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HomeMy WebLinkAboutPURDY MASONRY, INC -001939 -5/31/2011 Transmittal Sheet Page 1 Carmel Redevelopment Comm Purdy Masonry, Inc. Check: 1939 7601 Indianapolis Road Date: 5/31/2011 Zionsville, IN 46077 Vendor: PURDYM1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2 32 41,600.00 1,244.50 0.00 0.00 1,244.50 Application 2 3 32 94,313.33 9,431.33 0.00 0.00 9,431.32 Application 3 4 32 172,644.44 17,264.44 0.00 0.00 17,26441 Application 4 5 32 58,588.89 5,858.89 0.00 0.00 5,858.89 Application 5 6 32 27,432.22 2,743.22 0.00 0.00 2,743.22 Application 6 7 32 118,846.10 11,884.61 0.00 0.00 11,884.61 Application 7 8. 32 240,730.01 24,073.00 0.00 0.00 24,073.00 Application 8 11-1cr 32 -12,931.24 -12,931.24 0.00 0.00 -12,931.24 Adjust to balance 12 32 67,881.25 12,931.25 0.00 0.00 12,931.25 Application 12 15 32 12,940.60 12,940.60 0.00 0.00 12,940.60 App 15 on P7A 822,045.60 85,440.60 0.00 0.00 85,440.60 1 * AIADocument G7021CMa" — 1992 32 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWN ),OF CARMEL BY AND THROUGH PROJECT: varcei to-Keg. veg.Arts untr APPLICATION NO. 13 4/30/2011 Distribution to: IT'S REDEVELOPMENT COMMISSION CARMEL, IN PERIOD TO: OWNER ❑ CONSTRUCTION MANAGER El 1/8/2008 FROM CONTRACTOR)Masonry, Inc. VIA CONSTRUCT O�N�MANAGER: CONTRACT DATE: ARCHITECT ❑ 7601 Indianapolis Road b-IIEL SEX I ON COMPANY 2695 Zionsville, IN 46077 PROJECT NOS: / I CONTRACTOR ❑ VIA ARCHITECT:CSO ARCHITECTS FIELD ❑ #3020 EXT.CMU CONTRACT FOR: ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. 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 Continuation Sheet,AIA Document G703,is attached. 1,450,000.00 Certificates for Payment were issued an payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 17,940.60 payment shown hi t; '., . .r4 t einc. 2.Net change by Change Orders $ CONTRACTOR: 1,467,040.60 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 1,462,940.60 By: ■ ` Date: _ �( ' l 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ State of: BOONE 5.RETAII9ItAGE: County of: Stefanie Purdy a. %of Completed Work �('!�(� ("� Subscribed and sworn to before Notary Public Seal State of Indiana• -Wobtmn D+Eon 0703) $ ID I r im.n me this �4 day of I % 1 • Hendricks ounty My Commission Expires 06/29/2017 • b. %of Stored Material Notary Public: � 1s'" • (Column F on G703) $ My Commission ex I''.- . II Total Retainage(Lines 5a+5b or Total in Column I of G703). $ 70,5 .CO CERTIFICATE FOR PAYMENT �(} + ' /� In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 11 C�1 titio this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) y knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ � / ` accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) I CERTIFIED. 8.CURRENT PAYMENT DUE $ laIq yt) ,19..J I AMOUNT CERTIFIED $ 12,E 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differ. m the amount applied.Initial all figures on this ����QQ Application and the Continuation heet t ,re changed to conform with the mount certified.) (Line 3 less Line 6) $�'1 5 .O0 CO RUCTI•�'�NA I B � ,�/emu :/�# Date: ®� 2°7 Y� �t CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS AR ' TE J 17 17,940.00 0.00 {f � , Total changes approved.in previous months by Owner $ 0.00 $ 0.00 BY: ■-4 l,, „ Date: 124S11 1 it Total approved this Month $ 17 A4n Rn $ 0 00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor • TOTALS $ $ named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of 17,940.60 the Owner or Contractor under this Contract. NET CHANGES by Change Order $ Director of Redevelooment lyq(ooSo7 . 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 G702/CMaTM-1992.Copyright ©1992 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. JATA® ! Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, 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,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.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 G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA 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. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&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 to the Architect 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 previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a 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 G: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:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-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 G702/CMa. AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA® 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. ` --- ---- AI A Document G7O3TM - 1992 Continuation Sheet A1A Document G702TM-1992,Application and Certificate for Payment;or G732TM-2009, APPLICATION NO: Application and Certificate-for Payment,Construction Manager as Adviser Edition, 15 containing Contractor's signed certification is attached. APPLICATION DATE: g g JPERIOD T0: 4/26/2011 In tabulations below;,atnounts are in US dollars. 4/30/2011 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 2695 A B C D E `::F`: . G H WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS FINISH NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (C-C) (C,-C) (lf variable rate) (D+E) (Not inDorE) (D+E+F) 1 BOND 14,500.00 14,500.00 0.00 0.00 14,500.00 100.0C 0.00 1,450.00 2 SUBMITTALS 24,000.00 24,000.00 0.00 0.00 24,000.00 100.0C 0.00 2,400.00 3 MOCK UP 1,000.00 1,000.00 0.00 0.00 1,000.00. • .100:0C 0.00 100.00 4 MOBILIZATION 10,000.00 10,000.00 0.00 0.00 10,000.00 100.00 0.00 1,000.00 5 CLEAN UP 20,000.00 20,000.00 0.00 0.00 20 000.0C 100.00 0.00 2,000.00 6 . SAFETY 20,000.00 20,000.00 0.00 0.00 ' 20,000.00 100.00 0.00 2,000.00 7 ORIENTATION 3,000.00 3,000.00 0.00 0.00. ,' 3,000.00 100.00 0.00 300.00 8 REBAR MATERIAL 59,000.00 0.00 0.00 59,000.00' 59,000.00 100.00 0.00 5,900.00 9 REBAR LABOR 40,000.00 40,000.00 0.00 0.0C 40,000.00 100.00 0.00 4,000.00 10 GROUT MATERIAL 105,000.00 105,000.00 0.00 0.0C 105,000.00 100.00 0.00 10,500.00 11 GROUT LABOR 200,000.00 200,000.00 0.00 0.00 200,000.00 100.00 0.00 20,000.00 12 JOINT REINFORCEMENT 23,000.00 0.00 0.00 23,000.00 23,000.00 100.0C 0.00 2,300.00 13 WELD ON ANCHORS MATERIAL 14,000.00 0.00 0.00 14,000.00 14,000.00 100.00 0.00 1,400.00 14 WELD ON ANCHORS LABOR 19,000.00, 19,000.00 0.00 0.00 19,000.00 '100.0C 0.00 1,900.00 15 NORTH SIDE 0.00 0.0C 0.00 0.0C 0.00 O:OC 0.00 0.00 16 CMU MATERIAL 40,000.00 40,000.00 0.00 0.00 40,000.00 100.00 0.00 4,000.00 17 CMU LABOR 130,000.00 130,000.00 0.00 0.00 130,000.00 100.00 0.00 13,000.00 18 EAST SIDE 0.00 0.00 0.00 0.0C 0.00 0.00 0.00 0.00 19 CMU MATERIAL ' 45,000.00 45,000.00 0.00 0.0C 45,000.00 100.00 0.00 4,500.00 20 CMU LABOR , 137,625.00 137,625.00 0.00 0.0C 137,625.00 100.00 0.00 13,762.50 21 SOUTH,SIDE' ` 0.00 0.00 0.00 0.0C. 0.00 0.00 0.00 0.00 . " GRAND TOTAL 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 G703TM-1992.Copyright©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.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. ,0121OACD44 • `` a i1 Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G703TM1,Continuation Sheet,is to be used in conjunction with AIA Document G702TM' Application and Certificate for Payment,or AIA Document G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in A1A Documents A201 TM,General Conditions of the Contract for Construction,and A232Tm,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. Use of Current Documents.Prior to using any AIA 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 G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA 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. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment,or G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition,whichever is applicable. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect 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 in the project that 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 previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a 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 G.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.