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GENERAL PIPING, INC. -001663 -2/17/2011
CARMEL REDEVELOPMENT COMMISSION 0-01663 General Piping, Inc. Check: 1663 PO Box 34367 Date: 2/17/2011 Indianapolis, IN 46234 Vendor: GENERPIP Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. R 25 A 44 33,155.34 33,155.34 0.00 0.00 33,155. Application 25A 33,155.34 33,155.34 0.00 0.00 33;155.; — 8 / >!, TM =-=- = /4 Document 702/C ® 1992 Application and Certificate for Payment Construction Manager-Adviser Edition 4/K TO OWNER: City of Carmel PROJECT: CPAC 84% APPLICATION NO:025 g Distribution to: OWNER: PERIOD TO:October 31,2010 CONSTRUCTION MANAGER: FROM General Piping,Inc. VIA CONSTRUCTION Shiel Sexton CONTRACT DATE:June 11,2008 ARCHITECT: CONTRACTOR: P.O.Box 34367 MANAGER: PROJECT NOS:NA/2829/NA CONTRACTOR: Indianapolis,IN 46234 FIELD: CONTRACT FOR: VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner,and that current payment 1. ORIGINAL CONTRACT SUM $ 3,492,504.00 shown herein is now due. 2. NET CHANGE BY CHANGE ORDERS $ 221,209.00 CONTRACTOR: _ 3. CONTRACT SUM TO DATE(Line 1±2) $ 3,713,713.00 By: ■ . Date: October 19,2010 4. TOTAL COMPLETED & STORED TO DATE(Column G on G703) $ 3,464,784.93 State of:Indiana A 5. RETAINAGE: County of:Hendricks a. 100 %of Completed Work Subscribed and sworn to befor / (Column D+Eon G703) $ 161,762.59 me this // day of 6,41-4 be(t 2&(d b. 0 %of Stored Material Notary Public:Luke Roseboom (Column F on G703) $ 0.00 My Commission expires:July 07,2012 _,�_ Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 161,762.59 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 3,303,022.34 In accordance with the Contract Documents,based on on-site observations and the data comprising this (Line 4 Less Line 5 Total) application, the Construction Manager and Architect certify to the Owner that to the best of their 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 3,269,867.00 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 is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8. CURRENT PAYMENT DUE $ 33,155.34 AMOUNT CERTIFIED $ 33,155.34 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on tl- Continuation Sheet that are chat - to conform with the amount certified.) (Line 3 less Line 6) $ 410,690.66 CO TRUCTION M•'� ER: By: ��1N:.►?' -.:2--.4r 1jL. Date: /0/214/1=, CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC''J �,; F. Total changes approved in previous months by Owner$ 241,444.60$ 20,235.60 By: �/ ' Date: tS z.'l �� Total approved this Month PPr $ 0.00$ 0.00 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor named TOTALS $ 241,444.60$ 20,235.60 herein.Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order $ 221,209.00 AIA Document G702/CMaTN-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 AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible 1 under the law.This document was produced by AIA software at 09:42:25 on 10/20/2010 under Order No.9656147774 1 which expires on 05/13/2011,and is not for resale. User Notes: (1649764706) = _ Document 703 - 1992 Continuation Sheet AIA Document G702,APPLICATION AND CERTIFICATION FOR PAYMENT, APPLICATION NO:025 containing Contractor's signed certification is attached. APPLICATION DATE: 10/20/2010 In tabulations below,amounts are in US dollars. Use Column Ion Contracts where variable retainage for line items may apply. PERIOD TO: 10/31/2010 ARCHITECT'S PROJECT NO:NA A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 1 Bond 27,350.00 27,350.00 0.00 0.00 27,350.00 100.00% 0.00 2,735.00 Supervision/PM/Gen. 2 Cond. 