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HomeMy WebLinkAboutCOMPLETE MASONRY SERVICES -001778 -4/7/2011 Transmittal Sheet Page 1 Carmel Redevelopment Comm Complete Masonry Services Check: 1778 PO Box 236 Date: 4/7/2011 Yorktown, IN 47396 Vendor: COMPLET1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 1 38 116,250.00 10,241.60 0.00 0.00 10,241.60 Application 1 2 38 29,875.00 2,987.50 0.00 0.00 2,987.50 Application 2 3 38 56,355.00 5,635.50 0.00 0.00 5,635.50 Application 3 4 38 54,600.00 5,460.00 0.00 0.00 5,460.00 Application 4 5 38 116,000.00 11,600.00 0.00 0.00 11,600.00 Application 5 6 38 168,950.00 16,895.00 0.00 0.00 16,895.00 Application 6 7 38 92,500.00 9,250.00 0.00 0.00 9,250.00 Application 7 8 38 365,700.00 36,570.00 0.00 0.00 36,570.00 Application 8 9 38 427,826.00 6,753.30 0.00 0.00 6,753.30 Application 9 11 38 79,125.00 439.90 0.00 0.00 439.90 Application 11 14 38 25,784.00 251.80 0.00 0.00 251.80 Application 14 1,532,965.00 106,084.60 0.00 0.00 106,084.60 • tR4 ■ �WiSl Document G702/CMaTM - 1992 3g Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT:PARCEL 7A APPLICATION NO: 18 Distribution to: CARMEL REDEVELOPMENT COMMISSION REGIONAL PERFORMING ARTS CENTER PERIOD TO: 2/25/11 OWNER ❑ ONE CIVIC SQUARE CARMEL, INDIANA CARMEL, IN 46032 CONSTRUCTION MANAGER ❑ FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: ARCHITECT ❑ COMPLETE MASONRY SERVICES, INC. PROJECT NOS: J� / CONTRACTOR ❑ P.O. BOX 236 SHIEL SEXTON CO., INC. CMS 08-0 YORKTOWN, 47396 VIA ARCHITECT: AGREEMENT NO. 2695-4010 FIELD I=1 CONTRACT Fd #4010-INTERIOR MASONRY CSO ARCHITECTS INC. ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below,in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM . 2$134,000 00 payment shown herein is now due. 2. Net change by Change Orders $ 77,297.00 CONTRACTOR:coMP - E MASONRY SERVICES I■ 3.CONTRACT SUM TO DATE(Line 1 ±2) 2211,297.00 By: Date: 02/25/11 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) 2$211297 00 State of: INDIANA ERIC J. KELLY,PRESIDENT 5,RETAINAGE: County of: a. 0 %of Completed Work Subscribed and sworn toRbefore (Column D+Eon G703) $ 0.00 me this day of ' b. 0 %of Stored Material Notary Public:25th FEB.,2011 / l/4_, 1 ,..._, (Column F on G703) $ 0.00 My Commission expires: 02/28/15 Total Retainage(Lines 5a+Sb or Total in Column I of G703).. $ 0.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 2,211,297.00 In accordance with the Contract Documents, based on on-site observations and the data comprising this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 2,105,212.40 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 $ 106,084.60 AMOUNT CERTIFIED $ ID O 6 efrt 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs from - mount applied. Initial all fures on this Application and or • Continuation Sheet that e clr nged to conform with the amount •ertifed.) (Line 3 less Line 6) $ 0.00 CONS •UCTIO∎ Af / By: ■_,' '`� itr L A _ Date: 0712-5 1/ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT ..J �' ezl ig Total changes approved in previous months by OwnA0l$526.00 $13,834.00 By: " ' Date: Total approved this Month $ 0.00 $10,395.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS'01 26.00 $24,229.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order the Owner or Contractor under this Contract. 77A7 nn CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702/CMaTM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AlA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. c4ATA® TM Document G702/CMa - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition, 1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. • Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment The Owner should make payment directly to the Contractor based on the amount certified by the Construction Manager and Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form contains the name and address of the Contractor.Payment should not be made to any other party unless specifically indicated on G702/CMa. AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution of this MA® Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed. To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. i !IAI4 Document G703 TM - 1992 Continuation Sheet AIA Document G702TM,Application and Certification for Payment, COMPLETE MASONRY SERVICES INC. APPLICATION NO 18 containing Contractor's signed certification is attached. AGREEMENT#2695-4010 APPLICATION DATE: 02/25/2011 In tabulations below,amounts are stated to the nearest dollar. CMS JOB NO 08-07 