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Home My WebLink AboutSIGNATURE CONSTRUCTION, LLC- 179- 2/11/2011 Signature Construction, LLC Check: 179 720 3rd Ave., SW Date: 2/11/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4-15 58,699.99 58,699.99 0.00 0.00 58,699.99 App 15 on P7C1 Main Theater 58,699.99 58,699.99 0.00 0.00 58,699.99 179 2/11/2011 **********58,699.99 THE SUM OF FIFTY EIGHT THOUSAND SIX HUNDRED NINETY NINE DOLLARS AND 99 CENTS **** Signature Construction, LLC 720 3rd Ave., SW Carmel, IN 46032 Signature Construction, LLC Check: 179 720 3rd Ave., SW Date: 2/11/2011 Carmel, IN 46032 Vendor: SIGNAT01 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 4-15 58,699.99 58,699.99 0.00 0.00 58,699.99 App 15 on P7C1 Main Theater 58,699.99 58,699.99 0.00 0.00 58,699.99 APPLICATION AND CERTIFICATION FOR PAYMENT AlA DOCUMENT G702 PAGE ONE OF 2 OAGES2 TO OWNER.CRC at City of Carmel PROJECT'. 7C-I Main Theater APPLICATION NO:Application a i3 Distribution to: Application 411 Signature costs IOWN ER Carmel Indiana 46032 ARCHITECT PERIOD TO' 12/1612010 X CONTRACTOR PROM CONTRACTOR: VIA ARCHITECC:Pedcor Design Signature Construction Services LLC 1 720 3rd Avenue S W. PROJECT NOS: Carmel,Indiana 46032 CONTRACT FOR: CONTRACT D3hE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge. Application is made for payment,as shown below,in connection with the Contract- infomlation and belief the Work covered by this Application for Payment has been Continuation Sheet,AlA Document 0703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due, 1. ORIGINAL CONTRACT SUM $ 1,030,615.23 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3 CONTRACT SUM TO DATE(Line 1 t 2) $ 1030,615 23 4 TOTAL COMPLETED&STORED TO S 549,43 71 By_ r Daze: �L�iJ�/D 5 RETADIAGE: /Thomas E. onte.P esident JJJ / a. 0%of Completed Work $ 0 Subscribed and worn to before me this ,2. day of /,,)//C (Column D+E on 0703) LINEA BUCHANAN t o ,. Hancock County b. %of Stored Material S nr. ' (Column F on(1703) _._ ... Total Retainnge(Lines ia+Sb or jy's�u,'._ PAy August920, 0xplres ��)!'�' August 20,2011 Total in Column of 0703) S 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT t----- - & TOTAL EARNED LESS RETAINAGE $ 549.433 71 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the applicat ion,the Architect certifies to the Oweerthat to the best of the 7. LESS PREVIOUS GER'LIFIGATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from print-Certificate) $ 490733,72 the quality of the Work is in accordance with the Contract Documents,and the Contractor S. CURRENT PAYMENT DOE S 58,699.99 is entitled to payment of the AMOUNT CER'T'IFIED. 9. BALANCE TO FINISH.INCLUDING RETAINAGE Si 451,!$1.52 p Q(J (� (Line]less Line 6) AMOUNT'CERTIFIED $ SC] 6- (r f 9 CHANCE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation farnonnt carrple:cia fersfaow themnoumupphca Initial all figures on this Total changes approved Application and onehe Continua/ton Sheet that are charz cl tr cat!fism with the amount certified) in previous months by Ownet -RR{€4t`FL 'f: .-f/ss--13:— //, O/ ]oral approved this Month By: ��Lr Date: Af/ ,✓ 1f TOTALS $0.00 5000 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Lo De meter nalnea herein.Issuance,payment ono acceptance of payment arc without t NET CHANGES by Change Order S0.00 prejudice to any rights of the Owner or Contractor under this Contract. AlA DOCUMENT uses APPLICATION ANDCERTIFICATION FOR PAYMENT 1992 EDITION AlA Ol ESE THE AMfRICAK INSTITUTE OF AkCMITEOI5,1725 NEW YORK AVE.,N.W.WASHINGTON,DC fleas-5P92 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA ) COUNTY OF HAMILTOf) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and for labor as follows: Construction Management Services for a project known as Village on the Green Parcel 7c Main Theater, located at Carmel, Indiana and owned by the Carmel Redevelopment Commission and does state: CONDITIONAL WAIVER: that the balance due from the owner is the sum of fifty-eight thousand six hundred ninty-nine dollars and ninty-nine cents (558,699.99) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, finished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC T omas Koontz, President • Subscribed and sworn to before me this: /P/7//0 Notary Public, ,r rfr ' - LINDA BUCHANAN Hancock County My Commission Expires eir;�: Aupusi 20,2911 SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 . Application # 15 12/16/10 7C-1 Main Theater Carmel , Indiana WORK COMPLETED MATERIALS TOTAL BALANCE ITEM DESCRIPTION OF SCHEDULED FROM PREVIOUS THIS PRESENTLY COMPLETED AND TO NO. WORK VALUE APPLICATIONS PERIOD STORED STORED TO DATE 8 FINISH RETAINAGE Pre-Construction Services: Site Supervision 20,921.29 20,921.29 0.00 0.00 20,921.29 100% 0.00 0.00 Construction Management 3,139.47 3,139.47 - 0.00 3,139.47 100% 0.00 0.00 Design Drawings 5,068.68 5,068.68 0.00 0.00 5,068.68 100% 0.00 0.00 Jobsite Trailer 2,947.03 2,947.03 0.00 0.00 2,947.03 100% 0.00 0.00 General Conditions: Testing and Inspecting 31,430.00 27,704.75 1,139.50 0.00 28,844.25 92% 2,585.75 0.00 Site Supervision 255,689.00 146,267.93 18,265.46 0.00 164,533.39 64% 91,155.61 0.00 Construction Management 113,964.00 9,316.32 1,906.18 0.00 11,222.50 10% 102,741.50 0.00 Site Safety Director 21,104.00 3,876,36 836.15 0.00 4,712.51 22% 16,391.49 0,00 Design Drawings 48,742.53 33,334.13 290,33 0.00 33,624,46 698 15,118.07 0.00 Sanitary Facilities 16,461.00 0.00 2,810.68 0.00 2,810.68 17$ 13,650.32 0.00 Field Office 24,692.00 4,308.43 1,122.92 0.00 5,431.35 22% 19,260.65 0.00 Temporary Electric 4,748.00 281.59 0.00 0.00 281.59 6% 4,466.41 0.00 Office Supplies 4,748.00 4,070.43 452.88 0,00 4,523.31 95% 224.69 0.00 Temporary Telecommunications 9,022.00 286.43 0.00 0.00 286.43 3% 8,735.57 0.00 Temporary Water 949.00 112.46 0.00 0.00 112.46 12$ 836.54 0.00 Tools and Equipment 56,026.21 4,181.58 3,060.82 0.00 7,242.40 13% 48,783.81 0.00 Access Road 5,979.60 5,436.00 0.00 0.00 5,436.00 91% 543.60 0.00 Field Eng. and Surveying 6,331.00 3,050.00 0.00 0.00 3,050.00 48% 3,281.00 0.00 Insurance 17,432.00 16,141.00 0.00 0,00 16,141.00 93% 1,291.00 0.00 Health and Safety 4,748.00 147.66 0.00 0.00 147.66 3% 4, 600.34 0.00 Waste Disposal 67,270.00 532.95 1,629.80 0.00 2,162.75 3% 65,107.25 0.00 Project Signage 2,373.00 0,00 0.00 0.00 0.00 0% 2,373.00 0.00 Temp fencing 8,005.00 4,400.00 0.00 0.00 4,400.00 55% 3,605.00 0.00 Temp Electric Site 23,743.00 5,638.08 0 .00 0.00 5,638.08 24% 18,104.92 0.00 Temp Lighting Site 39,570.00 0.00 0.00 0.00 0.00 0% 39,570.00 0.00 Temp Water ite 15,194.00 0.00 0.00 0.00 0.00 0% 15,194.00 0,00 Temp Fire Protection 3,561.00 0.00 0.00 0.00 0.00 0% 3,561.00 0.00 Construction Management Fee 216,756.42 189,571.15 27,185.27 0.00 216,756.42 100% 0.00 0.00 1,030,615.23 490,733.72 ' 58,699.99 0.00 549,433.71 53% 481,181.52 0.00 • REQUISITION NO. 61 FOR DISBURSEMENT FROM ACQUISITION FUND The undersigned hereby states and certifies: (i) that he/she is the duly appointed, qualified and acting Chief Financial Officer of RBI Real Estate Services, LLC, the sole member of Carmel Theater Development Company, LLC (the "Company"), and, as such, is familiar with the facts herein certified and is authorized to certify the same; (ii) that, pursuant to Section 3.5 of the Trust Agreement by and among Wells Fargo Bank, N.A., as trustee (the "'Trustee"), and the Company, dated as of December 1, 2009 (the "Trust Agreement"), the undersigned hereby requests the Trustee to disburse this date from the Acquisition Fund under the Trust Agreement, to the payees set forth on the attached Annex I, the amounts set forth on the attached Annex. I; and (iii) that each obligation referred to herein is a proper charge against the Acquisition Fund, and that payment for such charge has not previously been made. CARMEL THEATER DEVELOPMENT COMPANY, I.,I.,C By: REI Real Estate Services, LLC, sole Member • By: .4gf____/• Printed: il�,�l�j� - r[a Title: MAO� S� ' Date: -z i Il CONSENT GIVEN: CITY OF CARMEL REDEVELOPMENT COMMISSION, for and on behalf of the City of Cannel Redevelopment District -'�j By r Printed: LItc ': CtoJ Title: Cara Pore Date: 2,/o�j