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 3 Labor 181,855.00 176,399.26 1,818.55 0.00 178,217.81 98.00% 3,637.19 10,911.30 4 Material 72,013.00 69,852.36 720.13 0.00 70,572.49 98.00% 1,440.52 4,320.78 5 Submittals 21,869.00 21,869.00 0.00 0.00 21,869.00 100.00% 0.00 2,077.56 6 Punchlist 12,000.00 10,200.00 960.00 0.00 11,160.00 93.00% 840.00 0.00 7 Closeout 6,000.00 0.00 0.00 0.00 0.00 0.00% 6,000.00 0.00 3D 8 CAD/Coordination 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 9 Labor 34,726.00 34,726.00 0.00 0.00 34,726.00 100.00% 0.00 3,279.58 10 Material 64,200.00 64,200.00 0.00 0.00 64,200.00 100.00% 0.00 6,099.00 11 Daily Clean-up 15,000.00 14,550.00 150.00 0.00 14,700.00 98.00% 300.00 675.00 AW#8-Plumbing 12 (4290A) 71,648.00 0.00 0.00 0.00 0.00 0.00% 71,648.00 0.00 AW#9-Water/Gas 13 (4290B) 117,330.93 0.00 0.00 0.00 0.00 0.00% 117,330.93 317.94 AW#10 Hyd. 14 (4300A) 4,682.00 0.00 0.00 0.00 0.00 0.00% 4,682.00 • 0.00 15 AW#16 CAD(4290) 10,000.00 0.00 0.00 0.00 0.00 0.00% 10,000.00 0.00 16 AW#16 CAD(4300) 10,000.00 0.00 0.00 0.00 0.00 0.00% 10,000.00 0.00 17 Mechanical ID 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 18 Labor 5,100.00 4,692.00 255.00 0.00 4,947.00 97.00% 153.00 0.00 19 Material 5,100.00 5,100.00 0.00 0.00 5,100.00 100.00% 0.00 0.00 AIA Document G703TM-1992.Copyright m 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 1 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /o NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (C-G) RATE) (D+E) (D+E+F) 20 Firestopping 0.00_ 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 21 Labor 5,350.00 5,296.50 0.00 0.00 5,296.50 99.00% 53.50 160.50 22 Material 5,939.00 5,939.00 0.00_ 0.00 5,939.00 100.00% 0.00 178.18 23 Housekeeping Pads 0.00 0.00 0.00_ 0.00 0.00 0.00% 0.00 0.00 24 Labor 1,411.00 1,411.00 0.00 0.00 1,411.00 100.00% 0.00 141.10 25 Material 2,676.00 2,676.00 0.00 0.00 2,676.00 100.00% 0.00 267.61 26 Painting 3,000.00 3,000.00 0.00 0.00 3,000.00 100.00% 0.00 135.00 Sleeves/Core Drill 27 Holes 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 28 Labor 19,200.00 19,200.00 0.00 0.00 19,200.00 100.00% 0.00 1,536.00 29 Material 31,800.00 31,800.00 0.00 0.00 31,800.00 100.00% 0.00 2,544.00 30 Grease Interceptor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 31 Labor 3,360.00 3,259.20 0.00 0.00 3,259.20 97.00% 100.80 0.00 32 Material 16,830.00 16,830.00 0.00 0.00 16,830.00 100.00% 0.00 0.00 33 Cranes and Lifts 24,000.00 24,000.00 0.00 0.00 24,000.00 100.00% 0.00 1,440.00 34 Underground WN 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 35 Labor 28,186.00 28,186.00 0.00 0.00 28,186.00 100.00% 0.00 