02/25/201 1 Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0: RETAINAGE 10% UNTIL 50%COMPLETE ARCHITECT'S PROJECT NO: A B • C D E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED SCHEDULED FROM PREVIOUS PRESENTLY % TO RETAINAGE ITEM DESCRIPTION OF WORK AND STORED VALUE (G NO. APPLICATION THIS PERIOD STORED +C) FINISH (If variable rate) TO DATE (D+E) (Not in D or E) (D+E+F) (C G) 1 BOND 20000 • 2000U 20000 100% 0 2 MOBILIZATION 3000 3000 3000 100% 0 3 DE-MOBILIZATION 3000 3000 3000 100% 0 4 NS/HAZCOM/SAFETY 12000 12000 12000 100% 0 5 SUBMITTALS • 15000 15000 15000 100% ' 0 6 DAILY CLEAN UP 22000 22000 22000 100% 0 7 ;LOSE OUT 8000 8000 8000 100% 0 8 =OUNDATION CMU _ABOR 48000 48000 48000 100% 0 MATERIAL • CMU 5000 5000 5000 100% 0 REBAR 3500 3500 3500 100% 0 GROUT 5250 5250 5250 100% 0 SHEET METAL 2000 2000 2000 100% 0 MORTAR AND SAND 1250 1250 1250 100% 0 ACCESSORIES 4250 4250 4250 100% 0 9 3ASEMENT/PLENIUM CMU _ABOR 270000 270000 270000 100% 0 MATERIAL CMU 26500 26500 26500 100% 0 REBAR 16650 16650 16650 • 100% 0 GROUT 31500 31500 31500 100% 0 SHEET METAL • 10000 10000 10000 100% 0 MORTAR AND SAND 7000 7000 7000 '00% 0 ACCFSSORIFS 24000 24000 24000 100% 0 SUB-TOTAL 537900 537900 0 0 537900 100% 0 0 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM—1992.Copyright©1963,1965, 1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. *4iITA®751 ,0: Document G703 TM- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AlA Document G702TM,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner.Procedures for their use are covered in AIA Document A201 T"',General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The ALA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA.Rights to reproduce the document may vary for users of AIA software.Licensed AlA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. COMPLETING G703-1992 - Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect actual construction costs. A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE ITEM SCHEDULED COMPLETED FROM PREVIOUS PRESENTLY % TO RETAINAGE NO DI;S('RIP'I'ION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G-C) FINISH (Oat-table rate) (D E) (Noun DorE) TO DATE (C-G) (D+E+F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS&MISC CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 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 the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. tAIA® Document G7O3TM - 1992 Continuation Sheet AIA Document G702TM,Application and Certification for Payment, APPLICATION NO: . containing Contractor's signed certification is attached. COMPLETE MASONRY SERVICES INC. APPLICATION DATE: 18 In tabulations below,amounts are stated to the nearest dollar. AGREEMENT#2695-4010 02/25/2011 Use Column I on Contracts where variable retainage for line items may apply. CMS JOB NO. 08-07 PERIOD TO: 02/25/2011 RETAINAGE 10%UNTIL 50%comp]FTF ARCHITECT'S PROJECT NO: A B C D E F G H WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS COMPLETED PRESENTLY % TO RETAINAGE ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G+C) FINISH (If variable rate) NO. (D+E) (Not inDorE) (D�ETF) (C G) 10 ORCHESTRA LOW/HI CMU LABOR 325000 325000 325000 '00% 0 MATERIALS CMU 30500 30500 30500 '00% 0 REBAR 21000 21000 21000 '00% 0 GROUT 32000 32000 32000 '00% 0 SHEET METAL 12000 12000 . 12000 '00% 0 MORTAR AND SAND 8000 8000 8000 '00% 0 ACCESSORIES 28000 28000 28000 '00% 0 11 BOX TIER CMU LABOR 175000 175000 175000 '00% 0 MATERIALS CMU 23500 23500 23500 '00% 0 REBAR 10000 10000 10000 '00% 0 GROUT 19000 19000 19000 '00% 0 SHEET METAL 5500 5500 5500 "00% 0 MORTAR AND SAND 4500 4500 4500 '00% 0 ACCESSORIES 15600 15600 15600 '00% 0 12 BALCONY LOW CMU LABOR 198000 198000 198000 '00% 0 MATERIALS CMU 19000 19000 19000 '00% 0 REBAR 12000 12000 12000 '00% 0 GROUT 19500 19500 19500 "00% 0 SHEET METAL 6000 6000 6000 X00% 0 • MORTAR AND SAND 5000 5000 5000 X00% 0 ACCESSORIES 11000 11000 11000 "00% 0 SUB-TOTAL 1518000 1518000 • 0 0 1518000 100% 0 ' 0 • CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM—1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. A Document G703 TM- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702Tm,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner.Procedures for their use are covered in AIA Document A201 TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The ALA will not pen-nit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed ALA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page. Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done. Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative proposes only,and are not intended to reflect actual conSinlaton costs. A WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED ITEM SCHEDULED FROM PREVIOUS PRESENTLY % TO RETAINAGE NU DESCRIPTION OF WORK VALUE APPLICATION TIIIS PERIOD STORED AND STORED IG-C) FINISH (I)variable rare) (D+E) (Not In Dor E) TO DATE IC-(3) D-E+r) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS&MISC.CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 B PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703TM-1992.Copyright©1963,1965,1966,1967,1970,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING: This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia org. • IAiA Document G703 TM - 1992 Continuation Sheet AIA Document G702TM,Application and Certification for Payment, APPLICATION NO: containing Contractor's signed certification is attached. COMPLETE MASONRY SERVICES INC. 18 in tabulations below,amounts are stated to the nearest dollar. AGREEMENT#2695-4010 APPLICATION DATE: 02/25/2011 Use Column I on Contracts where variable retainage for line items may apply. CMS JOB NO.08-07 PERIOD TO: 02/25/2011 • RETAINAGE 10% UNTIL 50%COMPLETE ARCHITECT'S PROJECT NO: A B C D E F G H 1 WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED SCHEDULED FROM PREVIOUS PRESENTLY % TO RETAINAGE ITEM DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (G=C) FINISH Wye—triable rate) NO. (D+E) (Not in D or E) (DO DATE) (C—G) 13 BALCONY HI CMU LABOR 195000 195000 195000 100% 0 MATERIALS CMU 17000 17000 17000 100% 0 REBAR 11000 11000 11000 100% 0 . GROUT 18000 18000 18000 100% 0 SHEET METAL 6000 6000 6000 100% 0 MORTAR AND SAND 5000 5000 5000 100% 0 ACCESSORIES 11000 11000 11000 100% 0 14 ATTIC CMU LABOR 125000 125000 125000 100% 0 MATERIALS CMU 17000 17000 17000 100% 0 REBAR 11000 11000 11000 100% 0 GROUT 18000 18000 18000 100% 0 SHEET METAL 6000 6000 6000 100% 0 MORTAR AND SAND 5000 5000 5000 100% 0 ACCESSORIES 11000 11000 • 11000 100% 0 15 SEALANTS SUBCONTRACT 85000 85000 85000 100% 0 16 DAMPROOFING SUBCONTRACT 20000 20000 • 20000 100% 0 17 ALLOWANCE - GENERAL 50000 39605 10395 50000 100% 0 ALLOWANCE -CAD 5000 5000 5000 100% 0 18 •C.O. #1 1526 1526 1526 100% 0 19 C.O. #2 -8798 -8798 -8798 100% 0 20 C.O. #3 5036 5036 5036 100% 0 SUB-TOTAL 2121692 2111297 10395 0 2121692 100% 0 0 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM—1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. .S.:1!iATA Document G703 TM- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702TM,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner.Procedures for their use are covered in AIA Document A201 TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The ALA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D& E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect actual construction costs. A H C I) E F G H I WORK COMPLETED TOTAL MATERIALS BALANCE ITEM SCHEDULED FROM COMPLETED ROM1I PREVIOUS PRESENTLY % TO RETAINAGE NO DESCRIPTION OF WORK VALUE APPLICATION THIS PERIOD STORED AND STORED (0-C) FINISH (/j,xmable rare) (D+E) /Norm DorE) TO DATE (C-G) D+E+FI 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5,000 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS A MISC.CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 B PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 AIA Document G703TM-1992.Copyright©1963,1965,1966,1967,1970,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING: This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. TM • P Document 6703 - 1992 Continuation Sheet AIA Document G702TM,Application and Certification for Payment, APPLICATION NO: • containing Contractor's signed certification is attached. COMPLETE MASONRY SERVICES INC. 18 APPLICATION DATE: In tabulations below,amounts are stated to the nearest dollar. AGREEMENT#2695-4010 PERIOD T0: 02/25/2011 Use Column_I on Contracts where variable retainage for line items may apply. CMS JOB NO.08-07 02/25/2011 RETAINAGE 10%UNTIL 50%COMPLFTE ARCHITECT'S PROJECT NO: A B C D E F G H 1 WORK COMPLETED TOTAL MATERIALS BALANCE SCHEDULED FROM PREVIOUS COMPLETED ITEM DESCRIPTION OF WORK PRESENTLY % TO RETAINAGE AND STORED VALUE APPLICATION THIS PERIOD STORED (G-C) FINISH (If variable rate) NO. (D+E) (Not in D or E) TO DATE) (C G) 21 CHANGE ORDER NO. 5 100000 100000 100000 0% 0 22 CHANGE ORDER NO. 6 -10395 -10395 -10395 0% 0 • 2211297 2211297 0 0 2211297 100% 0 0 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM—1992.Copyright©1963, 1965, 