HomeMy WebLinkAboutGEIGER & PETERS, INC. -001954 -6/15/2011 CARMEL REDEVELOPMENT COMMISSION 001954
Geiger& Peters, Inc. Check: 1954
PO Box 33807 Date: 6/15/2011
Indianapolis, IN 46203 Vendor: GEIGER1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt..Paid
11R-09119 85,506.00 85,506.00 0.00 0.00 85,506.00
App 11R on Building one
12-09119 -30,505.00 -30,505.00 0.00 . 0.00 -30,505.00
Credit on steel contract
55,001.00 55,001.00 0.00 0.00 55,001.00
1
APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION PAGE ONE OF FIVE PAGES
AIA DOCUMENT G702/CMa (Instructions on reverse side)
TO(OWNER): City of Cannel Community Develop.Corp. PROJECT:Village on the Green APPLICATION NO.: 11R-09119 Distribution to:
30 W Main St Suite 220 City Center Dr&3id Ave SWi Tt I 1 nii PERIOD TO: 1/31/11 OWNER
3 LL'.., I I �u'
Cannel,IN 46032 Cannel IN 46032 !�11 1 �._�';! i I 1 i, [� I� PROJECT NOS: CONSTRUCTION MANAGE]
VIA(CONSTRUCTION MANAGER): REI Construction I it ARCHITECHT
FROM(CONTRACTOR): Geiger&Peters,Inc. 11711 N Pennsylvania St Siuit�200 i3 i i i 1I I CONTRACT DATE: CONTRACTOR
,1Hi\I )1 k I
P 0 Box 33807 Cannel,IN46032
Indianapolis,Indiana 46203
317-359-9521 ;,
CONTRACT FOR: Structural Steel '. - •� x -._e,-
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge.Infor-
Application is made for Payment,as shown below,in connection with the Contract. mation and belief the Work covered by this Application for Payment has been completed
Continuation Sheet,AIA Document G703,is attached, 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 pay-
1.ORIGINAL CONTRACT SUM $ 800,930.00 ments received from the Owner,and that current payment shown herein is now due.
2.Net change by Change Orders $ 54,130.00 CONTRACTOR t
3.CONTRACT SUM TO DATE(Line 1+2) . $ 855,060.00 By: 1-- - 4 ' ' t Date: 1117111
4.TOTAL COMPLETED&STORED TO DATE $ 855,060.00 •
(Column G on G703) State ot: Indiana
County of Marion
5.RETAINAGE: Subscnbed and sworntobefore •, .......
a. 10 %of Completed Work me this 17th day of January,2011 �E JAMIE S. PETERS
(Column D+E on G703) $ o ,;o Notary ublic,nState of Indiana 1
b. 10 %of Stored Material (� '. :ii,;;,•; Commission #622941 ■
(Column F on G703) $ - ~;i-;:;y' My Commission Expires
Total Retainage(Line 5a+5b or 4 ia,. December 13, 201 8
Total in Column I of G703) . $ - Notary Public: Jamie S Peters ... ---_....., -._......"'-°'-_ `-"'—"`
My Commission expires: 12/13/18
6.TOTAL EARNED LESS RETAINAGE.. $ 855,060.00
(Line 4 less Line 5 Total)
ARCHITECTS CERTIFICATE FOR PAYMENT
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data
(Line 6 from prior Certificate) $ 769,554.00 comprising this application,the Architect certifies to the Owner that to the best of the
Owner's 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
8.CURRENT PAYMENT DUE ` $ 85,506.00 I is entitled to payment of the AMOUNT CERTIFIED.
9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED ... . . . . . . . $ YS-06 ��
(Line 3 less Line 6) $ - (Attach explanation if amount certified differs from the amount applied for. Initial
all figures on this Application and on the Continuation Sheet that are changed to
conform to the amount certified.)
CONSTRUCTION MANAGER: / `�/' .
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (//L��1
Total changes approved in By� Date:
previous months by Owner $ -
Total approved this month $ 54,13000 ARCHITECT.
