31,056.00 '27;950.40 3,105.60 0.00 31;056.00; 100:00% 0.00 3;105:60
36 BALCONY LOW
37 Resilient Material 1,500.00 1,500.00 0:00 0.00; 1;500:00 100.00% 0:00 150:00
.38. Resilient Labor 800.00 0.00 80.00 0.00. 80.00 10.00% 720.00; 8:00
39 Carpet.Material, 19,800.00 0.00 19,800.00 0.00 19,800:00 100.00% 0.00 1,980.00
40 Carpet.Labor. 4,000.00 0.00 0.00 0.00 0.00; 0.00% 4,000.00 0.00
41 Grout-,System Material 7;800:00 7800.00 0:00 0:00 7,800:00 100:00% 0:00 "780:00
-42 Grout,System°:Lab or 6;000:00 5;400:00 600.00 0:00 6,000,00, 100.00%a 0:00 600:00
43, BALCONY HIGH, 0.00 0:00 0:00. 0.00 0.00% 0':00 0:00
44 ResillentlMaterial 1;300.00 1',300:00 0.00 0:00 1;300.00 100.00% 0:00 130.00
45 Resilient Labor 800:00 0:00 0:00 0.00 0.00 0:00% 800.00 0:00
46 Carpet Material. 26,800.00 0.00 13;000.00 0.00 13,000.00 48:51% 13,800.00 1,300.00
47 Carpet Labor 5;200.00 .0.00 0.00 0:00 0:00 0.00% 5,200.00 0:00
48 Grout System Material. 28,384.00 20 384.00 0:00 0.00 20,384:00 100.00% 0.00 2,038:40
49 Grout System Labor '14,100.00. 12,690:00 1,410.00 0:00 14,100.00 100:00% 0:00 1,410.00
50 ATTIC 0:00 0:00 0:00 0.00 0:00% 000 0 00
51 Resilient Material 600.00 600.00 0:00 0.00 600,00 100.00% 0;00 80:00
52 Grout System Labor 400.00 0.00 0.00 0.00 0.00 0.00% 400 00 .0:00.
53 ALLOWANCE#5 15,000.00 4:729.00 0.00 0.00 4,729.00 31.53% 10,271.00 472.90.
54 ALLOWANCE#6 CAD;DRAWINGS. 5,000.00 0.00 0:00 0.00 0.00 0.00% 5:000.00' 0.00`
55 BOND/SUBMITTALS/CLOSEOUT 6,000.00 4;800.00'. 0:00 0:00 4;800:00 80:00% 1;200.00 480.00.
56 CO#1 RCP PAC 006 Changes. 2,885.00 1,442.50 0.00. boo 1,442.50 50.00% 1,442.50 144125
000 0:00• 0:00
TOTALS: .5443,785.00 5184,775.90 .51141235.60 50.00 $299,01:1.50 $0.00 $144,773.50 $29,901.15'
AFFIDAVIT AND WAIVER OF LIENS.
o Final X Partial o Payment to Follow
State of Indiana,
'SS
County of Marion
Carol S. Milli,being duly dul sworn states that she is the Vice-president of Certified Floorcovering Services,
Incorporated having contracted with Carmel Redevelopment Commission to furnish certain materials and/or labor
as follows: FLOORING; for a project known as: Parcel 7A, Realonal Performing:Arts Center and owned.by
Carmel Redevelopment Commission and does hereby further state on behalf of the aforementioned
subcontractor/supplier.
(PARTIAL WAIVER)that there is due from the contractor sum of Eighty Nine Thousand".Eloht Hundred Forty
Seven Dollars and 361100(69.84736).
[X]receipt of which is hereby acknowledged; or
[ I the"payment of which has been promised as the.sole consideration of this Affidavit and Partial Waiver of
Lien 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 contractor is the sum of
( 1 receipt of which is hereby acknowledged;or
[ j 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 such 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 or material or
both,furnished by the undersigned thereto; subject to limitations or conditions expressed herein,if-any,and
further certifies that no other party hasany claim or-:right to a lien on account of any work performed:or material
furnished to the undersigned for said project and within the scope:• this affidavit-and waiver:
Certified Floorcovering Service, Incorporated By Harry Milli, Pr '4ent
Signed: �tt
Harry Milli/. -resident
WITNESS MY HAND.AND NOTARIAL SEAL, this 29th day of September 2010
adAAL,--J. 4111,11‘)
My Commission Expires: 04-17-2017 Carol S. Milli
Residing in Boone County
AFFIDAVIT AND WAIVER OF LIENS
o Final X Partial o Payment to Follow
State of Indiana,
SS
County of Marion
Carol S. Milli,being duly sworn states that she is the°Vice-President of Certified Floorcovering Services;
incorporated having contracted with Cannel Redevelopment Commission to furnish certain materials and/or labor
as follows:FLOORING;fora project tcnown`as Parcel 7A, Regional Performing Arts Center and owned by
Carmel Redevelopment Commission and does hereby further state on behalf of the aforemenboned
subcontractor/supplier.
(PARTIAL WAIVER)that there is due from the contractor sum of Sixty Five,Thousand Four Hundred Seventy
Three Dotlarsand 20/100(65,473.20)
[X]receipt of which is hereby acknowledged;or
[ I 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 contractor is the sum of
($. )
[ ]receipt of which is hereby acknowledged; or
[ ]the Payment of which has been promised as the sole consideration of thiSAffidavit and Final Waiver of
Lien Which-shall become effective upon receipt of such 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 or material or
both,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 or material
furnished to the undersigned for said project and`within the scope of this avit and waiver.
Certified Flaordovering Service, Incorporated By Harry Milli, ° : 'dent '
Signed r`►/
9
a Mil':/Presid t
WITNESS MY HAND AND NOTARIAL SEAL,this 29th day of September ,20:10 .
ii 14161& ,
My Commission'Expires:04-17-2017 Carol S. Milli
Residing in Boone County _ .
1
F
AFFIDAVIT AND WAIVER OF LIENS
o Final X Partial a Payment to Follow
Stateol Indiana,
SS
County of Marion
Carol S. Milli, being duly sworn states that she is the Vice-President of Certified F1oorcovering Services,
Incorporated having contracted with,Carmel Redevelopment Commission to furnish certain Materials and/ortabor
as follows:FLOORING;for a project known as Parcel 7A, Regional Performing Arts Center and owned by
Carmel Redevelopment Commission and does hereby further state on behalf of the aforementioned
subcontractorisupplier:
(PARTIAL WAIVER)that there is due from the contractor sum of One Hundred and Two Thousand Eight
Hundred Twelve'Dollars and Four Cents(102,B12,04),
(XI 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 waivershail be effective only upon
receipt of payment thereof by.the'undersigned;
(FINAL WAIVER)that the final balance due from the contractor is the sure of
($_]
[ ]receipt of which is hereby acknowledged;Or
[ I.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 such payment.
THEREFORE,the undersigned waives'and releases unto the Owner of said premises,any°and all lien or,claim
whatsoever on the above-described;propeity and improvements.thereon on account of LABOR or material cr
both;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 or material
furnished to the undersigned for said project and Within the scop-o this affidavit and waiver.
Certified Floorcovering Service, Incorporated.By Harry Milli, Pr i%ant
/
Signed: hill, L h,• dui
Harry Milli 7 'resident
WITNESS MY HAND AND NOTARIAL SEAL, this 15th day of September ,20 10 .
My Commission Expires:04-17-2017 Carol S Milli
Residing"In Boone County
•