HomeMy WebLinkAboutSULLIVAN & POORE- 331- 8/11/2011 Sullivan & Poore Check: 331
Date: 8/11/2011
Vendor: SULLIVA1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
8 40,404.42 40,404.42 0.00 0.00 40,404.42
App 8 on theater
40,404.42 40,404.42 0.00 0.00 40,404.42
331
8/11/2011 """""'40,404.42
THE SUM OF FORTY THOUSAND FOUR HUNDRED FOUR DOLLARS AND 42 CENTS
Sullivan & Poore
Sullivan & Poore Check: 331
Date: 8/11/2011
Vendor: SULLIVA1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention D iscount Amt. Paid
8 40,404.42 40,404.42 0.00 0.00 40,404.42
App 8 on theater
40,404.42 40,404.42 0.00 0.00 40,404.42
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT 6702 PAGE ONE OF I PAGES2
TO OWNER: PROJECT: Village on the Green APPLICATION NO: 8 Distribution to:
Cannel Theater Development Corporation,LLC Parcel 7CI -Theater OWNER
11711 North Pennsylvania St,Suite 200 Cannel.IN 46032 ARCHITECT
Carmel, IN 46032 PERIOD TO: 5/31/2011 CONTRACTOR
FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Group,LLC
Sullivan&Poore 335 City Center Drive
1015 East 42nd Street,P.O.Box 55101 Cannel,IN 46032 PROJECT NOS: 12012
Indianapolis,IN 46205
CONTRACT DATE:
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 information and belicfthe Work covered by this Application for Payment has been
Continuation Sheet,AIA 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.
I. ORIGINAL CONTRACT SUM S 1,697,000,00
2. Net change by Change Orders S (b,061.00) CONTRACTOR:
3. CONTRACT SUM TO DATE(Line I f 2) S 1,6 1,939.00
4. TOTAL COMPLETED&STORED TO S 1 492,78/.00 Q 7 may//
5. RETAINAGE:
By: -/ X .�C Date: S/L�g/j/
a. 10%of Completed Work S 149,278.70 Subscribed and"swdin to belbre me /FM 121 3e// 7
day of
(Column U+Eon G703) _
b. 10%of Stored Material $
fir-ft j'y(40-1 1.4
(Column F on G703)
I otal Ketamage(Lines sa+30 or
Total in Column)of G703) $ 149,27830 ENGINEER'S CER IIHCA FE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE 5 1,343,5 8.30 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 Less Line 5 Total) comprising the application,the Engineer certifies to the Owner that to the best of the
7. LESS PREVIOUS CERTIFICATES FOR Engineers knowledge,information and belief the Work has progressed as indicated,
PAYMENT(Line 6 from prior Certificate) $ 1,303,103.88 the quality of the Work is in accordance with the Contract Documents,and the Contractor
8. CURRENT PAYMENT DUE S 40,404.41 is entitled to payment of the AMOUNT CER'T'IFIED,
9. BALANCE TO FINISH,INCLUDING RETAINAGE 3 328,430./0 J
(Line 3 less Line 6) AMOUNT CERTIFIED 5 (-10 0 y0 z LI 2-
CHANGE ORDER SUMMARY AUDI I IONS UEOUC I IONS (Attach explanation if amount certified differsfromthe amount applied.Initial all figures on this /I�
total changes approved Application and onthe Continuation,Sleet that are Ora wed to conform with the amount certified)
1
in previous months by Owner $0.00 S0.00 —FttBINCER--Ca�✓i .Ar . `
Total TOTALS this Month ($25,061.00) By: �/��.x G.L��/� Date: L///I/
($25,061.00) $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
contractor named nercln.issuance,payment ana acceptance oT payment are wonout
NET CHANGES by Change Order ($25,061.00) prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT 0702'APRIDAMON AND CERTIFICATION FOR PAYMENT'1992 EDITION-AIA'01992 THE AMERICAN INSTITUTE OF ARCHITECTS.1735 NEW YORK AVE.,NW,WASHINGTON,DC 200Ob5292
Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee.