TOTALS $ 54,13000 By: Date:
NET CHANGES by Change Order $54,130.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con-
tractor named herein. Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract. w(/
.
AIA DOCUMENT G702/CMa'APPLICATION AND CERTIFICATE FOR PAYMENT•CONSTRUCTION MANAGER ADVISER EDITION
1992 EDITION•1992'AIA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.,WASHINGTON, G7O2/Cma-1992
D.C.2006-5292
r - CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE TWO OF FIVE PAGES
' AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NO.: 11R-09119
' Contractor's signed Certification is attached. Geiger&Peters APPLICATION DATE: 1/17/11
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 1/31/11
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:
A B C D I E F G H I
SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE
VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G:C) TO FINISH
ITEM DESCRIPTION OF APPLICATION STORED AND STORED (C-G)
NO. WORK ESTIMATED (D+E) (NOT IN TO DATE
COST D OR E) (D+E+F)
1 Detailing&Shop Drawings $ 38,700.00 $ 38,700.00 $ - $ 38,700.00 100% $ -
2 AnchorBolts/Embeds $ 6,800.00 $ 6,800.00 $ - $ 6,800.00 100% $ -
3 Payment&Performance Bond $ 4,000.00 $ 4,000.00 $ - $ 4,000.00 100% $ -
4 #05120 Structural Steel $ -
5 Fabrication&Material $ 432,670.00 $ 432,670.00 $ - $ 432,670.00 100% $ -
6 Erection $ 94,620.00 $ 94,620.00 $ - $ 94,620.00 100% $ -
7 #052100 Steel Joist $ -
8 Material $ 26,500.00 $ 26,500.00 $ - $ 26,500.00 100% $ -
9 Erection $ 14,600.00 $ 14,600.00 $ - $ 14,600.00 100% $ -
10 #05310 Roof Deck $ -
11 Material $ 10,360.00 $ 10,360.00 $ - $ 10,360.00 100% $ -
1 2 Erection $ 5,180.00 $ 5,180.00 $ - $ 5,180.00 100% $ -
13 #05360 Floor Deck $ -
14 Material $ 31,200.00 $ 31,200.00 $ - $ 31,200.00 100% $ -
15 Erection $ 15,600.00 $ 15,600.00 $ - $ 15,600.00 100% $ -
16 #05500 Metal Fabrication
17 Material $ 5,600.00 $ 5,600.00 $ - $ 5,600.00 100% $ -
18 Erection $ 1,500.00 $ 1,500.00 $ - $ 1,500.00 100% $ -
19 #05510 Metal Stairs
20 Material $ 44,300.00 $ 44,300.00 $ - $ 44,300.00 100% $ -
21 Erection $ 18,100.00 $ 18,100.00 $ - $ 18,100.00 100% $ -
22 #055213 Tube Railing
23 Material $ 7,400.00 $ 7,400.00 $ - $ 7,400.00 100% $ -
24 Erection $ 4,200.00 $ 4,200.00 $ - $ 4,200.00 100% $ -
25
$ 761,330.00 $ 761,330.00 $ - $ - $ 761,330.00 100% $ - $ -
. AIA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AlA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK
AVENUE,N.W., WASHINGTON,D.C. 20006-5292
G703-1992
CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE THREE OF FIVE PAGES
AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NO.: 11R-09119
Contractor's signed Certification is attached. APPLICATION DATE: 1/17/11
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 1/31/11
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:
A B C D E • F G H I
SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE
VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G:C) TO FINISH
ITEM DESCRIPTION OF APPLICATION STORED AND STORED (C-G)
NO. WORK ESTIMATED (D+E) (NOT IN TO DATE
COST D OR E) (D+E+F)
26 #057300 Decorative Metal Railings
27 Material $ 26,800.00 $ 26,800.00 $ - $ 26,800.00 100% $
28 Erection $ 12,800.00 $ 12,800.00 $ - $ 12,800.00 100% $
29 $ -
30 c/o#1 $ 54,130.00 $ 54,130.00 $ - $ 54,130.00 100% $
31 co#2 REI ICO
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
$ 855,060.00 $ 855,060.00 $ - $ - $ 855,060.00 100% $ - $ -
AIA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AIA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK
AVENUE,N.W.,WASHINGTON,D.C. 20006-5292
G703-1992
WAIVER OF LIEN TO DATE
STATE OF Indiana )
COUNTY OF Marion } SS
TO WHOM IT MAY CONCERN:
WHEREAS the undersigned has been employed by REI Construction
to furnish Structural Steel
for the premises knows as Village on the Green
of which City of Carmel Community Develop. Corp. is the owner.
