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Home My WebLink AboutW R DUNKIN & SON, INC.- 002851- 4/19/2012 CARMEL REDEVELOPMENT COMMISSION 0 02851 W R Dunkin & Son, Inc. Check: 2851 PO Box 2247 Date: 4/19/2012 Anderson, IN 46018 Vendor: DUNKINW1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 26 51 954.00 9. 54.00 0.00 0.00 954.00 App 26 954.00. 954.00 ` 0.00' •• 0.00 954.00 ,. THE,tkEYTODOCUMENT,SECURITYb.1EAT'ACTIVATED,THUMB'^PRINT ADDITIONAL'SECURIT,YFEATURESINCLUDED`+.SEEBACKFOR,DETAIL'S, Pts6PES,C Carmel Redevelopment Commission REGIONS P ti .30 West Main Street 0 02851 I Suite 220 20-1421/740 : 1 h i 'I`Aml I:6. Carmel, IN 46032 f '2851 I DATE AMOUNT. 4/19/2012 *,� 954 00 PAY THE SUM OF NINE HUNDRED FIFTY FOUR DOLLARS AND NO CENTS********************************* TO THE _ ,,., ORDER' OF - W R Dunkin & Son, Inc: PO Box 2247 `ts ESi Anderson, IN 46018 ' : „E _' 11'00 285 511° 1:0 740 14 2 1 31: 008 7 SO4 1 110 CARMEL REDEVELOPMENT COMMISSION 0-02851 W R Dunkin & Son, Inc. Check: 2851 PO Box 2247 Date: 4/19/2012 Anderson, IN 46018 Vendor: DUNKINW1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 26 51 . 954.00 954.00 0.00 0.00 954-.00 App 26 954:00 954.00 0.00 0.00 954:00 (-11-52 COMPUTEREASE FORMS DIVISION(877)577-5791 i T-37228'. 1tk27 * AIA G732T� ® 2009 Document fi - Application and Certificate for Payment, Construction Manager as Adviser Edition TO OWNER: Cannel Redevelop't Comm PROJECT: Parcel 7A,#5010 CPA APPLICATION NO:026 DISTRIBUTION TO: One Civic Square 777 3rd Ave S.W. OWNER Cannel,IN 46032 Cannel,IN 46032 PERIOD TO:March 30,2012 CONSTRUCTION MANAGER FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co.,Inc. CONTRACT DATE:February 23,2009 ARCHITECT CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:25310H/2695/5010/2695 CONTRACTOR O Anderson,IN 46018 FIELD CONTRACT FOR: Bid Package#5010-Gen VIA ARCHITECT: CSO Architects Trades CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the . st of the Contractor's knowledge,information and belief the Work covered by this Application 1 ayment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract Contract Documents,that all amounts have paid . the Contractor for Work for which previous MA Document G703TM,Continuation Sheet,is attached. Certificates for Payment were iss -: ,• pa ;.--' received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 1,480,000.00 payme. is ,•w du,. 2.NET CHANGES IN THE WORK $ -140,991.00 CO : ' 0.4e W ' _ Inc. 3.CONTRACT SUM TO DATE(Line 1 t 2) $ 1,339,009.00 By: �'7.jia�II►�� Date: March 30,2012 4.TOTAL COMPLETED AND STORED TO DATE(Column G on G703) $ 1,339,009.00 Sta>of:Indiana — 5.RETAINAGE: rcunty of:Madis: 774-05,e5 MARTHA A CARPENTER a. 0 %of Completed Work Subscribed and sworn to be •re NOTARY PUBLIC (Column D+Eon G703) $ 0.00 me this 30th day of March, 2 2 OF INDIANA /�flATE E 1-8-17 b. 0 %of Stored Material Notary Public:Martha A Carpenter�r • _ Lam. , (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b, or Total in Column Ion G703) $ 0.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1,339,009.00 In accordance with the Contract Documents, based on evaluations of the Work and the data (Line 4 minus Line S Total) comprising this application,the Construction Manager and Architect certify to the Owner that to the 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1,338,055.00 best of their knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of (Line 6 from prior Certificate) the AMOUNT CERTIFIED. 