2,818.60 36 Material 35,120.00 35,120.00 0.00 0.00 35,120.00 100.00% 0.00 3,512.00 37 Underground Storm 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 38 Labor 6,303.00 6,303.00 0.00 0.00 6,303.00 100.00% 0.00 630.30 39 Material 10,637.00 10,637.00 0.00 0.00 10,637.00 100.00% 0.00 1,063.70 40 Underslab Drainage 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 41 Labor 9,500.00 9,500.00 0.00 0.00 9,500.00 100.00% 0.00 950.00 42 Material 1,71 4.00 1,714.00 0.00 0.00 1,714.00 1 00.00% 0.00 171.40 Aboveground W/V 43 (M) 165,426.00 165,426.00 0.00 0.00 165,426.00 100.00% 0.00 14,888.34 Aboveground W/V 44 (L) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 45 Basement 33,050.00 33,050.00 0.00 0.00 33,050.00 100.00% 0.00 2,247.40 AIA Document G703 r'4-1992.Copyright m 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 2 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED e/e BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 46 Plenum 17,879.00 17,879.00 0.00 0.00 17,879.00 100.00% 0.00 446.98 47 Orchestra 22,368.00 22,368.00 0.00 0.00 22,368.00 100.00% 0.00 559.21 48 Box Tier 18,144.00 18,144.00 0.00 0.00 18,144.00 100.00% 0.00 453.60 49 Balcony 18,409.00 18,409.00 0.00 0.00 18,409.00 100.00% 0.00 92.05 50 Attic 7,121.00 7,121.00 0.00 0.00 7,121.00 100.00% 0.00 35.61 Aboveground Storm 51 (M) 67,165.00 67,165.00 0.00 0.00 67,165.00 100.00% 0.00 6,044.86 Aboveground WN (L) Aboveground Storm 52 (L) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 53 Basement 6,120.00 6,120.00 0.00 0.00 6,120.00 100.00% 0.00 459.00 54 Plenum 365.00 365.00 0.00 0.00 365.00 100.00% 0.00 0.00 55 Orchestra 7,856.00 7,856.00 0.00 0.00 7,856.00 100.00% 0.00 314.24 56 Box Tier 3,665.00 3,665.00 0.00 0.00 3,665.00 100.00% 0.00 18.33 57 Balcony 15,976.00 15,976.00 0.00 0.00 15,976.00 100.00% 0.00 127.81 58 Attic 9,667.00 9,667.00 0.00 0.00 9,667.00 100.00% 0.00 77.34 59 Force Main 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 60 Labor 7,546.00 7,395.08 150.92 0.00 7,546.00 100.00% 0.00 528.22 61 Material 27,882.00 27,882.00 0.00 0.00 27,882.00 100.00% 0.00 2,369.98 68 Domestic Water(M) 184,831.00 184,831.00 0.00 0.00 184,831.00 100.00% 0.00 15,710.64 69 Domestic Water(L) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 70 Basement 85,091.00 85,091.00 0.00 0.00 85,091.00 100.00% 0.00 2,046.17 71 Plenum 19,393.00 19,393.00 0.00 0.00 19,393.00 100.00% 0.00 232.72 72 Orchestra 26,728.00 26,728.00 0.00 0.00 26,728.00 100.00% 0.00 320.74 73 Box Tier 18,955.00 18,955.00 0.00 0.00 18,955.00 100.00% 0.00 227.46 74 Balcony 17,692.00 17,692.00 0.00 0.00 17,692.00 100.00% 0.00 123.84 75 Attic 823.00 823.00 0.00 0.00 823.00 100.00% 0.00 5.76 76 Incoming Dom. 