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GENERAL PIPING, INC. -001935 -5/31/2011
CARMEL REDEVELOPMENT COMMISSION 001935 General Piping, Inc. Check: 1935 PO Box 34367 Date: 5/31/2011 Indianapolis, IN 46234 Vendor: GENERPIP Prior Invoice . P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 1 44 320,942.00 32,094.20 0.00 0.00 32,094.20 Application 1 2 44 573,856.56 57,385.65 27,717.26 0.00 29,668.39 Application 2 894,798.56 89,479.85 27,717.26 0.00 61,762.59 , . b Document G732' — 2009 Ai/ Application and Certificate for Payment, Construction Manager as Adviser Edition TO OWNER: City of Cannel PROJECT: CPAC 84% APPLICATION NO:031 DISTRIBUTION TO: OWNER PERIOD TO:April 30,2011 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: General Construction VIA ARCHITECT: CSO Architects OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the beat 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 ALA Document G7037"' Continuation Sheet,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 CHANGES IN THE WORK - $ 191,209.00 CONTRACTOR: . 3. CONTRACT SUM TO DATE(Line I±2) $ 3,683,713.00 By: �' /� Date: May 05,2011 4. TOTAL COMPLETED AND STORED TO DATE(Column G on G703) $ 3,599,540.46 State of:Indiana 4• -. 5. RETAINAGE: County of:Hen cks „N-'''''• ! C a. 100 %of Completed Work Subscribed and sworn to before '.. J5— Y 11'(4 r 201( :'7 (Column D+Eon G703 $ 100,000.00 rile this day of yy • b. 0 %of Stored Material Notary Public:Luke Rosebootii (Column F on G703) $ 0.00 My Commission expires:July 07,2012 •. Total Retainage(Lines 5a+Sb,or Total in Column I on G703) $ 100,000.00 CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 3,499,540.46 In accordance with the Contract Documents,based on evaluations of the WO k afid the data comprising (Line 4 mimtr Line S Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 3,437,777.87 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 6. CURRENT PAYMENT DUE I S 61,762.591 AMOUNT CERTlFED $ 61,762.59 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Attach explanation ifamount certified differs from r e amoupt applied.Initial all figures on this Application and on the t tinuation Sheet 1-. are. anged/to conform with the amou t certifi:'.) (Line 3 mimes Line 6) $ 184,172.54 r ' / i9 , BY \��4�..►`�i�_�—'S`r► -, ■! Date: SUMMARY OF CHANGES IN THE WORK ADDITIONS D E D U C T I O N S ARC ' :7.-(N T':I''' a Prime Contractors are responsible for performi : ;,,rtfons the Project,the Architect's Certification Lc not -a ired) Total changes approved in previous months by Owner$ 331,444.60 S 140,235.60 By: `4.1p-- ..r/11.1 " Date: Total approved this month including Construction �_ VI S 000$ 0 Change Directives . This • • to is not: gotiable.The a UNT CERTIFIED is payable only to the Contractor named TOTALS $ 331,444.60$ 140,235.60 herei' ssuance,pa • sad— a nce of payment are without prejudice to any rights of the Owner NET CHANGES IN THE WORK $ 191,209.00 or Contractor under this Contract AIA Dectansrk(2732' —2000(formerly 0702'°C100—1012).Copyright O 1992 and 2009 by The American Institute of Architects.Ail lights reosrver.WARNING:This AtAe Document to protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlAe Document,or any portion of it,mey result in severe civil and criminal penalties,and will be prosecuted to 1 the maximum oxtent possible under the law.This document was produced by AIA software et 12:29:15 on 05/05/2011 under Order No.0889551328 1 which er'tires on 05/13/2012,and is not for resale. User Notes: (1833258033) stTi NigarAIA Document 6703" ® 1992 Continuation Sheet AIA Document,G702TM-1992,Application and Certification for Payment,or G736TM-2009, APPLICATION NO:031 Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars. PERIOD TO: Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:NA A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o/a 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) 1 Bond 27,350.00 27,350.00 0.00 0.00 27,350.00 100.00% 0.00 0.00 Supervision/PM/Gen. 2 Cond. 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 3 Labor 181,855.00 181,855.00 0.00 0.00 181,855.00 100.00% 0.00 0.00 4 Material 72,013.00 72,013.00 0.00 0.00 72,013.00 100.00% 0.01 0.00 5 Submittals 21,869.00 21,869.00 0.00 0.00 21,869.00 100.00% 0.00 0.00 6 Punchlist 12,000.00 12,000.00 0.00 0.00 12,000.00 100.00% 0.00 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 0.00 10 Material 64,200.00 64,200.00 0.00 0.00 64,200.00 100.00% 0.00 0.00 II Daily Clean-up 15,000.00 15,000.00 0.00 0.00 15,000.00 100.00% 0.00 0.00 AW#8-Plumbing 12 (4290A) 16,148.00 0.00 0.00 0.00 0.00 0.00% 16,148.00 0.00 AW#9-Water/Gas 13 (4290B) 39,386.54 0.00 0.00 0.00 0.00 0.00% 39,386.54 0.00 AW#10 Hyd. 14 (4300A) 2,638.00 0.00 0.00 0.00 0.00 0.00% 2,638.00 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 5,100.00 0.00 0.00 5,100.00 100.00% 0.00 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 G703".