THE undersigned,for and in consideration of Eighty Five Thousand Five Hundred Six and 00/100
($ 85,506.00 ) Dollars,and other good and valuable considerations,the receipt whereof is hereby acknowledged,do(es)hereby
waive and release any and all lien or claim of or right to, lien,under the statutes of the State of Indiana,relating to mechanics' liens,with respect to
above-described premises,and the improvements thereon,and on the material,fixtures,apparatus or machinery furnished,and on the moneys,
funds or other considerations due or to become due from the owner,on account of all labor,services,material,fixtures,apparatus or machinery,
furnished to this date by the undersigned,for the above described premises, including extras*.
DATE 1/17/2011 COMPANY NAME Geiger&Peters Inc.
ADDRESS P 0 Box 33807 Indianapolis,IN 46203 1
SIGNATURE AND TITLE // /j'
Cf�]�-vim ✓�� ,Z -t' eii i.
Controller �, '�
*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE O ERS,BOTH ORAL AND WRITTEN,TO THE CONTRACT. 1 :}1
CONTRACTOR'S AFFIDAVIT , 2 ;',
STATE OF Indiana
:
COUNTY OF Marion ) SS ,�
c--:',
TO WHOM IT MAY CONCERN: ', �y %' ,'\
THE UNDERSIGNED, Kristine M Grace BEING DULY SWORN,,DE_EOSES
AND SAYS THAT HE OR SHE IS Controller 4\ 6E--,:'-�
Geiger&Peters Inc. °WHO IS THE
CONTRACTOR FURNISHING Structural Steel WORK ON THE BUILDING
LOCATED AT City Center Dr&3rd Ave SW Carmel IN 46032
OWNED BY City of Carmel Community Develop.Corp.
That the total amount of the contract including extras*,is $ 855,060.00 on which he or she has received payment of
$ 769,554.00 prior to this payment. That all waivers are true,correct and genuine and delivered unconditionally
and that there is no claim either legal or equitable to defeat the validity of said waivers. That the following are the names and addresses of all
parties who have furnished material or labor,or both,for said work and all parties having contracts or sub contracts for specific portions of said
work or for material entering into the construction thereof and the amount due or to become due to each,and that the items mentioned include all
labor and material required to complete said work according to plans and specifications:
NAMES AND ADDRESSES WHAT FOR CONTRACT PRICE AMOUNT THIS BALANCE DUE
INCLUDING EXTRAS' PAID PAYMENT
Geiger&Peters Inc. Structural Steel 855,060.00 769,554.00 85,506.00 0.00
TOTAL LABOR AND MATERIAL INCLUDING EXTRAS TO COMPLETE 855,060.00 769,554.00 85,506.00 0.00
That there are no other contracts for said work outstanding,and that there is nothing due or to become due to any person for material, labor or
other work of any kind done or to be done upon or in connection with said work other than above stated.