8.CURRENT PAYMENT DUE 1$ 954.001 AMOUNT CERTIFIED $ 954.00 (Attach explanation f amount certified differs rom the • ount applied Initial all figures on this 9.BALANCE TO FINISH,INCLUDING RETAINAGE Application and o L , Continuation S •et th, are ch.nged to conform with the amount certified) (Line 3 minus Line 6) $ 0.00 CO,STRUCTION 2' .GE". By: '�� ' ,AA Date: nV SUMMARY OF CHANGES IN THE WORK ADDITIONS DEDUCTIONS AR ` CT.� IT :1" ultiple 'r me Contractors are responsible for performi orti ns of the Q I Project, the Architect's Certifi • '. is not required) Total changes approved in previous months by Owner$ 0.00$ 81,040.00 By: 4ir Date: 4 12- Total approved this month including Construction $ 0.00$ 59,951.00 Change Directives This 'ertifi : is n.t negoti.. e. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0.00$ 140,991.00 name• •: m. Issuan•• • ent and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. NET CHANGES IN THE WORK $ -140,991.00 AIA Document G732*",—2009(formerly 0702TMCMa—1992).Copyright®1992 and 2009 by The American Institute of Architects.All tights reserved.WARNING:This AIAm 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 1 ale. to the maximum extent possible under the law.This document was produced by AIA software at 10:02:55 on 03/30/2012 under Order No.0215931572_1 which expires on 05/10/2012,and is not for(a593571) User Notes: 1AIA TM Document 6703 - 1992 . Continuation Sheet AIA Document,G702 1992,Application and Certification for Payment,or G736' 2009, APPLICATION NO:026 Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE:03/30/2012 containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars. PERIOD TO:03/30/2012 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO:25310H 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 THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION (NOT 1N D OR E) DATE (C-G) RATE) (D+E) (D+E+F) 01010 Performance Bond 26,400.00 26,400.00 0.00 0.00 26,400.00 100.00% 0.00 0.00 Mobilize/ 01015 Demobilize 8,000.00 8,000.00 0.00 0.00 8,000.00 100.00% 0.00 0.00 - Supervision/ 01020 Coordination 87,000.00 87,000.00 0.00 0.00 87,000.00 100.00% 0.00 0.00 - General Conditions- 01025 M 30,000.00 30,000.00 0.00 0.00 30,000.00 100.00% 0.00 0.00 General Conditions- 01026 L 34,000.00 34,000.00 0.00 0.00 34,000.00 100.00% 0.00 0.00 1400A Organ Facade Pipes 200,000.00 200,000.00 0.00, 0.00 200,000.00 100.00% 0.00 0.00 Carpentry Labor 1400B Hours 32,000.00 32,000.00 0.00 0.00 32,000.00 100.00% 0.00 0.00 Provide Tie-Off 1400C Points at Balconies 25,000.00 7,000.00 18,000.00 0.00 25,000.00 100.00% 0.00 0.00 Vertical Partition System&Backfold 1400D Doors 15,000.00 15,000.00 0.00 0.00 15,000.00 100.00% 0.00 0.00 16'X16'Temporary 1400E Overhead Door 6,000.00 6,000.00 0.00 0.00 6,000.00 100.00% 0.00 0.00 Temporary OHD Enclosure and 1400F Insulation 10,000.00 1,644.00 8,356.00 0.00 10,000.00 100.00% 0.00 0.00 1000 SY of BX 1200 1400G Tensar Geogrid 17,000.00 4,117.00 12,883.00 0.00 17,000.00 100.00% 0.00 0.00 1400H 350 CY of#2 Stone 18,200.00 5,718.00 12,482.00 0.00 18,200.00 100.00% 0.00 0.00 AIA Document G703"-1992.Copyright®1963,1985,1966,1987,1970,1978,1983 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 I prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 09:57:07 on 03/30/2012 under Order No.021 5931 57 2_1 which expires on 05/10/2012,and is not for