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 or G732 form,whichever is applicable. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 of AIA Document A201 or Section 7.3 of AIA Document A232. The following is an example ofa Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only.and are not intended to reflect actual construction costs. A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE FROM PREVIOUS COMPLETED ITEM SCHEDULED PRESENTLY % TO I2ETAINAGI: NO DESCRIPTION or WORK VALUE STORED AND STORED APPLICATION TIIIS PERIOD TO DATE (G-C) FINISII (If;unable rare) (D-E) (Norm Dor El /D+E+F) (C-GI 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15000 10000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 / 5 CURBS G MISC.CONC. 5,000 0 0 • 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703TM—1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 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. op- ‘-' Document G703 TM - 1992 Continuation Sheet • AIA Document G702TM-1992,Application and Certificate for Payment,or G732TM-2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, 15 containing Contractor's signed certification is attached. APPLICATION DATE: g g • PERIOD TO: 4/26/2011 In tabulations below, •amounts are in US dollars. 4/30/2011 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 2695 A B C D E F'.;,.' G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS FINISH NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G-C) (C G) (If variable rate) (D+E) (Not in D or E) (D+E+F) 22 CMU MATERIAL 50,000.00 50,000.00 0.00 0.00 50,000.0C 100.00 0.00 5,000.00 23 CMU LABOR 145,250.00 145,250.00 0.00 0.00 145,250.00 100.00. 0.00 14,525.00 24 WEST SIDE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 25 CMU MATERIAL 45,000.00 45,000.00 0.00 0.00 45,000.00 100.0C 0.00 4,500.00 26 CMU LABOR 130,625.00 130,625.00 0.00 0.00 139,625:0C 100.00 0.00 13,062.50 27 MORTAR&SAND 25,000.00 25,000.00 0.00 0.00 'r. 25,000.0C 100.00 0.00 2,500.00 28 ACCESSORIES 10,000.00 10,000.00 0.00 0.00 .: 10,000.00 100.0C 0.00 1,000.00 29 UPPER DRUM 0.00 • 0.00 0.00 0.00 0.00 0.00 0.00 0.00 30 CMU MATERIAL 15,000.00 15,000.00 0.00 0.0C 15,000.00 100.00 0.00 1,500.00 31 CMU LABOR 90,000.00 90,000.00 0.00 0.0C 90,000.00 100.00 0.00 9,000.00 32 GROUT MATERIAL 11,500.00 11,500.0C 0.00 0.0C 11,500.00 100.00 0.00 1,150.00 33 GROUT LABOR 20,000.00 20,000.0C 0.00 0.0C 20,000.00 100.00 0.00 2,000.00 34 MORTAR&SAND 2,500.00 2,500.0C 0.00 0.00 2,500.00 100.00 0.00 250.00 35 ALLOWANCE CORRECTION -5,000.00 0.0C -5,000.00 0.00 -5,000.00 100.00 0.00 -500.00 36 CHANGE ORDER#1 0.00 0.0C 0.00 0.00 0.00 0.00 0.00 0.00 37 CHANGE ORDER#2 8,279.15 0.0C 8,279.15 0.00 8,279.15 100.00 0.0) 827.92 38 CHANGE ORDER#3 9,661.45 0.00 9,661.45 0.00 9,661.45 , 100.00 0.03 966.15 39 ALLOWANCE 5,000.00 0.0C 0.00 0.00 0.00' ":. 0.00 5,000.0) 0.00 GRAND TOTAL $1,467,920 60 $1,354,000 00 $12.940.60 •$96,000.00 $1,462,940.60 99.62 $5,000.g0 $146,294.07 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 G703TM-1992.Copyright©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.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale 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. 10121OAC !AIA ` m= Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.ALA Document G703T51,Continuation Sheet,is to be used in conjunction with AIA Document G702T51 Application and Certificate for Payment,or AIA Document G732T51,Application and Certificate for Payment,Construction Manager as Adviser Edition.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Documents A201 TM,General Conditions of the Contract for Construction,and A232TM,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. Use of Current Documents.Prior to using any AIA 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 A1A.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 G703,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 A1A. Rights to reproduce the document may vary for users 'of A1A 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. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment,or G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition,whichever is applicable. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect 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 in the project that 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 previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a 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.Although Change Orders could he incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 or G732 form,whichever is applicable. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 of AIA Document A201 or Section 7.3 of AIA Document A232. The following is an example ofa Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes onht and are not intended to reflect actual construction costs. A B C D . I E F G H 1 WORK COMPLETED TOTAL MA ERIALS BALANCE ITERI SCHEDULED COMPLETED FROM PREVIOUS PRESENTLY % 1'O RETAINAGE NO DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G-C) FINISH (l)variable rate) (D+E) (A)I,D,m E) TO DATE (C-GI ID+E�FJ 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS 8 MISC.CONC 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G7035' -1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 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 Ale 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. WAIVER OF LIEN FINAL PARTIAL X PAYMENT TO FOLLOW X DON PURDY BEING DULY SWORN THAT HE IS PRESIDENT OF PURDY MASONRY, INC. AND HAVING CONTRACTED WITH CITY OF CARMEL BY AND THROUGH IT'S REDEVELOPMENT COMMISSION TO FURNISH CERTAIN LABOR & MATERIAL FOR THE PROJECT KNOWN AS PARCEL 7A-REGIONAL PERFORMING ART'S CENTER LOCATED IN CARMEL, IN AND OWNED BY CITY OF CARMEL BY AND THROUGH IT'S REDEVELOPMENT COMMISSION DOES FURTHER STATE: MASONRY THE AMOUNT WHICH IS DUE FROM THE OWNER IS THE SUM OF: TWELVE THOUSAND NINE HUNDRED FORTY DOLLARS AND 60/100. $12,940.60 THE PAYMENT WHICH HAS BEEN PROMISED AS THE SOLE CONSIDERATION FOR THIS AFFIDAVIT AND PARTIAL WAIVER OF LIEN WHICH IS GIVEN TO AND FOR SAID AMOUNT, EFFECTIVE UPON RECIEPT OF PAYMENT. PURDY MASONRY, INC. _ 41 / 'J �PRESIb T / WITNESS MY HAND AND NOTORIAL SEAL THIS 26TH DAY OF APRIL 2011 ♦EA Il . I _.�_� STEFANIE PURD ' MY COMMISSION EXPIRES: 6/29/17 COUNTY OF RESIDENCE: HENDRICKS Stefanie Purdy Notary Public Seal State of Indiana Hendricks County My Commission Expires 06/29/2017 e TM Document G702/CMa - 1992 32 Application and Certificate for Payment Construction Manager-Adviser Edition • TO OWNER: PROJECT: Parcel 7A-Reg. Perf.Arts Cntr APPLICATION NO: 16 Distribution to: . CITY OF CARMEL BY AND THROUGH 4/30/2011 ITS REDEVELOPMENT COMMISSION PERIOD TO: OWNER ❑ CARMEL, IN • CONSTRUCTION MANAGER ❑ 1/8/2008 FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ urdy Masonry, Inc. SHIEL SEXTON COMPANY 2695 7601 Indianapolis Road PROJECT NOS: / / CONTRACTOR ❑ Zionsville, IN 46077 VIA ARCHITECT: CSO ARCHITECTS FIELD ❑ CONTRACT FOR: #3020 EXT.CMU ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Continuation Sheet,AIA Document 0703,is attached. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous 1,450,000.00 Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ payment shown herein is now du- 2.2. Net change by Change Orders $ CONTRACT " Purdy Maso , I'c. 1,467,940.60 / r / l^ 3.CONTRACT SUM TO DATE(Line I ±2) $ By: �, Date: Li—a V — (1 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 1,462,940.60 State of: - 1 BOONE 5.RETA�I��E: County of: Notary Public Seal State of Indiana a. u u%of Completed Work 0.00 Subscribe d sworn to b fore .. \ Hendricks County (Column D+Eon G703) $ me this day: 1 t My Commission Expires 06/29/2017 b 0.00%of Stored Material Notary Public: �.i. ' 9AA0)1 (Column F on 0703) $ 0.00 My Commission expire �'I Total Retainage(Lines 5a+5b or Total in Column I of G703). $ 0.00 CERTIFICATE FOR PAYMENT +I n (f\ In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $�`tb Cl bite,�J this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) (�'� knowledge, information and belief the Work has progressed..as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $1 3 to accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT . (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ ..1@ 9COC AMOUNT CERTIFIED $ 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs •om tl e amount applied. Initial all figures on this Application and on tl Continuation Sh. tha.are banged to conform with the amount certified.) (Line 3 less Line 6) $ V)an,00 CONST _CTIO ►�i, ' By: ►i.