DATE 1/17/2011 SIGNATURE: njL ' -
SUBSCRIBED AND SWORN TO BEFORE ME THIS 17th D OF January 2011
(-7(--c,-- -)
Jamie S Peters Resident of Marion County My Commission expires 12/13/18
*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS,BOTH ORAL AND WRITTEN,TO THE CONTRACT.
h,,E 3TA.Ip* JAMIE S. PET
i o -).'s Notary Public. State of t:,,.;na
i. :ri; Marion County
"'- ' :- Commission #62204;
":;=,y > My Commission Expi,:,;
a December 13. 20• ,1
APPLICATION AND CERTIFICATE FOR PAYMENT CONSTRUCTION MANAGER-ADVISER EDITION PAGE ONE OF FIVE PAGES
AIA DOCUMENT G702/CMa (Instructions on reverse side)
TO(OWNER): City of Cannel Community Develop.Corp. PROJECT:Village on the Green APPLICATION NO.:12-09119 _ Distribution to:
30 W Main St Suite 220 City Center Dr&3rd Ave SW PERIOD TO: 4/30/11 OWNER
Carmel,IN 46032 Carmel IN 46032 PROJECT NOS: CONS1I<UCTION MANAGES
VIA(CONSTRUCTION MANAGER): REI Construction ARCHIT'ECHT
FROM(CONTRACTOR): Geiger&Peters,Inc. 11711 N Pennsylvania St Suite 200 CONTRACT DATE: CONTRACTOR
P 0 Box 33807 Cannel,IN 46032
Indianapolis,Indiana 46203
317-359-9521
CONTRACT FOR: Structural Steel
CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge.Infor-
Application is made for Payment,as shown below,in connection with the Contract. oration and belief the Work covered by this Application for Payment has been completed
Continuation Sheet,AIA Document G703,is attached. 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 pay-
1.ORIGINAL CONTRACT SUM $ 800,930.00 ments received from the Owner,and that current payment shown herein is now due.
2.Net change by Change Orders $ 23,625.00 CONTRACTOR: i
3.CONTRACT SUM TO DATE(Line 1+2) $ 824,555.00 By: 114 ,J,L;,-t_ -,ice J,/) )41.(�Q Date: 4/20111
4.TOTAL COMPLETED&STORED TO DATE $ 824,555.00
(Column G on 0703) Stated: Indiana
County of: Marion _ ... _.. __. ..
5.RETAINAGE: Subscribed and sworn tobefore +E•' ra JAMIE S. PETERS
a. 10 %of Completed Work methis 20th day of Apn1,2(]W ,, . .:001q..-'A.-ii Notary Public, State of Indiana
(Column DI-E on G703) $ 7 °; Marion County
b. 10%ofStored Material e.. ts,T; Commission N 622941 Expires
(Column F on G703) $ - w_.
Total Retainage(Line Sa+5b or '✓. -..-__a° __December 132018-
Total in Column I of 0703) $ - Notary Public: JamieJeters
My Commission expires: 12/13118
6.TOTAL EARNED LESS RETAINAGE $ 824,555.00
(Line 4 less Line 5 Total)
ARCHITECT'S CERTIFICATE FOR PAYMENT
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In accordance with the Contract Documents,based on on-site observations and the data
(Line 6 from prior Certificate) $ 855,060.00 comprising this application,the Architect certifies to the Owner that to the best of the
Owner's 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
8.CURRENT PAYMENT DUE $ (30,505.00) is entitled to payment of the AMOUNT CERTIFIED.