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 AIA Document G703 TM-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 3 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /o NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION DATE (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) Water Service 77 Labor 6,864.00 6,864.00 0.00 0.00 6,864.00 100.00% 0.00 274.56 78 Material 7,163.00 7,163.00 0.00 0.00 7,163.00 100.00% 0.00 716.30 79 Drains/Cleanouts(M) 25,175.00 25,175.00 0.00 0.00 25,175.00 100.00% 0.00 2,517.50 80 Drains/Cleanouts(L) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 81 Basement 21,076.00 21,076.00 0.00 0.00 21,076.00 100.00% 0.00 2,107.60 82 Plenum 1,920.00 1,920.00 0.00 0.00 1,920.00 100.00% 0.00 153.60 83 Orchestra 1,320.00 1,320.00 0.00 0.00 1,320.00 100.00% 0.00 118.80 84 Box Tier 3,120.00 3,120.00 0.00 0.00 3,120.00 100.00% 0.00 249.60 85 Balcony 2,400.00 2,400.00 0.00 0.00 2,400.00 100.00% 0.00 120.00 86 Attic 3,720.00 3,720.00 0.00 0.00 3,720.00 100.00% 0.00 186.00 87 Carriers(M) 12,347.00 12,347.00 0.00 0.00 12,347.00 100.00% 0.00 1,222.35 88 Carriers(L) 0.00_ 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 89 Basement 1,200.00 1,200.00 0.00 0.00 1,200.00 100.00% 0.00 102.00 90 Plenum 6,750.00 6,750.00 0.00 0.00 6,750.00 100.00% 0.00 573.76 91 Orchestra 2,100.00 2,100.00 0.00 0.00 2,100.00 100.00% 0.00 178.50 92 Box Tier 4,500.00 4,500.00 0.00 0.00 4,500.00 100.00% 0.00 382.50 93 Balcony 3,000.00 3,000.00 0.00 0.00 3,000.00 100.00% 0.00 225.00 94 Attic 300.00 300.00 0.00 0.00 300.00 100.00% 0.00 22.50 Gas Pressure 95 Regulator 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 96 Labor 480.00 360.00 120.00 0.00 480.00 100.00% 0.00 0.00 97 Material 277.00 277.00 0.00 0.00 277.00 100.00% 0.00 0.00 98 Gas Piping 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 99 Labor 2,858.00 2,715.10 142.90 0.00 2,858.00 100.00% 0.00 0.00 100 Material 1,220.00 1,220.00 0.00 0.00 1,220.00 100.00% 0.00 109.80 101 Kitchen Connections 6,000.00 5,880.00 0.00 0.00 5,880.00 98.00% 120.00 0.00 108 Water Softener 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 AIA Document G703"-1992.Copyright t9 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 4 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H 1 WORK COMPLETED TOTAL FROM MATERIALS COMPLETED e BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /e NO. WORK VALUE PREVIOUS STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION THIS PERIOD DATE (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 109 Labor 2,400.00 2,400.00 0.00 0.00 2,400.00 100.00% 0.00 0.00 110 Material 1,453.00 1,453.00 0.00 0.00 1,453.00 100.00% 0.00 0.00 Thermostatic Mixing 111 Valves 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 112 Labor 840.00 840.00 0.00 0.00 840.00 100.00% 0.00 0.00 113 Material 1,159.00 1,159.00 0.00 0.00 1,159.00 100.00% 0.00 115.90 114 Backflow Preventers 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 115 Labor 1,920.00 1,920.00 0.00 0.00 1,920.00 100.00% 0.00 0.00 116 Material 4,337.00 4,337.00 0.00 0.00 4,337.00 100.00% 0.00 433.70 117 Vibration Isolation 29,532.00 29,236.68 295.32 0.00 29,532.00 100.00% 0.00 1,033.63 Condensate Piping 118 (M) 1,608.00 1,608.00 0.00 0.00 1,608.00 100.00% 0.00 112.56 Condensate Piping 119 (L) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 120 Basement 8,592.00 8,592.00 0.00 0.00 8,592.00 100.00% 0.00 0.00 121 Orchestra 928.00 928.00 0.00 0.00 928.00 100.00% 0.00 0.00 122 Box Tier 353.00 353.00 0.00 0.00 353.00 100.00% 