��/%�i/ Ll�_; Date: 941. 3)/t I CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHI .i! 1 Total changes approved in previous months by Owner $ 17,940.60 $ 0.00 By: Date: SIR2 `a Total approved this Month $ 0.00 $ This Cert.'cate i .' negot -ble. .. - MOUNT CERTIFIED is payable only to the Contractor TOTALS $ 1 1,940.60 $ 0.00 named h': ein. ce, paym nt and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 17,940.60 the Ow -r o.l'ontr ctor un.n- this Contract. ,/ CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assureefoititt8�n9 Qe to . 77 IL /Pt AIA Document G702/CMaTM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyrig 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 maximu 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. m �O, -' = Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, 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,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.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 G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA 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. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&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 to the Architect 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 werelisted 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 atthe end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a 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 G: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:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment . • The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and_Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of theContractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® 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. __ . ! AIA Document G703' - 1992 . Continuation Sheet AIA Document G702TM-1992,Application and Certificate for Payment,or G732TM-2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 16 containing Contractor'ssigned certification is attached. .. 4/26/2011 In tabulations below,amounts are in US dollars. PERIOD TO: where variable retainage for line items may apply. N'6 30/2011 Use Column I on-Contracts g Y PP Y� ARCHITECT'S PROJECT : 2695 B C D E F ,. G H I WORK COMPLETED • MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS FINISH NO. . VALUE STORED STORED TO DATE (G-C) (� G) (If variable rate) APPLICATION THIS PERIOD (D+E) (Not in D or E) (D+E+F) 1 BOND 14,500.00 14,500.00 0.00 0.00 14,500.01 100.00 0.00 0.00 2 SUBMITTALS 24,000.00 24,000.00 0.00 0.00 24,000.01 100.00 0.00 0.00 3 MOCK UP 1,000.00 1,000.00 0.00 0.00 1,000.01 100.00 an 0.00 4 MOBILIZATION 10,000.00 10,000.00 0.00 0.00 10,000.01 100.00 0.0) 0.00 5 . CLEAN UP 20,000.00 20,000.00 • 0.00 0.00 .. 20,000:01 100.00 0.0) 0.00 6 SAFETY 20,000.00 20,000.00 0.00 0.00 20,000.01 100.00 0.0) 0.00 7 ORIENTATION 3,000.00 3,000.00 0.00 0.00 3,000.01 100:00 0.0) 0.00 8 REBAR MATERIAL 59,000.00 5 9'r 000 . 00 0.00 0 00 59,000.01 100.00 0.0) 0.00 9 REBAR LABOR 40,000.00 40,000.0 0.00 0.0 40,000.01 100.00 0.0) 0.00 10 GROUT MATERIAL 105,000.00 105,000.0 0.00 0.0 105,000.01 100.00 0.0) 0.00 11 GROUT LABOR 200,000.00 200,000.0 0.00 0.0 200,000.00 100.00 0.0) 0.00 12 JOINT REINFORCEMENT 23,000.00 23, 000. 00 0.00 0 . 00 23,000.00 100.00 0.0) 0.00 13 WELD ON ANCHORS MATERIAL 14,000.00 1 4, 0 Q 0. 00 0.00 0 . 00 14,000.01 100.00 0.0) 0.00 14 WELD ON ANCHORS LABOR 19,000.00 19,000.01 0.00 0.00 19,000.01 100.00 0.0) 0.00 15 NORTH SIDE 0.00 0.01 0.00 0.00 0.01 0.00 an 0.00 16 CMU MATERIAL 40,000.00 40,000.01 0.00 0.00 40,000.01 100.00 0.0) 0.00 17 CMU LABOR 130,000.00 130,000.01 0.00 0.00 130,000.01 100.00 0.0) 0.00 18 EAST SIDE . .. 