9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED ' Z A SC7sc
(Line 3 less Line 6) $ - (Attach explanation if amount certified differs from the amount applied for. Initial
all figures on this Application and on the Continuation Sheer that are changed to
conform to the amount cert fed)
CONSTRUCTION MANAGER: /
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS / n n
Total changes approved in B : /�fi� =--- rsd 1_ Date: !�
previous months by Owner S 55,542.00 3076.00
Total approved this month S 2,263 00 31104.00 ARCHITECT:
TOTALS S 57,805,00 3418000 By Date:
NET CHANGES by CMnge Ouch _ S23,625 00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Con-
tractor named herein. Issuance,payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
\nU
AIA DOCUMENT G702/CMa•APPLICATION AND CERTIFICATE FOR PAYMENT'CONSTRUCTION MANAGER-ADVISER EDITION
1992 EDITION•1992'AIA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.,WASHINGTON, G702/Cma-1992
• D.C.2006-5292
CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE TWO OF FIVE PAGES
AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NO.: 12-09119
Contractor's signed Certification is attached. Geiger&Peters APPLICATION DATE: 4/20/11
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 4/30/11
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:
A B C D { E F G H I
SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE
VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G:C) TO FINISH
ITEM DESCRIPTION OF APPLICATION STORED AND STORED (C-G)
NO. WORK ESTIMATED (D+E) (NOT IN TO DATE
COST D OR E) (D+E+F)
1 Detailing&Shop Drawings $ 38,700.00 $ 38,700.00 $ - $ 38,700.00 100% $ -
2 Anchor Bolts/Embeds $ 6,800.00 $ 6,800.00 $ - $ 6,800.00 100% $ -
3 Payment&Performance Bond $ 4,000.00 $ 4,000.00 $ - $ 4,000.00 100% $ -
4 #05120 Structural Steel $ -
5 Fabrication&Material $ 432,670.00 $ 432,670.00 $ - $ 432,670.00 100% $ -
6 Erection $ 94,620.00 $ 94,620.00 $ - $ 94,620.00 100% $ -
7 #052100 Steel Joist $
8 Material $ 26,500.00 $ 26,500.00 $ - $ 26,500.00 100% $ -
9 Erection $ 14,600.00 $ 14,600.00 $ - $ 14,600.00 100% $ -
10 #05310 Root Deck $ -
II Material $ 10,360.00 $ 10,360.00 $ - $ 10,360.00 100% $ -
1 2 Erection $ 5,180.00 $ 5,180.00 $ - $ 5,180.00 100% $ -
13 #05360 Floor Deck $ -
14 Material $ 31,200.00 $ 31,200.00 $ - $ 31,200.00 100% $ -
15 Erection $ 15,600.00 $ 15,600.00 $ - $ 15,600.00 100% $ -
16 #05500 Metal Fabrication
17 Material $ 5,600.00 $ 5,600.00 $ - $ 5,600.00 100% $ -
I8 Erection $ 1,500.00 $ 1,500.00 $ - $ 1,500.00 100% $ -
19 #05510 Metal Stairs
20 Material $ 44,300.00 $ 44,300.00 $ - $ 44,300.00 100% $ -
21 Erection $ 18,100.00 $ 18,100.00 $ - $ 18,100.00 100% $ -
22 #055213 Tube Railing
23 Material $ 7,400.00 $ 7,400.00 $ - $ 7,400.00 100% $ -
24 Erection $ 4,200.00 $ 4,200.00 $ - $ 4,200.00 100% $ -
25
$ 761,330.00 $ 761,330.00 $ - $ - $ 761,330.00 100% $ - $ -
AIA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION MA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK
AVENUE,N.W.,WASHINGTON,D.C. 20006-5292
G703-1992
CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE THREE OF FIVE PAGES
AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NO.: 12-09119
Contractor's signed Certification is attached. APPLICATION DATE: 4/20/11
In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 4/30/11
Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:
A B C D I E F G H I
SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE
VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G:C) TO FINISH
ITEM DESCRIPTION OF APPLICATION STORED AND STORED (C-G)
NO. WORK ESTIMATED (D+E) (NOT IN TO DATE
COST D ORE) (D+E+F)
26 #057300 Decorative Metal Railings
27 Material $ 26,800.00 $ 26,800.00 $ - $ 26,800.00 100% $ -
28 Erection $ 12,800.00 $ 12,800.00 $ - $ 12,800.00 100% $ -
29 $ -
30 co al $ 54,130.00 $ 54,130.00 $ - $ 54,130.00 100% $ -
31 cro#2 REl lco
32 cro#2 $ (3,076.00) $ (3,076.00) $ (3,076.00) 100% $ -
33 cro#s $ 1,412.00 $ 1,412.00 $ 1,412.00 100% $ -
34 cio#4 $ 2,263.00 $ 2,263.00 $ 2,263.00 100% $ -
35 sal.Tazcredit $ (31,104.00) $ (31,104.00) $ (31,104.00) 100% $ -
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
$ 824,555.00 $ 855,060.00 $ (30,505.00) $ - $ 824,555.00 100% $ - $ -
ALA DOCUMENT G702 APPLICATION AND CERTIFICATE FOR PAYMENT 1992 EDITION AIA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK
AVENUE,N.W.,WASHINGTON,D.C. 20006-5292
G703-1992
WAIVER OF LIEN TO DATE
STATE OF Indiana )
COUNTY OF Marion ) SS
TO WHOM IT MAY CONCERN:
WHEREAS the undersigned has been employed by REI Construction
to furnish Structural Steel
for the premises knows as Village on the Green
of which City of Carmel Community Develop.Corp. is the owner.