0.00 0.00 123 Hydronic Piping(M) 197,044.00 197,044.00 0.00 0.00 197,044.00 100.00% 0.00 15,763.52 124 Hydronic Piping(L) 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 125 Basement 90,564.00 90,564.00 0.00 0.00 90,564.00 100.00% 0.00 1,358.46 126 Plenum 14,180.00 14,180.00 0.00 0.00 14,180.00 100.00% 0.00 0.00 127 Orchestra 26,716.00 26,716.00 0.00 0.00 26,716.00 100.00% 0.00 0.00 128 Box Tier 25,375.00 25,375.00 0.00 0.00 25,375.00 100.00% 0.00 0.00 129 Balcony 43,190.00 43,190.00 0.00 0.00 43,190.00 100.00% 0.00 0.00 130 Attic 13,309.00 13,309.00 0.00 0.00 13,309.00 100.00% 0.00 0.00 131 Anchors and Guides 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 132 Labor 2,880.00 2,880.00 0.00 0.00 2,880.00 100.00% 0.00 172.80 133 Material 1,834.00 1,834.00 0.00 0.00 1,834.00 100.00% 0.00 183.40 134 Miscellaneous 79,294.00 78,501.06 792.94 0.00 79,294.00 100.00% 0.00 4,757.65 AIA Document G7031"-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 5 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS FROM COMPLETED o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /o NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G_C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) Supports 135 Hydronic Specialties 77,660.00 77,660.00 0.00 0.00 77,660.00 100.00% 0.00 0.00 139 Water Treatment 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 140 Labor 600.00 600.00 0.00 0.00 600.00 100.00% 0.00 0.00 141 Material 3,132.00 3,132.00 0.00 0.00 3,132.00 100.00% 0.00 0.00 Riggin/Offloading 143 HVAC Equipment 3,840.00 3,840.00 0.00 0.00 3,840.00 100.00% 0.00 0.00 144 AHU Connections 55,320.00 55,320.00 0.00 0.00 55,320.00 100.00% 0.00 0.00 Duct Heating Coil 145 Connections 1,260.00 1,260.00 0.00 0.00 1,260.00 100.00% 0.00 0.00 VAV Connections- 146 Basement 8,285.00 8,285.00 0.00 0.00 8,285.00 100.00% 0.00 0.00 VAV Connections- 147 Plenum 1,763.00 1,763.00 0.00 0.00 1,763.00 100.00% 0.00 0.00 VAV Connections- 148 Orchestra 1,586.00 1,586.00 0.00 0.00 1,586.00 100.00% 0.00 0.00 VAV Connections- 149 Box Tier 4,231.00 4,231.00 0.00 0.00 4,231.00 100.00% 0.00 0.00 VAV Connections- 150 Balcony 3,173.00 3,173.00 0.00 0.00 3,173.00 100.00% 0.00 0.00 VAV Connections- 151 Attic 2,820.00 2,820.00 0.00 0.00 2,820.00 100.00% 0.00 0.00 Unit Heater Connections- 152 Basement 428.00 428.00 0.00 0.00 428.00 100.00% 0.00 0.00 Unit Heater Connections- 154 Orchestra 215.00 215.00 0.00 0.00 215.00 100.00% 0.00 0.00 Unit Heater Connections-Box 155 Tier 107.00 107.00 0.00 0.00 107.00 100.00% 0.00 0.00 AIA Document G703TM-1992.Copyright C 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 AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to 6 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H 1 WORK COMPLETED TOTAL FROM MATERIALS COMPLETED e/e BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) FCU Connections- 156 Basement 2,057.00 2,057.00 0.00 0.00 2,057.00 100.00% 0.00 0.00 FCU Connections- 157 Orchestra 1,028.00 1,028.00 0.00 0.00 1,028.00 100.00% 0.00 0.00 FCU Connections- 158 Box Tier 515.00 515.00 0.00 0.00 515.00 100.00% 0.00 0.00 159 Radiant Floor System 