0.00 0.01 0.00 0.00 0.01 ' 0.00 0.0) 0.00 19 CMU MATERIAL 45,000.00 45,000.01 0.00 0.00 45,000.01 100.00 0.03 0.00 20 CMU LABOR. ... 137,625.00 137,625.01 0.00 0.00 137,625.01 100.00 • 0.00 0.00 21 SOUTH'SIDE: 0.00 0.0) 0.00 0.00 •': • 0.01 0.00 0.00 0.00 GRAND TOTAL 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 G703TM-1992.Copyright©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.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®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. 101210ACD44 • ,�` � Document G7031M- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G703T"1,Continuation Sheet,is to be used in conjunction with AEA Document G7O2TM, Application and Certificate for Payment,or AIA Document G732Tm,Application and Certificate for Payment,Construction Manager as Adviser Edition.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in A1A.Documents A201TM,General Conditions of the Contract for Construction,and A232Tm,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. Use of Current Documents.Prior to using any AIA 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 G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA 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. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment,or G732Tm,Application and Certificate for Payment,Construction Manager as Adviser Edition,whichever is applicable. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect 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 in the project that 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 previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a 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 G.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.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 or G732 form,whichever is applicable. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 of AIA Document A201 or Section 7.3 of AIA Document A232. The following a an example of a Continuation Sheet for work in progress.Please note that dollar amounts shottn below are for illustrative purposes only,and are not intended to reflect actual construction costs. _ A B C D I E F G H _ I WORK COMPLETED TOTAL MATERIALS BALANCE FROM PREVIOUS COMPLETED ITEM SCHEDULED PRESENTLY % TO RLTAINAGE NO DESCRIPTION OF WORK VALUE STORED AND STORED APPLICATION THIS PERIOD TO DATE (G-C) FINISII (lI,anable rate) (D+E) (lie D.x El ID+E+F) (C-G) I MOBILIZATION 5,000 5,000 0 0 5,000 100 0 . 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS d MISC CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 B PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G7035"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 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. 4! ATA TM Document G703 - 1992 • Continuation Sheet AIA Document G702TM-1992,Application and Certificate for Payment,or G732TM-2009, APPLICATION NO: Application and Certificate for.Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 16 containing Contractor's signed certification is attached. 4/26/2011 In tabulations below;amounts are in US dollars. PERIOD T0: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT 1630/2011 B C D E F G H I WORK COMPLETED MATERIALS, TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS FINISH NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G_C) (C,-G) (If variable rate) (D+E) (Not inDorE) (D+E+F) 22 CMU MATERIAL 50,000.00 50,000.01 0.00 0.00 50,000.00 100.00 0.00 0.00 23 CMU LABOR 145,250.00 145,250.01 0.00 0.00 145,250.00 100.00 0.00 0.00 24 WEST SIDE 0.00 0.01 0.00 0.00 0.00 0.00 0.00 0.00 25 CMU MATERIAL. 45,000.00 45,000.01 0.00 0.00 45,000.00 100.00 0.00 0.00 26 CMU LABOR . . 130,625.00 130,625.01 0.00 0.00 . 130,625:00 100.00 0.00 0.00 27 MORTAR&,SAND 25,000.00 25,000.01 0.00 0.00 25,000.00 100.00 0.00 • (.00 28 ACCESSORIES 10,000.00 10,000.01 0.00 0.00 10,000.00 100.00 0.0) 0.00 29 - UPPER DRUM 0.0) 0.01 0.00 '0.00 0.00 0.00 0.0) 0.00 30 CMU MATERIAL 15,000.03 15,000.01 0.00 0.00 15,000.00 100.00 0.0) 0.00 31 CMU LABOR 90,000.0) 90,000.0) 0.00 0.00 90,000.00 100.00 0.0) 0.00 32 GROUT MATERIAL 11,500.0) 11,500.01 0.00 0.00 11;500.00 100.00 0.00 0.00 33 GROUT LABOR 20,000.0) 20,000.01 • 0.00 0.00 20,000.00 100.00 0.0) 0.00 34 MORTAR&SAND 2,500.00 2,500.01 0.00 0.00 2,500.00 100.00 0.0) 0.00 35 ALLOWANCE CORRECTION -5,000.00 -5,000.01 0.00 0.00 -5,000.00 100.00 0.0) 0.00 36 CHANGE ORDER#1 0.00 0.01 0.00 0.00 0.00 0.00 0.0) 0.00 37 CHANGE ORDER#2 8,279.15 8,279.1. 