1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. tik=AIA Document G703 TM- 1992 Instructions Continuation Sheet GENERAL INFORMATION Purpose and Related Documents.AIA Document G702T11,Application and Certificate for Payment,is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed for use on Projects where the Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201 TM,General Conditions of the Contract for Construction. Use of Current Documents.Prior to using any AIA Contract Document,users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document.The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G703,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA).To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. COMPLETING G703-1992 Heading.This information should be completed in a manner consistent with similar information on AIA Document G702,Application and Certificate for Payment. Columns A,B&C.These columns should be completed by identifying the various portions of the Project and their scheduled values consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal the original Contract Sum.The total of column C may be adjusted by Change Orders during the Project. Column D.Enter in this column the amount of completed Work covered by the previous application(columns D&E from the previous application).Values from column F(Materials Presently Stored)from the previous application should not be entered in this column. Column E.Enter here the value of Work completed at the time of this application,including the value of materials incorporated in the project that were listed on the previous application under Materials Presently Stored(column F). Column F.Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period.This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed This Period.) Column G.Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H.Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I.This column is normally used only for contracts where variable retainage is permitted on a line-item basis. It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders.Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule. The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702 form. Construction Change Directives.Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201. The following is an example of a Continuation Sheet for work in progress.Please note that dollar amounts shown below are for illustrative purposes only,and are not intended to reflect actual construction costs. A B C D I E P G H I WORK COMPLETED TOTAL MATERIALS BALANCE COMPLETED ITEM DI:SC'KII'I'ION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY AND STORED TO RETAINAGE NO VALE APPLICATION THIS PERIOD STORED (G-0 FINISH (II vanahle rate) ID+E) (Nn in Dar El TO DATE (C- GI (0* F) 1 MOBILIZATION 5,000 5,000 0 0 5,000 100 0 2 STUMP REMOVAL 5,000 5,000 0 0 5,000 100 0 3 EARTH WORK 15,000 10,000 5G00 0 15,000 100 0 4 LOWER RETAINING WALL 10,000 0 5,000 0 5,000 50 5,000 5 CURBS&MISC CONC. 5,000 0 0 0 0 0 5,000 6 PAVING,UPPER DRIVE 20,000 0 0 0 0 0 20,000 7 PAVING,LOWER DRIVE 20,000 0 0 0 0 0 20,000 8 PAVERS 20,000 0 0 10,000 10,000 50 10,000 9 BRICK WORK 5,000 0 0 0 0 0 5,000 10 11 GRAND TOTAL 105,000 20,000 10,000 10,000 40,000 65,000 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 the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. P-0 Document G7061M 1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER❑ PARCEL 7A Regional Performing Arts Ctr CONTRACT FOR: BP #4010 Interior Masonry ARCHITECT❑ Carmel, Indiana CONTRACTOR ❑ TO OWNER:(Name and address) CONTRACT DATED: SURETY ❑ Carmel Redevelopment Commission One Civic Square OTHER ❑ Carmel, IN 46032 STATE OF: Indiana COUNTY OF: Delaware The undersigned hereby certifies that,except as listed below,payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished,for all work,labor, and services performed,and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered. EXCEPTIONS: None SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1. Consent of Surety to Final Payment. Whenever COMPLETE MASONRY SERVICES INC. Surety is involved, Consent of Surety is P.0. BOX 236 required. AIA Document G707,Consent of YORKTOWN, IN 47396 Surety, may be used for this purpose. Indicate Attachment I Yes ❑No BY: The following supporting documents should be attached (Signature o authorizes -'presen _ hereto if required by the Owner: Eric J. Kelly, President 1. Contractor's Release or Waiver of Liens, (Printed name and title) conditional upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me on this date: Subcontractors and material and equipment 2/25/2011 suppliers, to the extent required by the Owner, • accompanied by a list thereof. Notary Public: 2L 3. Contractor's Affidavit of Release of Liens My Commission Expires: 2/28/2015 (AIA Document G706A). CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G706TM—1994.Copyright©1970 and 1994 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e- mail The American Institute of Architects'legal counsel,copyright @aia.org. • Document G706 TM - 1994 Instructions Contractor's Affidavit of Payment of Debts and Claims GENERAL INFORMATION Purpose.This document is intended for use when the Contractor is required to provide a sworn statement verifying that debts and claims have been settled,except for those listed by the Contractor under"EXCEPTIONS"in the document. G706 is typically executed as a condition of final payment. Related Documents.This document may be used with most of the AIA's Owner-Contractor agreements and general conditions, such as A201 and its related family of documents. G706 also requires the attachment of several supporting documents,including G706A, Contractor's Affidavit of Release of Liens, and G707,Consent of Surety to Reduction in or Release of Retainage. Use of Current Documents.Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G706, but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AlA software. Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects' legal counsel, copyright@aia.org. CHANGES FROM THE PREVIOUS EDITION A cross-reference to AIA Document A20I has been deleted to permit the use of G706 with other families of AIA documents, including construction management, interiors and design/build. COMPLETING THE G706 FORM General.The Owner-Contractor Agreement is the usual source of required information such as the contract date and the names and addresses of the Owner,Project and Contractor. Architect's Project No.This information is typically supplied by the Architect and entered on the form by the Contractor. Contract For.This refers to the scope of the contract, such as General Construction or Mechanical Work. Affidavit.Indicate the state and county where the Affidavit is made. This is not necessarily the same location as the Project, but should be the location where the notary is authorized to administer sworn oaths. If there are any EXCEPTIONS to the statement,these should be listed in the space provided;otherwise enter as"None." It may be a stipulation of the Contract Documents that the Owner has the right to require the Contractor to furnish a bond to cover each exception listed on the Affidavit. Supporting Documents.The AIA documents listed as attachments to the G706 form should be of the same(current)edition date as G706.The AIA does not publish a"Release or Waiver of Liens"for contractors or subcontractors because of the great diversity of releases or waivers permitted by various state mechanics lien laws. Forms for such purposes may be available from local contractors' associations or may be written with the assistance of legal counsel. EXECUTION OF THE DOCUMENT The Notary Public should administer a sworn oath to the Contractor referencing the written statements appearing on G706,and should duly sign and seal this document containing the Contractor's signature. G706 should be signed by the Contractor or the Contractor's authorized representative. AIA Document G706TM—1994.Copyright©1970 and 1994 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e- • • mail The American Institute of Architects'legal counsel,copyright @aia.org. =LAIA Document G7O6ATM - 1994 Contractor's Affidavit of Release of Liens PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER ❑ PARCEL 7A Regional Performing Arts CtrCONTRACTFOR: BP #4010 Interior Masonry ARCHITECT❑ Carmel, Indiana CONTRACTOR ❑ TO OWNER: (Name and address) CONTRACT DATED: SURETY ❑ Carmel Redevelopment Commission One Civic Square OTHER❑ Carmel, IN 46032 STATE OF: Indiana COUNTY OF: Delaware The undersigned hereby certifies that to the best of the undersigned's knowledge,information and belief,except as listed below,the Releases or Waivers of Lien attached hereto include the Contractor,all Subcontractors,all suppliers of materials and equipment,and all performers of Work,labor or services who have or may have liens or encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner out of the performance of the Contract referenced above. EXCEPTIONS: "NONE" SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1. Contractor's