NU-TEC ROOFING CONTRACTORS, LL -001702 -3/17/2011 CiFdAMEL REDEVELOPMENT COMMISSION 001702
Nu-Tec Roofing Contractors, LL Check: 1702
5025 Emco Drive Date: 3/17/2011
Indianapolis, IN 46220 Vendor: NUTECROO
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
5 496.80 496.80 0.00 0.00 496.80
Application 5
J
496.80 496.80 0.00 0:00 496.80
APP`•ICATION AND CERTIFICATION FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION \
AIA DOCUMENT G702/Cma PAGE ONE OF 2 PAGES
TO OWNER: PROJECT: APPLICATION NO: 5 Distribution to:
REI Construction,LLC Village on the Green-Office Building One PERIOD TO: 1/31/11 OWNER
11711 N.Pennsylvania St.,#200 3rd Ave. SW and City Center Dr. PROJECT NOS: 09-123 CONSTRUCTION
Carmel, IN 46032 Carmel, IN 46032 MANAGER
FROM CONTRACTOR: fir? 0 T CONTRACT DATE: 3/9/10 ARCHITECT
Nu-Tec Roofing Contractors, LLC 11))11 lJ l) u CONTRACTOR
5025 Emco Drive VIA CONSTRUCTION MANAGER: JAN 2 1 2011 ii
Indianapolis,IN 46220 VIA ARCHITECT:
CONTRACT FOR: Roofing-Sheet Metal Work
CONTRACTOR'S APPLICATION FOR PAYMENT y The undersigned-C-ont ractor 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, is 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
payments received from the Owner,and that current payment shown herein is now due.
1. ORIGINAL CONTRACT SUM $ 130,100.00
2. Net change by Change Orders $ 552.00 CONTRACTOR: Nu-Tec Roofing Contractors,LLC
3. CONTRACT SUM TO DATE(Line 1 ±2) $ 130,652.00
4. TOTAL COMPLETED&STORED TO $ 130,652.00
DATE (Column G on G703) By: Date: 1/21/11
5. RETAINAGE: Otis Burdine,Division Manager
a. 10 %of Completed Work $ 13,065.20 State of: Indiana Count ,act Marion
(Column D+Eon G703) Subscribed and sworn to before me this 21 d RA.�:y aye 2011
b. %of Stored Material $ 0.00 Notary Public: Jean A.Rathsack Cify� ,, -TS.r:,
(Column F on G703) My Commission expires: 6/15/17 —4•Q.°a°xt A ")' ���w
Total Retainage(Lines 5a+5b or 4 o it An74
Total in Column I of G703) $ 13,065.20 CERTIFICATE FOR PAYMENT ° a MY COMMISSION '<
6. TOTAL EARNED LESS RETAINAGE $ 117,586.80 In accordance with the Contract Documents,based on on-sri3blervatOgli ii OF ddtZa
(Line 4 Less Line 5 Total) comprising this application,the Construction Manager and cc f,?+.'tlie°C7"�'
7. LESS PREVIOUS CERTIFICATES FOR that to the best of their knowledge,information and belief the`V@f ,1y tee°
PAYMENT(Line 6 from prior Certificate) $ 117,090.00 indicated,the quality of the Work is in accordance with the Confra)Q�c ��
8. CURRENT PAYMENT DUE $ 496.80 the Contractor is entitled to payment of the AMOUNT CERTIFIEDI.4<<t;I i tt E tt,�ee
9. BALANCE TO FINISH,INCLUDING RETAINAGE J
(Line 3 less Line 6) t
13,065.20 AMOUNT CERTIFIED $ 7 1 p L1 9
o
(Attach explanation if amount certified differs from the amount applied. Initial all figures on this
Application and on the Continuation Sheet that are changed to conform with the amount certified.)
CONSTRUCTION MANAGER:
• E ORD R MMARY ADDITION DED TISN !
Total changes approved By: --i Date: i....