-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 1 the maximum extent possible under the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and is not for resale. User Notes: (859264612) A B C D E F G H I - WORK COMPLETED TOTAL FROM MATERIALS COMPLETED 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) 20 Firestopping 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 21 Labor 5,350.00 5,350.00 0.00 0.00 5,350.00 100.00% 0.00 0.00 22 Material 5,939.00 5,939.00 0.00 0.00 5,939.00 100.00% 0.00 0.00 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 0.00 25 Material 2,676.00 2,676.00 0.00 0.00 2,676.00 100.00% 0.00 0.00 26 Painting 3,000.00 3,000.00 0.00 0.00 3,000.00 100.00% 0.00 0.00 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 0.00 29 Material 31,800.00 31,800.00_ 0.00 0.00 31,800.00 100.00% 0.00 0.00 30 Grease Interceptor 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 31 Labor 3,360.00 3,360.00 0.00 0.00 3,360.00 100.00% 0.00 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 0.00 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 0.00 36 Material 35,120.00 35,120.00 0.00 0.00 35,120.00 100.00% 0.00 0.00 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 0.00 39 Material 10,637.00 10,637.00 0.00 0.00 10,637.00 100.00% 0.00 0.00 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 0.00 42 Material 1,714.00 1,714.00 0.00 0.00 1,714.00 100.00% 0.00 0.00 Aboveground WN 43 (M) 165,426.00 165,426.00 0.00 0.00 165,426.00 100.00% 0.00 0.00 Aboveground WN 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'"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale 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 proseculeci to 2 the maximum extent possible under the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and is not for resale. User Notes: (859264612) A B C D E F G H I WORK COMPLETED TOTAL FROM /e MATERIALS COMPLETED e BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO _C) FINISH (IF VARIABLE APPLICATION (NOT TN D OR E) DATE (C-G) RATE) (D+E) (D+E+F) 46 Plenum 17,879.00 17,879.00 0.00 0.00 17,879.00 100.00% 0.00 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 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 7,546.00 0.00 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"-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 3 the maximum extent possible under the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and Is not for resale. User Notes: (859264612) 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) 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 480.00 480.00 0.00 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 2,858.00 0.00 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 6,000.00 0.00 0.00 6,000.00 100.00% 0.00 0.00 108 Water Softener 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 MA Document 0703"'-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 4 the maximum extent possible under the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and is not for resale. User Notes: (859264612) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS PRESS ITEM DESCRIPTION OF SCHEDULED PRESENT LY /°COMPLETED e BALANCE TO RETAINAGE PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G 4-C) (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 . 1,1 59.00 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 29,532.00 0.00 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 79,294.00 0.00 0.00 79,294.00 100.00% 0.00 4,757.65 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 Ale 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 5 the maximum extent possible under the law.This document was produced byAIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and is not for resale. User Notes: (859264612) 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 STORED AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD 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 G703'.-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 MA'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 byAlA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012.and Is not for resale. User Notes: (859264612) A B C D E F G H I WORK COMPLETED TOTAL ITEM DESCRIPTION OF SCHEDULED FROM RE ERNTLY COMPLETED ale BALANCE TO RETAINAGE 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 15,360.00 0.00 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- 1.65 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 31,937.00 0.00 0.00 31,937.00 100.00% 0.00 638.74 171 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 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 7 the maximum extent possible under the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and is not for resale. User Notes: . (859264612) A B C D E F G H _ 1 WORK COMPLETED TOTAL FROM MATERIALS COMPLETED 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) (NOT IN D OR E) (C-G) RATE) (D+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 '13,835.00 0.00 0.00 13,835.00 100.00% 0.00 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 83,003.00 0.00 0.00 83,003.00 100.00% 0.00 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 51,877.00 0.00 0.00 51,877.00 100.00% 0.00 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 15,563.00 0.00 0.00 15,563.00 100.00% 0.00 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 15,563.00 0.00 0.00 15,563.00 100.00% 0.00 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"0-1992.