Release or Waiver of Liens, COMPLETE MASONRY SERVICES INC. conditional upon receipt of final payment. P.O. BOX 236 YORKTOWN, IN 47396 2. Separate Releases or Waivers of Liens from BY: Subcontractors and material and equipment suppliers,to the extent required by the Owner, (Signature of authorized representative) accompanied by a list thereof. Eric J. Kelly, President (Printed name and title) Subscribed and sworn to before me on this date: 2/25/2011 _4 Notary Public: My Commission Expires: 2/28/2015 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G706ATM—1994.Copyright©1970 and 1994 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document, or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents, e-mail The American Institute of Architects'legal counsel,copyright @aia.org. A ZTAIVZ Document G706A TM- 1994 Instructions Contractor's Affidavit of Release of Liens GENERAL INFORMATION Purpose.This document is intended for use as companion to AIA Document G706,Contractor's Affidavit of Payment of Debts and Claims. Related Documents.This document may be used with most of AIA's Owner-Contractor agreements and general conditions,such as A201 and its related family of documents. As noted above,this is a companion document to AIA Document G706. Use of Current Documents. Prior to using any ALA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. Reproductions.This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G706A, but only for use in connection with a particular project. The AIA will not permit reproduction outside of the limited license for reproduction granted above, except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software. Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AlA Contract Documents, e-mail The American Institute of Architects'legal counsel,copyright @aia.org. CHANGES FROM THE PREVIOUS EDITION A cross reference to AIA Document A201 has been deleted to permit the use of G706A with other families of AIA documents, including construction management, interiors and design/build. COMPLETING THE G706A FORM General.The Owner-Contractor Agreement is the usual source of required information such as the contract date and the names and addresses of the Owner, Project and Contractor. Architect's Project No.This information is typically supplied by the Architect and entered on the form by the Contractor. Contract For.This refers to the scope of the contract, such as "General Construction" or"Mechanical Work." Affidavit.Indicate the state and county where the Affidavit is made. This is not necessarily the same location as the Project,but should be the location where the notary is authorized to administer sworn oaths.If there are any EXCEPTIONS to the statement,these should be listed in the space provided; otherwise enter as "None." It may be a stipulation of the Contract Documents that the Owner has the right to require the Contractor to furnish a bond to cover each exception listed on the Affidavit. Supporting Documents.The AIA does not publish a"Release or Waiver of Liens" for contractors or subcontractors because of the great diversity of releases or waivers permitted by various state mechanics lien laws. Forms for such purposes may be available from local contractors'associations or may be written with the assistance of legal counsel. EXECUTION OF THE DOCUMENT The Notary Public should administer a sworn oath to the Contractor in reference to the written statements appearing on G706A,and should duly sign and seal this document containing the Contractor's signature. G706A should be signed by the Contractor or the Contractor's authorized representative. AIA Document G706ATM—1994.Copyright©1970 and 1994 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 the maximum extent possible under the law. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents. e-mail The American Institute of Architects'legal counsel,copyright @aia.org. r a CONSENT OF OWNER SURETY COMPANY ARCHITECT TO FINAL PAYMENT CONTRACTOR 0 AIA.DOCUMENT G707 SURETY I OTHER Bond No.:929 452 205 PROJECT: Regional Performing Arts Center (name,address) 211 City Center Drive Carmel,IN 46032 TO(Owner) City of Carmel ARCHITECT'S PROJECT NO: Redevelopment Commission One Civic Square Carmel,IN 46032 CONTRACT FOR: Parcel 7A,Interior Rough Construction Package P4 CONTRACT DATE: April 17,2008 ' CONTRACTOR: Complete Masonry Services,Inc.,P.O.Box 236,Yorktown,IN 47396 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (here insert name and address of Surety as it appears in the