/ /
in previous months by Owner $552.00 ARCHITECT:
Total approved this Month By: Date:
TOTALS $552.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
NET CHANGES by Change Order $552.00 Contractor named herein. Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT G702/CMa-APPLICATION AND CERTIFICATION FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.. N.W.,WASHINGTON,DC 20006-5292
1;+92 EDITION•AIA •01992
tiers may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. R\
.. LI)16,000
CONTINUATION SHEET AIA DOCUMENT 6703 PAGE OF 2 PAGES
AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT,containing APPLICATION NO: 5
Contractor's signed certification is attached. APPLICATION DATE: 1/21/1 1
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 1/31/11 .
Use Column Ion Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 09-123
A B C D E F G H I
ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE
NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (0=C) TO FINISH (IF VARIABLE
APPLICATION STORED AND STORED (C-G) RATE)
(D.+E) (NOT IN TO DATE
D OR E) (D+E+F)
1 Bond $2,600.00 $2,600.00 $0.00 $0.00 $2,600.00 100.00% $0.00 $260.00
2 Roofing Material $72,330.00 $72,330.00 $0.00 $0.00 $72,330.00 100.00% $0.00 $7,233.00
3 Roofing Labor $31,400.00 $31,400.00 $0.00 $0.00 $31;400.00 100.00% $0.00 $3,140.00
4 Sheet Metal Material $16,000.00 $16,000.00 $0.00 $0.00 $16,000.00 100.00% $0.00 $1,600.00
5 Sheet Metal Labor $7,770.00 $7,770.00 $0.00 $0.00 $7,770.00 100.00% $0.00 $777.00
6 #1 Relocate Roof Curb $552.00 $0.00 $552.00 $0.00 $552.00 100.00% $0.00 $55.20
GRAND TOTALS $130,652.00 $130,100.00 $552.00 $0.00 $130,652.00 100% $0.00 $13,065.20
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
APPLICATION FOR PAYMENT
PARTIAL WAIVER OF LIEN
Contractor: Nu-Tec Roofing Contractors, LLC O<
Address: 5025 Emco Dr.
CS-Indianapolis, IN 46220 ✓ �C%
q
Project Name and Address: Village on the Green - Office Building One N ��1
3rd Avenue SW and City Center Drive `UJJ 0
Carmel, IN 46032
Period to: 1/31/11
Job #: 09-123
The Undersigned has been contracted by REI Construction, LLC as a Contractor in connection with construction
of the Project owned by Owner and located as indicated above.
The Undersigned, for and in consideration of any and all amounts paid to the Undersigned up to and including the
date of execution hereof and other good and valuable consideration, the receipt whereof is hereby acknowledged,
waives and releases any and all liens, notices of liens or of character, against, on or relating to or connected with the
above-described Project and improvements located thereon and related thereto, on account of labor or services,
materials, equipment, tools, machinery or apparatus furnished or leased, or which may be furnished or leased by, or
at the request of, the Undersigned for the Project. The Undersigned hereby warrants that the Project cannot be made
subject to any valid lien or claim by anyone who furnished or leased labor or services, materials, equipment, tools,
machinery or apparatus to, or at the request of, the Undersigned for use in the Project. This instrument, and the
waiver, release and representations hereunder, are for the benefit of, and may be relied upon by, the Owner, its
successors, assigns and mortgagees, the above-named General Contractor or Construction Manager, and any other
person by or through whom payments have been made to the Undersigned.
The undersigned, for and in consideration of the total payments in the sum of $ 496.00
the receipt of which is hereby acknowledged, does hereby waive, release remise and relinquish any and all right to
claim any lien or liens for work done or materials furnished, or any kind or class of lien whatsoever for said building or
premises or project
Dated this 21st day of January, 2011
Nu-Tec Roofing Contractors, LLC
Company Name
BY: TITLE: Division Manager
NAME: Otis Burdine
STATE OF IN
COUNTY OF Marion
Subscribed and sworn to before me, a Notary Public in and for said County and State, this 21st
day of January , , 2010
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My commission expirekao��j� q�r My county residence is Hamilton
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Notary ®Do y0k 'i"°/54
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Printed Jean A. Rathsack
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