resale. User Notes: (728157641) • A B C D E F G H I WORK COMPLETED MATERIALS TOTAL FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PREVIOUS AND STORED TO FINISH (IF VARIABLE NO. WORK VALUE APPLICATION THIS PERIOD (NOT IN OR E) DATE (G_C) (C-G) RATE) (D+E) (D+E+F) 1400J 200 CY of#53 Stone 10,000.00 1,746.00 8,254.00 0.00 10,000.00 100.00% 0.00 0.00 1400K General Allowance 75,000.00 74,070.00 930.00 0.00 75,000.00 100.00% 0.00 0.00 CAD As-Built 1400L Allowance 5,000.00 5,000.00 0.00 0.00 5,000.00 100.00% 0.00 0.00 General Clean Up- 01560 M 4,000.00 4,000.00 0.00 0.00 4,000.00 100.00% 0.00 0.00 01561 General Clean Up-L 25,000.00 25,000.00 0.00 0.00 25,000.00 100.00% 0.00 0.00 Final Cleaning(Items 01562 in BP 5010 10,000.00 10,000.00 0.00 0.00 10,000.00 100.00% 0.00 0.00 • Dewatering for 9 02110 Months-M-Eq 18,500.00 18,500.00 0.00 0.00 18,500.00 100.00% 0.00 0.00 _ Dewatering for 9 02111 Months-L-Eq 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00% 0.00 0.00 Piping from Tri-Plex 02240 to Lift Station 21,000.00 21,000.00 0.00 0.00 21,000.00 100.00% 0.00 0.00 Interior Metal Fabrications- 05504 Submittals 6,200.00 6,200.00 0.00 0.00 6,200.00 100.00% 0.00 0.00 Interior Metal Fabrications- 05505 Materials 86,500.00 86,500.00 0.00 0.00 86,500.00 100.00% 0.00 0.00 Interior Metal 05506 Fabrications-Erection 24,000.00 24,000.00 0.00 0.00 24,000.00 100.00% 0.00 0.00 Miscellaneous Metals 05511 -M 5,640.00 5,640.00 0.00 0.00 5,640.00 100.00% 0.00 0.00 Miscellaneous Metals 05512 -L 2,500.00 2,500.00 0.00 0.00 2,500.00 100.00% 0.00 0.00 Interior Rough 06100,Carpentry-M 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00% 0.00 0.00 Interior Rough 06101 Carpentry-L 36,500.00 36,500.00 0.00 0.00 36,500.00 100.00% 0.00 0.00 07810 Skylight Shade-M 62,000.00 62,000.00 0.00 0.00 62,000.00 100.00% 0.00 0.00 MA Document G703"-1992.Copyright®1983,1985,1966,1987,1970,1978,1983 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 2 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 09:67:07 on 03/30/2012 under Order No.0215931572_1 which expires on 05/10/2012,and Is not for resale. User Notes: (728157841) A B C D ( E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY COMPLETED % BALANCE TO RETAINAGE NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G r C) FINISH (IF VARIABLE APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+E+F) Skylight Shade- 07811 Installation 29,500.00 29,500.00 0.00 0.00 29,500.00 100.00% 0.00 0.00 07910 Joint Sealants-M 48,000.00 48,000.00 0.00 0.00 48,000.00 100.00% 0.00 0.00 07911 Joint Sealants-L 24,500.00 24,500.00 0.00 0.00 24,500.00 100.00% 0.00 0.00 08810 Interior Glazing 42,000.00 42,000.00 0.00 0.00 42,000.00 100.00% 0.00 0.00 09610 Access Flooring 19,500.00 19,500.00 0.00 0.00 19,500.00 100.00% 0.00 0.00 09710 FRP Wall Panels-M 1,000.00 1,000.00 0.00 0.00 1,000.00 100.00% 0.00 0.00 09711 FRP Wall Panels-L 2,000.00 2,000.00 0.00 0.00 2,000.00 100.00% 0.00 0.00 . Acoustic Fabric 09712 Wrapped Panels 42,500.00 42,500.00 0.00 0.00 42,500.00 100.00% 0.00 0.00 10210 Toilet Compartments 44,000.00 44,000.00 0.00 0.00 44,000.00 100.00% 0.00 0.00 - Backfold Door 10220 Tracks-M 5,000.00 5,000.00 0.00 0.00 5,000.00 100.00% 0.00 0.00 Backfold Door 10221 Tracks-L 4,560.00 4,560.00 0.00 0.00 4,560.00 100.00% 0.00 0.00 10222 Operable Partition 21,000.00 21,000.00 0.00 0.00 21,000.00 100.00% 0.00 0.00 10223 Wire Mesh Partitions 9,500.00 9,500.00 0.00 