THE undersigned,for and in consideration of Less Thirty Thousand Five Hundred Five and 00/100
(S -30,505.00 ) Dollars,and other good and valuable considerations,the receipt whereof is hereby acknowledged,do(es)hereby
waive and release any and all lien or claim of,or right to,lien,under the statutes of the State of Indiana,relating to mechanics'liens,with respect to
above-described premises,and the improvements thereon,and on the material,fixtures,apparatus or machinery furnished,and on the moneys,
funds or other considerations due or to become due from the owner,on account of all labor,services,material,fixtures,apparatus or machinery,
furnished to this date by the undersigned,for the above described premises,including extras*.
DATE 4/20/2011 COMPANY NAME Geiger&Peters Inc.
ADDRESS P 0 Box 33807 Indianapolis,IN 46203
SIGNATURE AND TITLE ,(t,,,t (4 7\1 r' t" fie'° ' Controller
*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS,BOTH ORAL AND WRITTEN,TO THE CONTRACT.
CONTRACTOR'S AFFIDAVIT
STATE OF Indiana )
COUNTY OF Marion ) SS
TO WHOM IT MAY CONCERN:
THE UNDERSIGNED, Kristine M Grace BEING DULY SWORN,DEPOSES
AND SAYS THAT HE OR SHE IS Controller OF
Geiger&Peters Inc. WHO IS THE
CONTRACTOR FURNISHING Structural Steel WORK ON THE BUILDING
LOCATED AT City Center Dr&3rd Ave SW Cannel IN 46032
OWNED BY City of Carmel Community Develop.Corp.
That the total amount of the contract including extras*is $ 824,555.00 on which he or she has received payment of
$ 855,060.00 prior to this payment. That all waivers are true,correct and genuine and delivered unconditionally
and that there is no claim either legal or equitable to defeat the validity of said waivers. That the following are the names and addresses of all
parties who have furnished material or labor,or both,for said work and all parties having contracts or sub contracts for specific portions of said
work or for material entering into the construction thereof and the amount due or to become due to each,and that the items mentioned include all
labor and material required to complete said work according to plans and specifications:
NAMES AND ADDRESSES WHAT FOR CONTRACT PRICE AMOUNT T
nvINCLUDING r_xrn,+s• PAID PAYMENT ENT BALANCE DUE
Geiger&Peters Inc. Structural Steel 824,555.00 855,060.00 -30,505.00 0.00
.
TOTAL LABOR AND MATERIAL INCLUDING EXTRAS TO COMPLETE 824,555.00 855,060.00 -30,505.00 0.00
That there are no other contracts for said work outstanding,and that there is nothing due or to become due to any person for material,labor or
other work of any kind done or to be done upon or in connection with said work other than above stated.
DATE 4/20/2011 SIGNATURE: ,/ ,7 1 L
2 th 11[Y OF A.ril 2011
SUBSCRIBED AND SWORN TO BEFORE ME THIS 0 .
CrJamie S Peters Resident of Marion Co '!h!. o i l,' ,'A 1 .t',,,; ,.,. _. ._.
*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS,BOTH ORAL AND WRITTEN.TO THE CONTRACT. 1 ,''' o. JAMIE S. PETERS
;.j. L- Notary Public, State of Indiana
Marion County
I. y,.
�i = Commission fi 622941
y �.>'x My Commission Expires
`'' December 13, 2018 ,