bond). Continental Casualty Company,333 S.Wabash Avenue,Chicago,IL 60604 on bond of(here insert name and address of Contractor as it appears in the bond) Complete Masonry Services,Inc.,P.O.Box 236,Yorktown,-IN 47396 hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to:(here insert name and address of Owner) City of Carmel Redevelopment Commission One Civic Square Carmel,IN 46032 as set forth in the said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand thisl 8th day of February 92011 • Continental Casualty Company S Signature of Authorized Representative Attest: Sheree Hsieh Attorney-in-fact (Seal): Title NOTE; This form is to be used as a companion document to AIA DOCUMENT G706,CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,Current Edition AIA DOCUMENT G707•CONSENT OF SURETY COMPANY TO FINAL PAYMENT•APRIL 1970 EDITION•AIAMiM ONE PAGE ®1970•THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,NW,WASHINGTON,D.C.20006 S-4869 • POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That Continental Casualty Company,an Illinois insurance company,National Fire Insurance Company of Hartford,an Illinois insurance company,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company(herein called "the CNA Companies"),are duly organized and existing insurance companies having their principal offices in the City of Chicago,and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make,constitute and appoint Michael M Bill, Edward L Mournighan, Michael H Bill, Cynthia L Jenkins, Ginger .1 Krahn, Sheree Hsieh, Brenda Johnston,Cindy H Stellhorn,Individually of Indianapolis,IN,their true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on their behalf bonds,undertakings and other obligatory instruments of similar nature -In Unlimited Amounts- and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney,pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law and Resolutions,printed on the reverse hereof,duly adopted,as indicated,by the Boards of Directors of the insurance companies. In Witness Whereof,the CNA Companies have caused these presents to be signed by their Senior Vice President and their corporate seals to be hereto affixed on this 26th day of August,2009. Continental Casualty Company k�' w�r} R+�� "sow � National Fire Insurance Company of Hartford Iconoo+ure ‘ C i I oo01+4tfo at American Casualty Company of Reading,Pennsylvania OV SEAL JULIA 'a • !� .� 4, ►i! f .1 t ,, t � ..1 .e tee? ! ... . Jac' yne �. Belcastro Senior Vice President State of Illinois,County of Cook,ss: On this 26th day of August,2009,before me personally came Jacquelyne M.Belcastro to me known,who,being by me duly sworn,did depose and say: that she resides in the City of Chicago,State of Illinois;that she is a Senior Vice President of Continental Casualty Company,an Illinois insurance company,National Fire Insurance Company of Hartford,an Illinois insurance company,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company described in and which executed the above instrument;that she knows the seals of said insurance companies;that the seals affixed to the said instrument are such corporate seals;that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that she signed her name thereto pursuant to like authority,and acknowledges same to be the act and deed of said insurance companies. OFFICAL SEAL �tidfl�r�RT.. b t9t7rPotP►�6RAKOC aerie (5)0/14.4A4 OMf 1L>7 eei1M3 My Commission Expires September 17,2013 Eliza Price Notary Public CERTIFICATE I,Mary A.Ribikawskis,Assistant Secretary of Continental Casualty Company,an Illinois insurance company,National Fire Insurance Company of Hartford,an Illinois insurance company,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force,and further certify that the By-Law and Resolution of the Board of Directors of the insurance companies printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance companies this 18th day of February , 2 011 Continental Casualty Company kts-c^ erg R,'�e k National Fire Insurance Company of Hartford 1 000PORAre 9i� e. co f ewc0et0+urro American Casualty Company of Reading,Pennsylvania pJULY 11. c) SERI- S V LY a 44 a cogi....,.zcz, Mary A.R ika kis Assistant Secretary Form F6853-5/2009 Authorizing By-Laws and Resolutions ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY: This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the Board of Directors of the Company. "Article IX—Execution of Documents Section 3. Appointment of Attorney-in-fact. The Chairman of the Board of Directors, the President or any Executive, Senior