0.00 9,500.00 100.00% 0.00 0.00 Toilet Accessories- 10224 M 34,000.00 34,000.00 0.00 0.00 34,000.00 100.00% 0.00 0.00 Toilet Accessories- 10225 L 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00% 0.00 0.00 10510 Metal Lockers 16,500.00 16,500.00 0.00 0.00 16,500.00 100.00% 0.00 0.00 10520 Phenolic Lockers-M 110,000.00 110,000.00 0.00 0.00 110,000.00 100.00% 0.00 0,00 10521 Phenolic Lockers-L 29,000.00 29,000.00 0.00 0.00 29,000.00 100.00% 0.00 0.00 10610 Corner Guards-M 9,500.00 9,500.00 0.00 0.00 9,500.00 100.00% 0.00 0.00 10611 Corner Guards-L 3,500.00 3,500.00 0.00 0.00 3,500.00 100.00% 0.00 0.00 17001 Changr Order No.01 -81,040.00 -81,040.00 0.00 0.00 -81,040.00 100.00% 0.00 0.00 17003 Changr Order No.03 -59,951.00 0.00 -59,951.00 0.00 -59,951.00 100.00% 0.00 0.00 GRAND TOTAL $1,339,009.00 $1,338,055.00 $954.00 $0.00 $1,339,009.00 100.00% $0.00 $0.00 AIA Document 0703^-1992.Copyright 0 1963,1985,1966,1987,1970,1978,1883 and 1992 by The American institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be 3 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 09:57:07 on 03/30/2012 under Order No.0215931572_1 which expires on 05/10/2012,and is not for resale. User Notes: (726157641) • AFFIDAVIT AND WAIVER OF LIEN [X]FINAL [ ] PARTIAL [X] PAYMENT TO FOLLOW State of Indiana,County of Madison. SS Bradley Tyler , being duly sworn states that he is the Project Manager of W. R. Dunkin & Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Bid Package 5010-Interior Finishes for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Application for Payment # has been received for work performed through (PARTIAL WAIVER)that there is due from the contractor the sum of dollars and 00/cents ($ 0.00) Application for Payment # 26 for work performed through 03/30/12 . (FINAL WAIVER)that the final balance due from the Owner is the sum of Nine Hundred Fifty-four dollars and 00/cents($954.00 ) THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above described property and improvements thereon on account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a ';n on acco i t-o ny work .- ormed or material furnished to the undersigned for said project,and w*.- the she se of this - it and :iv- . W.R.Dunkin&Son,Inc. Title: Project Manager WITNESS MY HAND AND NOTARIAL SEAL,this 30th day of March ,2012 \-Atek■-/-a/462 ,127,-/C/ (Notary Public) My Commission Expires:January 08,2017 Printed Martha A. Carpenter Residing in Madison County 41Y P`d MARTHA A.CARPENTER z L z NOTARY PUBLIC `�� STATE OF INDIANA �OF My Commission Expires 1-8-17 • \g9/1 _ =AIA Document G7061M 01994 Contractor's Affidavit of Payment of Debts and Claims PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: ❑ Parcel 7A,#5010 Carmel 25310H ARCHITECT:❑ Performing Arts CONTRACTOR: ❑ 777 3rd Ave S.W. CONTRACT FOR:Bid Package#5010- SURETY: ❑ Carmel,IN 46032 General Trades OTHER: ❑ TO OWNER: (Name and address) CONTRACT DATED: February 23,2009 Carmel Redevelopment Commission One Civic Square Carmel,IN 46032 STATE OF:Indiana COUNTY OF:Madison 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 W.R. Dunkin&Son,Inc. Surety is involved, Consent of Surety is PO Box 2247 required. AIA Document G707,Consent of Anderson,IN 46018 / Surety,may be used for this purpose Indicate Attachment ® Yes ❑ No �'i � B Ii'�►:. T h e following supporting documents should be attached (Signature o f s i z e d r . -figtive) hereto if required by the