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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 •