or Group Vice President may, from time to time, appoint by written certificates attorneys-in-fact to act in behalf of the Company in the execution of policies of insurance, bonds, undertakings and other obligatoryoinstruments of like nature. Such attorneys-in-fact, subject to the limitations set forth in their respective certificates of authority,shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thererto. The Chairman of the Board of Directors,the President or any Executive,Senior or Group Vice President or the Board of Directors,may,at any time,revoke all power and authority previously given to any attorney-in-fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17th day of February, 1993. "Resolved,that the signature of the President or any Executive,Senior or Group Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted pursuant to Section 3 of Article IX of the By-Laws, and the signature of the Secretary or an Assistant Secretary and the seal of the Company may be affixed by facsimile to any certificate of any such power and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall,with respect to any bond or undertaking to which it is attached,continue to be valid and binding an the Company." ADOPTED BY THE BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING,PENNSYLVANIA: This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the Board of Directors of the Company. "Article VI—Execution of Documents Section 3 Appointment of Attorney-in-fact. The Chairman of the Board of Directors,the President or any Executive or Senior Vice President may, from time to time, appoint by written certificates attorneys-in-fact to act in behalf of the Company in the execution of policies of insurance,bonds, undertakings and other obligatory instruments of like nature. Such attorneys-in-fact,subject to the limitations set forth in their respective certificates of authority,shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The President or any Executive,Senior Vice President or the Board of Directors may at any time revoke all power and authority previously given to any attorney-in-fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17th day of February,1993. "Resolved,that the signature of the President or any Executive,Senior or Group Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted pursuant to Section 2 of Article VI of the By-Laws, and the signature of the Secretary or an Assistant Secretary and the seal of the Company may be affixed by facsimile to any certificate of any such power and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and seated shall,with respect to any bond or undertaking to which it is attached,continue to be valid and binding on the Company." ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD: This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the Board of Directors of the Company. "Article VII—Execution of Documents Section 3. Appointment of Attorney-in-Fact. The Chairman of the Board of Directors, the President or any Executive or Senior Vice President may,from time to time,appoint by written certificates attorneys-in-fact to act in behalf of the Company in the execution of policies of insurance,bonds, undertakings and other obligatory instruments of like nature. Such attorneys-in-fact,subject to the limitations set forth in their respective certificates of authority shall have full power to bind the Company by their signature and execution of any such instruments and to attach the seal of the Company thereto. The Chairman of the Board of Directors, the President or any Executive,Senior Vice President or the Board of Directors,may,at any time, revoke all power and authority previously given to any attorney-in-fact." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 17`"day of February,1993. "RESOLVED: That the signature of the President,an Executive Vice President or any Senior or Group Vice President and the seal of the Insurance Company may be affixed by facsimile on any power of attorney granted pursuant to the Resolution adopted by this Board of Directors on February 17, 1993 and the signature of a Secretary or an Assistant Secretary and the seal of the Insurance Company may be affixed by facsimile to any certificate of any such power,and any power or certificate bearing such facsimile signature and seal shall be valid and binding on the Insurance Company. Any such power so executed and sealed and certified by certificate so executed and sealed,shall with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Insurance Company."