Owner: Bradley Tyler,Project Manager 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 March 30, 2012 suppliers,to the extent required by the Owner, accompanied by a list thereof. � ��,� � Notary Public: Q� �� z ' 1v Martha A. Carpenter 3. Contractor's Affidavit of Release of Liens My Commission Expires: January 08,2017 (AIA Document G706A). ,v, °oe MARTHA A.CARPENTER 2"1....1i-1`c, NOTARY PUBLIC �V4 Y STATE OF INDIANA My Comralcsba Expires 1 8 17 AIA Document G706TM—1994.Copyright©1970 and 1994 by The American Institute of• - -. - • • . _ _. .• •- • • • .. 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.This document was produced by AIA software at 09:49:07 on 03/30/2012 under Order No.0215931572_1 which expires on 05/10/2012,and is not for resale. User Notes: (1295336295) tV Document "706A ® 1994~ Contractor's Affidavit of Release of Liens PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: ❑ Parcel 7A,#5010 Carmel Performing 25310H ARCHITECT:❑ Arts 777 3rd Ave S.W. CONTRACT FOR:Bid Package#5010 CONTRACTOR: ❑ Cannel,IN 46032 - General Trades SURETY:❑ TO OWNER: (Name and address) CONTRACT DATED:February 23, 2009 OTHER: ❑ Carmel Redevelopment Commission One Civic Square Carmel,IN 46032 STATE OF:Indiana COUNTY OF:Madison 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, W.R. Dunkin&Son,Inc. // conditional upon receipt of final payment. PO Box 2247 Anderson,iN 2. Separate Releases or Waivers of Liens from BY: Aft( ; Subcontractors and material and equipment (Signature of.PFhorized/ suppliers,to the extent required by the Owner, represen • e) accompanied by a list thereof Bradley Ty er,Project Manager (Printed name and title) Subscribed and sworn to before me on this date: March 30, 2012 Notary Public: � ._. i Martha A. Carpenter My Commission Expires: January 08,2017 4,v°0m MARTHA A.CARPENTER 201%(-6 NOTARY PUBLIC `�' ;i STATE OF INDIANA of My Commission Expires 1-8-17 AIA Document G706ATM—1994.Copyright©1982 and 1994 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.This document was produced by AIA software at 09:47:32 on 03/30/2012 under Order No.0215931572_1 which expires on 05/10/2012,and is not for resale. User Notes: (1731744855) CONSENT OF ARCHITECT ❑ SURETY COMPANY CONTRACT ❑ OR ❑ TO FINAL PAYMENT SURETY OTHER AIA DOCUMENT G707 PRF 7606866 00 PROJECT: Carmel Regional Performing Arts Center-Interior Finish Package P5 (name, address) 777 3rd Ave. S.W., Carmel, IN TO (Owner) I Carmel Redevelopment Commission —1 ARCHITECT'S PROJECT NO: 2531 OH One Civic Square CONTRACT FOR: General Trades Bid Package for P5. Carmel, IN 46032 L I CONTRACT DATE: February 23, 2009 CONTRACTOR: W.R. Dunkin & Son, Inc. 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 Company) FIDELITY AND DEPOSIT COMPANY OF MARYLAND ,SURETY COMPANY, 9229 Delegates Row, Suite 300 Indianapolis, IN 46240 on bond of (here insert name and address of Contractor) W.R. Dunkin & Son, Inc. 2911 Enterprise Drive CONTRACTOR, Anderson, IN 46018 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) Carmel Redevelopment Commission, One Civic Square, Carmel, IN 46032 , OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 231d day of March 2012 FIDELITY AND DEPOSIT COMPANY OF MARYLAND Surety Company BY: Qiel juiLQ Attest: Signature of Authorized epr entative (Seal): Carol J. Hudson, Attorney-In-Fact Title Attorney-In-Fact NOTE: This form is to be used as a companion document to AIA DOCUMENT 