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 160 Labor 20,483.00 20,483.00 0.00 0.00 20,483.00 100.00% 0.00 1,904.92 161 Material 11,816.00 11,816.00 0.00 0.00 11,816.00 100.00% 0.00 1,181.60 Humidifier 162 Connections 15,360.00 14,131.20 1,228.80 0.00 15,360.00 100.00% 0.00 0.00 FTR Connections- 163 Basement 664.00 664.00 0.00 0.00 664.00 100.00% 0.00 0.00 FTR Connections- 164 Plenum 2,656.00 2,656.00 0.00 0.00 2,656.00 100.00% 0.00 0.00 FTR Connections- 165 Orchestra 14,605.00 14,605.00 0.00 0.00 14,605.00 100.00% 0.00 0.00 FTR Connections- 166 Box Tier 6,307.00 6,307.00 0.00 0.00 6,307.00 100.00% 0.00 0.00 FTR Connections- 167 Balcony 9,958.00 9,958.00 0.00 0.00 9,958.00 100.00% 0.00 0.00 FTR Connections- 168 Attic 1,992.00 1,992.00 0.00 0.00 1,992.00 100.00% 0.00 0.00 169 Insulation-Basement 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 170 Labor 31,937.00 31,617.64 0.00 0.00 31,617.64 99.00% 319.36 638.74 171 Material 27,208.00 27,208.00 0.00 0.00 27,208.00 100.00% 0.00 2,176.64 172 Insulation-Plenum 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 173 Labor 18,103.00 18,103.00 0.00 0.00 18,103.00 100.00% 0.00 0.00 174 Material 15,423.00 15,423.00 0.00 0.00 15,423.00 100.00% 0.00 0.00 175 Insulation-Orchestra 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 176 Labor 14,914.00 14,914.00 0.00 0.00 14,914.00 100.00% 0.00 0.00 AIA Document G703 T"-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 7 ' the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13(2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /e NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 177 Material 12,706.00 12,706.00 0.00 0.00 12,706.00 100.00% 0.00 0.00 178 Insulation-Box Tier 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 179 Labor 13,835.00 13,835.00 0.00 0.00 13,835.00 100.00% 0.00 0.00 180 Material 11,786.00 11,786.00 0.00 0.00 11,786.00 100.00% 0.00 0.00 181 Insulation-Balcony 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 182 Labor 13,835.00 13,696.65 0.00 0.00 13,696.65 99.00% 138.35 0.00 183 Material 11,786.00 11,786.00 0.00 0.00 11,786.00 100.00% 0.00 0.00 184 Insulation-Attic 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 185 Labor 13,835.00 13,835.00 0.00 0.00 13,835.00 100.00% 0.00 0.00 186 Material 11,786.00 11,786.00 0.00 0:00 11,786.00 100.00% 0.00 0.00 Temp.Controls- 187 Engineering 64,446.00 64,446.00 0.00 0.00 64,446.00 100.00% 0.00 6,444.60 Temp.Controls- 188 Basement 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 189 Labor 83,003.00 78,852.89 1,660.06 0.00 80,512.95 97.00% 2,490.05 0.00 190 Material 151,376.00 151,376.00 0.00 0.00 151,376.00 100.00% 0.00 12,110.09 Temp.Controls- 191 Plenum 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 192 Labor 51,877.00 49,283.17 1,037.54 0.00 50,320.71 97.00% 1,556.29 0.00 193 Material 78,178.00 78,178.00 0.00 0.00 78,178.00 100.00% 0.00 5,472.46 Temp.Controls- 194 Orchestra 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 195 Labor 15,563.00 14,318.00 311.26 0.00 14,629.26 94.00% 933.74 0.00 196 Material 25,508.00 25,508.00 0.00 0.00 25,508.00 100.00% 0.00 0.00 