0.00 0.00 8,279.15 100.00 0.0) 0.00 38 CHANGE ORDER#3 9,661.45 9,661.4. 0.00 0.00 9,661.45 . 100.00 0.0) 0.00 39 ALLOWANCE 5,000.00 0.01 0.00 0.00 0.00 '0.00 5,000.0) 0.00 GRAND TOTAL . ... . 1 , 4 6 2, 9 4 0. 6 0 $0.00 0 . 00 $1.462.940.6) 99.63 $5.000.03 $0.00 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 G703TM-1992.Copyright©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.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. 101210nc049 4111/4 - == Document G703"- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G7O3TM,Continuation Sheet,is to be used in conjunction with AIA Document G702TM' Application and Certificate for Payment,or AIA Document G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner.Procedures for their use are covered in AIA Documents A201TM,General Conditions of the Contract for Construction,and A232Tm,General Conditions of the Contract for Construction,Construction Manager as Adviser Edition. Use of Current Documents.Prior to using any AIA 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 G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA 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. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment,or G732TM,Application and Certificate for Payment,Construction Manager as Adviser Edition,whichever is applicable. Columns A,B and C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect 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 in the project that 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 previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a 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 G.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.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project, this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 or G732 form,whichever is applicable. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 of AIA Document A201 or Section 7.3 of AIA Document A232. The following is an example ofa Continuation Sheet for work in progress.Please note that dollar amounts sho,,n be/air are for illustrative purposes only.and are not intended to reflect actual construction costs. A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED ITEM SCHEDULED FROM PREVIOUS PRESENTLY % TO RETAINAGE NO DESCRIPTION OF WORK VALUE APPLICATION TI IIS PERIOD STORED AND STORED (G-C) FINISH (I/inr,ab/e rate) (0+£) (MI ur1),£1 TO DATE (C_G) (1)+E F) I MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS&MISC.CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TO FAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703TM-1992.Copyright©1963,1965,1966,1967,1970, 1978,1983 and 1992 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. WAIVER OF LIEN FINAL PARTIAL X PAYMENT TO FOLLOW X DON PURDY BEING DULY SWORN THAT HE IS PRESIDENT OF PURDY MASONRY, INC. AND HAVING CONTRACTED WITH CITY OF CARMEL BY AND THROUGH IT'S REDEVELOPMENT COMMISSION TO FURNISH CERTAIN LABOR & MATERIAL FOR THE PROJECT KNOWN AS PARCEL 7A-REGIONAL PERFORMING ART'S CENTER LOCATED IN CARMEL, IN AND OWNED BY CITY OF CARMEL BY AND THROUGH IT'S REDEVELOPMENT COMMISSION DOES FURTHER STATE: MASONRY THE AMOUNT WHICH IS DUE FROM THE OWNER IS THE SUM OF: SEVENTY TWO THOUSAND FIVE HUNDRED DOLLARS AND 00/100. $72,500.00 THE PAYMENT WHICH HAS BEEN PROMISED AS THE SOLE CONSIDERATION FOR THIS AFFIDAVIT AND PARTIAL WAIVER OF LIEN WHICH IS GIVEN TO AND FOR SAID AMOUNT, EFFECTIVE UPON RECIEPT OF PAYMENT. PURDY MASONRY, INC. lib V ID NT / WITNESS MY HAND AND NOTORIAL SEAL THIS 26T" DAY OF APRIL 2011 ��_I,_ , 11 L`► STEFANIE PURE MY COMMISSION EXPIRES: 6/29/17 COUNTY OF RESIDENCE: HENDRICKS Stefanie Purdy Notary Public Seal State of Indiana Hendncks County My Commission Expires 06/29/2017