0706, CONTRACTOR"S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition AIA DOCUMENT G707 • CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 1970 EDITION • AIA® ONE PAGE ©1970 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., NW, WASHINGTON, D.C.. 20006 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland,by THEODORE G. MARTINEZ,Vice President, and GREGORY E. MURRAY, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By-Law • id Company, which are set forth on the reverse side hereof and are hereby certified to be in full force and eff-.t r:i a•t: M-reof, does hereby nominate, constitute and appoint Paula SOLLARS and Carol J. HUD 144,011 �l . •rso �'ana, EACH its true and lawful agent and Attorney-in-Fact,to make, execute, seal .•- r,�.r�t�v-, `iAR : o• oa•{k� , and as its act and deed: any and all bonds and undertakings,and t . • "':'h be•u�•:,�+•—+► `•�,�t��'""gs in pursuance of these presents,shall be as binding upon said Co•+1.. y i • a .•1 :1.'t and purposes, as if they had been duly executed and acknowledged b � 'tied' •, t •�. ; linnwpany at its office in Baltimore,Md., in their own proper persons. Thio1;`' :ya • re k+y' .t • . •ehalf of Tim PATISHALL, Paula SOLLARS, Carol J. HUDSON, dated Fe , 20 V The said Assistant .cages elfeby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2,of the By-Lrslyrsaid Company,and is now in force. IN WITNESS WHEREOF, the said Vice-President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 18th day of November, A.D.2009. ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND 'gyp DfPcis," Me -at O G 1� YL L / /t/y; By: Gregory E. Murray Assistant Secretary Theodore G. Martinez State of Maryland ss. City of Baltimore On this 18th day of November, A.D. 2009, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came THEODORE G. MARTINEZ, Vice President, and GREGORY E. MURRAY, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith,that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. •�GT � ri4 �� 1 1;:t...` . pli.r4 0. Maria D. Adamski Notary Public My Commission Expires: July 8,2011 POA-F 044-2077 EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND "Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice-President, or any of the Senior Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in the nature of mortgages,...and to affix the seal of the Company thereto." CERTIFICATE I,the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that the Vice-President who executed the said Power of Attorney was one of the additional Vice-Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company, this 45 jtki day of Oril4 Jz� , g■-Q j • Assistant Secretary Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee i "t4 V-' /, Purchase Order No. 22 q7 Terms i1�pr��y /y Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3 30 /2 2 / / 2l /974 9sq. 0 .D Total 9-S'y. 70 • I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have -• - ; e in accor- dance with IC 5-11-10-1.6. , 20 12- GFer#c Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 IN SUM OF $ /•U 66'/ • $ 9.c17/ • ON ACCOUNT OF APPROPRIATION FOR 9 Board Members DEPT or INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), 9 1./5/6e'�c% 95'yJo or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except G/-• // 20 /2- xebiltIVeeDirector Title Cost distribution ledger classification if Carmel Redevelopment Commission claim paid motor vehicle highway fund