Temp.Controls-Box 197 Tier 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 198 Labor 15,563.00 14,006.71 311.26 0.00 14,317.97 92.00% 1,245.03 0.00 199 Material 25,508.00 25,508.00 0.00 0.00 25,508.00 100.00% 0.00 0.00 200 Temp.Controls- 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 AIA Document G703" -1992.Copyright m 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 8 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /o NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G_C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) Balcony 201 Labor 15,563.00 14,006.71 311.26 0.00 14,317.97 92.00% 1,245.03 0.00 202 Material 22,701.00 22,701.00 0.00 0.00 22,701.00 100.00% 0.00 0.00 Temp.Controls- 203 Attic 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 204 Labor 15,563.00 14,006.71 0.00 0.00 14,006.71 90.00% 1,556.29 0.00 205 Material 16,170.00 16,170.00 0.00 0.00 16,170.00 100.00% 0.00 0.00 206 Test and Balance 19,474.00 6,815.10 0.00 0.00 6,815.10 35.00% 12,658.90 0.00 CO#1 -GPI#2- -0 207 Leach/Russel -24,090.00 -24,090.00 0.00 0.00 -24,090.00 100.00% 0.00 -2,409.00 CO#2-GPI#3-ASI 208 #18 1,776.00 1,776.00 0.00 0.00 1,776.00 100.00% 0.00 177.60 GPI#6-Triplex 209 Sump Basin 61,694.00 61,694.00 0.00 0.00 61,694.00 100.00% 0.00 3,084.70 GPI#7A-Basement 210 Kitchen Revisions 17,328.00 17,328.00 0.00 0.00 17,328.00 100.00% 0.00 356.26 GPI#10- Box Tier 211 Catering Kitchen 85,312.00 85,312.00 0.00 0.00 85,312.00 100.00% 0.00 1,706.25 AW 4300A-001 - 213 F#15 7,277.00 7,277.00 0.00 0.00 7,277.00 100.00% 0.00 72.78 AW 4300A-002- 214 F#18 8,605.00 8,605.00 0.00 0.00 8,605.00 100.00% 0.00 86.06 215 AW 4290A-001 -F#5 1,392.00 1,392.00 0.00 0.00 1,392.00 100.00% 0.00 139.21 216 AW 4290A-003-F#8 1,372.00 1,372.00 0.00 0.00 1,372.00 100.00% 0.00 137.21 217 AW 4290A-002-F#9 1,845.00 1,845.00 0.00 0.00 1,845.00 100.00% 0.00 184.50 AW 4290B-001 - 218 F#19 8,044.00 8,044.00 0.00 0.00 8,044.00 100.00% 0.00 80.44 AW 4290A-004- 219 F#23A 5,361.00 5,361.00 0.00 0.00 5,361.00 100.00% 0.00 536.10 AW 4290B- 220 Water/Sewer Bills 18,033.07 15,277.22 2,755.85 0.00 18,033.07 100.00% 0.00 317.94 AIA Document G703",-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 9 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /o NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G_C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) AW 4300A-005- 221 F#27 21,740.00 21,740.00 0.00 0.00 21,740.00 100.00% 0.00 0.00 AW 4300A-003- 222 F#24 5,023.00 5,023.00 0.00 0.00 5,023.00 100.00% 0.00 0.00 AW 4290A-005- 223 F#28 6,928.00 5,542.40 1,385.60 0.00 6,928.00 100.00% 0.00 0.00 AW 4300A-006- 224 F#25 10,104.00 10,104.00 0.00 0.00 10,104.00 100.00% 0.00 0.00 GPI#22-Crossover 225 Bridge 17,533.00 17,533.00 0.00 0.00 17,533.00 100.00% 0.00 876.65 226 AW 4300A-11-F#45 579.00 579.00 0.00 0.00 579.00 100.00% 0.00 0.00 227 AW 4300A-10-F#43 6,563.00 6,563.00 0.00 0.00 6,563.00 100.00% 0.00 0.00 AW 4290A-008- 228 F#41 5,933.00 5,933.00 0.00 0.00 5,933.00 100.00% 0.00 0.00 CO#8-GPI#30- 229 Lift Station Slab 7,946.00 7,946.00 0.00 0.00 7,946.00 100.00% 0.00 0.00 AW 4300A-013- 230 F#58 