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 8 the maximum extent possible under the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and Is not for resale. User Notes: (859264612) • A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE 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 15,563.00 0.00 0.00 15,563.00 100.00% 0.00 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 .15,563.00 0.00 0.00 15,563.00 100.00% 0.00 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 19,474.00 0.00 0.00 19,474.00 100.00% 0.00 0.00 CO#1-GPI#2- 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 71.32 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 22,218.46 22,218.46 0.00 0.00 22,218.46 100.00% 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 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 9 the maximum extent possible ander the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and Is not for resale. User Notes: (859264612) A B C D E F G _ H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (C'-C) (C-G) RATE) (D+E) (NOTIN DORE) (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 6,928.00 0.00 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 G703r"-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 .10 the maximum extent possible under the law.This document was produced by AIA software at 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and is not for resale. User Notes: (859264612) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY % BALANCE TO RETAINAGE 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 4290A-012- 238 F#82 4,791.00 4,791.00 0.00 0.00 4,791.00 100.00% 0.00 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 4,132.00 0.00 0.00 4,132.00 100.00% 0.00 0.00 AW 4290B-014- 242 F#93 12,460.00 12,460.00 0.00 0,00 12,460.00 100.00% 0.00 0.00 AW 4290B-015- 243 F#101 3,759.00 3,759.00 0.00 0.00 3,759.00 100.00% 0.00 0.00 AW 4300A-025- 244 F#59 1,594.00 1,594.00 0.00 0.00 1,594.00 100.00% 0.00 0.00 AW 4300A-026- 245 F#102 450.00 450.00 0.00 0.00 450.00 100.00% 0.00 0.00 AW 4290A-017- 246 F#67 5,500.00 5,500.00 0.00 0.00 5,500.00 100.00% 0.00 0.00 247 AW-4290A 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 CO#6-Reduce 248 AW429A$50,000 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 CO#9-Reduce 249 AW429B$20,000 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 CO#11-Reduce 250 AW4290B$50,000 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 251 CO#12-Settlement 90,000.00 90,000.00 0.00 0.00 90,000.00 100.00% 0.00 0.00 GRAND TOTAL $3,683,713.00 $3,599,540.46 $0.00 $0.00 $3,599,540.46 97.72% $84,172.54 $100,000.00 MA Document G703' -1992.Copyright 01963,1965,1966.1967.1970,1976,1983 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 MA 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 12:26:41 on 05/05/2011 under Order No.0689551328_1 which expires on 05/13/2012,and Is not for resale. User Notes: (859264612) CONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT PROJECT: Carmel Performing Arts Center Upon receipt by the undersigned of a check from City of Carmel Rdvlpmnt Comm. in the sum of $61,762.59 payable to General Piping Inc. and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanic's lien, stop notice, any state or federal statutory bond right, any private bond right, any claim for payment and any rights under any similar ordinance, rule or statute related to claim or payment rights for persons in the undersigned's position, the undersigned has on the job of City of Carmel Rdvlpmnt Comm. located at 777 3rd Ave. SW, Carmel, IN 46032 to the following extent. This release covers a progress payment for labor, services, equipment or materials furnished to the jobsite or to City of Carmel Rdvlpmnt Comm. through 04/30/11 only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date or pending modifications and changes. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic's lien, stop notice or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that furnished labor, services, equipment or material was not compensated by the progress payment. The undersigned warrants that he either has already paid or will use the monies he receives from this progress payment to promptly pay in full all of his laborers, subcontractors, materialmen and suppliers for all work, materials, equipment or services provided for or to the above-referenced project up to the date of this waiver. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned. DATE: 5151 )\ General Piping Inc. gnature) et. / Te4S. (title) OHIO FARMERS INSURANCE COMPANY Consent to Reduction in Retainage • Consent to Partial Release of Retainage To the Obligee: City of Cannel Redevelopment Commission One Civic Square Carmel,IN 46032 Regarding Project: Parcel 7A,Regional Performing Arts Center- Interior Finish Contract Dated: June 1 1,2008 Bond No.: 0051795 In accordance with the provisions of the Contract between the Obligee and the Contractor as indicated above, Ohio Farmers Insurance Company, P. 0. Box 5001,Westfield Center, Ohio 44251-5001, as surety on bond of contractor, General Piping,Inc. 1175 Western Drive Indianapolis, IN 46241 hereby approves the reduction in retainage or partial release of retainage to the Contractor as follows: Reduce to 5100,000 Ohio Farmers Insurance Co. agrees that such reduction in retainage or partial release of retainage to the Contractor shall not relieve Ohio Farmers Insurance Company of any of its obligations to the Obligee, City of Carmel Redevelopment Commission One Civic Square Carmel,IN 46032 as set forth in our bond. Dated: May 5,2011 OHIO FARMERS INSURANCE COMPANY ` By �L,�� _orna NI Adams norney In Fact Obligee's Copy • I THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME POWER#AND ISSUED PRIOR TO 09129110,FOR ANY PERSON OR PERSONS NAMED BELOW. : General POWER NO. 1302892 04 Power Westfield Insurance Co. of Attorney Westfield National Insurance Co, CERTIFIED COPY Ohio Farmers insurance Co. Westfield Center, 01110 Kneel All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to Individually as a "Company" and collectively as "Companies," duly organized and existing under the laws of the State of Ohio,and having Its principal office In Westfield Center, Medina County,Ohio,do by these presents make,constitute and appoint RICHARD A. BITTLES, MICHAEL C.CONOVER,HAROLD W.STARK,III,LORNA M.ADAMS, MARTHA L. DENTON,JOHN J. WIGGINS,JOHN R.FARMLEY,TERESA J.WILSON,MARILYN A.SHROUT,JOINTLY OR SEVERALLY of GREENCASTLE and State of IN its true and lawful Attorney(s)-in-Fact,with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE,OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President,sealed with the corporate seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-In-Fact may do In the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: "Be It Resolved,that the President,any Senior Executive,any Secretary or any Fidelity& Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney-In-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and deliver,any and all bonds, recognizances, contracts, agreements of Indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such Instruments so executed by any such Attorney-in-Fact shall be as binding upon the Company as If signed by the President and sealed and attested by the Corporate Secretary." "Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which It is attached." (Each adopted at a meeting held on February 8,2000). in Witness Whereof,WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 29th day of SEPTEMBER A.D.,2010 . . U 11b,1y,,,1 Mill,,, Corporate ,,r`''1:Utf,4,, a,, ,,.-(1ONAL�'I ,••"'lKSU WESTFIELD INSURANCE COMPANY Seals /�Nti°....,., C + x�P,.• NSG ' �QS,.. R�lyta WESTFIELD NATIONAL INSURANCE COMPANY Atilxed Ivr' w. O. -i'4•• •,."�: FARMERS INSURANCE CO OHIO CE MPANY \y 1-4' el\'' '.- ,r0 � .• 1548 :Z? G r . State of Ohio �"4n.+..•""s',�S ''",,,„,„.,,0•0` ,,#' ` 0` Ilil,,,,,,,"•• By County of Medina ss.: Richard L. Kinnaird, Jr., Senior Executive On this 29th day of SEPTEMBER A.D.,2010 , before me personally came Richard L. Kinnaird, Jr. to me known, who, being by me duly sworn, did depose and say,that he resides In Medina, Ohio; that he Is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY arid OHIO FARMERS INSURANCE COMPANY, the companies described In and which executed the above Instrument;that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order. Notarial ,,,w,,,,,yl /.. / ��Seal o`O"R1 A t '. Affixed '�A.�.`)j/j.F / •Ar-' ,, William J. Kahelin,A rney at Law, Notary Public State of Ohio =-N�3 .'le 4f o My Commission Does Not Expire(Sec. 147.03 Ohlo Revised Code) County of Medina ss.: y`4' k-- •o4 E. of I,Frank A. Carrino,Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OH-110 FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing Is a true and correct copy of.a Power of Attorney, executed by said Companies,which Is still In full force and effect;and furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are In full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 5 day of May A.D., 201 1 . „1.,410% ,,,,,,I,I,,,,ll „. 111/ll rO%tjIll4,0% ,\ :\?rf•At,✓Ns,, °CPISUR4y% N t 5 .L 1.-01 SEAL ,71_ ( CNARifRE �.) /—i' ' • „n f� =�• �j•., 1B4t3 ,?�; Frank A. Carrillo, Secrete y Secretary ....... / "- ° °... 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