4,521.00 4,521.00 0.00 0.00 4,521.00 100.00% 0.00 0.00 AW 4300A-012- 231 F#48 2,937.00 2,937.00 0.00 0.00 2,937.00 100.00% 0.00 0.00 AW 4290A-009- 232 F#57 -1,105.00 -1,105.00 0.00 0.00 -1,105.00 100.00% 0.00 0.00 AW 4290A-007- 233 F#36 1,653.00 1,653.00 0.00 0.00 1,653.00 100.00% 0.00 0.00 AW 4300A-009- 234 F#17 2,376.00 2,376.00 0.00 0.00 2,376.00 100.00% 0.00 0.00 CO#10-GPI#50- 235 ASI 104 40,550.00 40,550.00 0.00 0.00 40,550.00 100.00% 0.00 0.00 AW 4300A-014- 236 F#66 3,304.00 3,304.00 0.00 0.00 3,304.00 100.00% 0.00 0.00 AW 4300A-015- 237 F#65 2,995.00 2,995.00 0.00 0.00 2,995.00 100.00% 0.00 0.00 AIA Document G703 T"-1992.Copyright m 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 10 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS STORED AND STORED TO (G G_C) FINISH (IF VARIABLE APPLICATION THIS PERIOD DATE (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) AW 4290A-012- 238 F#82 4,791.00 2,155.95 2,155.95 0.00 4,311.90 90.00% 479.10 0.00 AW 4290A-011 - 239 F#13 182.00 182.00 0.00 0.00 182.00 100.00% 0.00 0.00 AW 4300A-019- 240 F#47 1,761.00 1,761.00 0.00 0.00 1,761.00 100.00% 0.00 0.00 AW 4290B-013 - 241 F#91 4,132.00 0.00 4,132.00 0.00 4,132.00 100.00% 0.00 0.00 AW 4290B-014- 242 F#93 12,460.00 0.00 12,460.00 0.00 12,460.00 100.00% 0.00 0.00 GRAND TOTAL $3,713,713.00 $3,431,629.59 $33,155.34 $0.00 $3,464,784.93 93.30% $248,928.07 $161,762.59 AIA Document G703171-1992.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 AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to 11 the maximum extent possible under the law.This document was produced by AIA software at 09:50:04 on 10/20/2010 under Order No.9656147774_1 which expires on 05/13/2011,and is not for resale. User Notes: (1869109842) Application#25a Affidavit and Waiver of Lien [ ] Final [ x] Partial [ ] Payment Received State of Indiana, County of Marion SS: Anthony Richardson being duly sworn states that he is the Secretary/Treasurer of General Piping, Inc. having contracted with the City of Carmel to furnish certain materials and/or labor as follows: Mechanical Work for a project known as Parcel 7A, Regional Performing Arts Center located at 211 City Center Drive Carmel, IN 46032 and owned by the City of Carmel and does hereby further state on behalf of the aforementioned Contractor: Partial Waiver ...that there is due from the Owner the sum of Thirty Three Thousand One Hundred Fifty Five Dollars and 34 Cents ($33,155.34) [ ] receipt of which is hereby acknowledged; or [ x] the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; Final Waiver ...that the final balance due from the Owner is the sum of [ ] receipt of which is hereby acknowledged; or [ ] the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which shall become effective upon receipt of such payment. Therefore, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. General Piping, Inc. / Secretary/Treasurer (Firm) (Authoriz epresentative) (Title) Witness my hand and Notorial Seal, this 20th say of Oc be be 2O1O Luke Roseboom Lam` - (Printed) (Notary Pubic) My Commission Expires: July 7, 2012 Residing in Hendricks County