•
G703 CONTINUATION SHEET
Poet 1 or
Finns Project: Application No,: g
Carmel neater Deslvania nt Corporation,LI G Sullivan&Poore Village on the Green Application Date NI 5111
11711 North Pennsylvania St,Suite 200 1015 East 42nd Street,P.O.Boa 55101 Parcel]CI-TT Period To: 5/31/11
Carmel,IAN 16032 B Indianapolis,IN 46205 Carmel,IN 46032 Eng.Pro(5 12012
C 11 E F G H I
Work Completed ObrePals Total
Item PreslOy Completed Balance Raninape
Scheduled From Previous Stored and Stored To If
Description of Wort Value Application This Period (Not in 'F9 Dote
(C/C) Finish-G) Variable
120-1000 MOBILIZATION 15,000.10 15,000.00 0.00 0.00 15,000.00 100% 0,00 1,510,00
120-1001 .S'0103111TALS 10,011000 10,000,00 0.00 0,00 In,000,01 100%
VIBRATION ISOLATION 0.00 1.10,1
120-1002 LABOR 3,000.00 1,500,00 1,500.00 0,00 3,01,00 100% 0.00 300.00
120.1003 MATERIAL 10,000.00 10,000,00 0.00 0.00 10,000,00 100% 0,004 1,000.00
MECHANICAL INSULATION
120-1004 LABOR 96,000.00 48,000.00 0.00 0.00 11,000.00 50% 48,000.00
120.1005 MATERIAL 3.200.00
61,01.00 12,000.00 0.00 0.00 31,000.00 50% 32,000.00 3,200.00
FIRE PROTECTION
121-1090 DESIGN DRAWINGS 30,000.00 20,000.00 0.00 0.00 20,000,00 100% 0.00 2,00000
121-1001 LOWER LEVEL-MATERIAL, 7000.00 7,000.00 0.00
121-1002 LOWER LEVELLABOR 0,00 7,000,00 100% 0.00 750.00
:300.1 4,500,00 0,00 0.00 4,500.00 100% 0.00 95000
121-1003 FIRST FLOOR-MATERIAL 19,81.1 19.800.00 O.OD 0.00 19,800.00 IOOX
121-1001 FIRST FLOOR-LABOR 0.00 1,200.00
13,30000 12,000,00 0.00 0.00 11,300.00 100% 0.00 1,230.00
121-1005
SECOND FLOOR-MATERIAL. 17,200.00 17,200.00 0.00 0.00 17,200.00 100% 0.00 1,720.00
121-1006 SECOND FLOOR-LABOR 7,300.00 7,200,00 0.00 0.00 7,200.00 100%
121-1007 THEATER-MATERIAL 0.00 720.00
121-1006 10,900.00 10,900.00 0.00 0.00 10,900.00 100% 0.00 1,090,00
TIIEAE MATERIA 17,000.00 10,900.00 0.00 0,00 17,000.00 100% 0.00
121-1009 Sl'ACG6IATF:RIAL 1,090.00
121 5,200,00 7,000.00 0.00 0.00 5,200.00 100% 0.00 520,00
1010 STAGE-LABOR
121-1011 0,200,00 0.200.00 0.00 0.00 0,200.00 100% 0.00 020.00
FIRE PIIMP.NA]'ERIAI.
15,800.00 15,100.00 0,00 0.00 15,100,00 100% 0.00 4,020.00
121-I013 FIRE PUMP-LABOR 5.100.1 5,100.00
121-1013 IINDERGROUNII-SIATERIAL 0.00 0.00 5,700,00 100% 0.00 580.00
1,700.00 4,700.00 0.00 0.00 1.700.1 100% 0.00 470.00 100%121-1511 UNDERGROUND-LABOR ia100
121-1015 PREACTION-MATERIAL
2,000.00 0.00 0.00 2,000.00 100% 0.00 200.00
16,0110.1 16.000.00 0.00 0.00 16.000.011 100% 0.00 1.600.00
121-1016 PRF,ACTION-IAflOR 1,000.1 1,000.00 0.00 0.00 1,000,00 100%
DOMESTIC WATER PIPING 0.1 400.00
122-1000 LABOR 40,000.00 38,000.00 2,000.00 0,00 40,000,00 100%
122.1001 MATERIAL 32,000.00 400, 0.00 32,000.00 100% 0.00 3.200.00
DOMESTIC WATER PUMPS '0' 1 1'x'1 0.00 ],200.00
122.1002 LABOR 1,500,00 1,425.00 75.00 0.00 1,500,00 100%
122-1003 MATERIAL 0.00 100.00
1.000.00 950.00 50.00 0.00 1.10.1 100% 0.00 11.1
BELOW GRADE ISFOµNf
122-1004 LABOR 20,000.00 20,000.00 0.00 0.00 20,000.00 100% 0.00 2,000.00
122-1005 AIATERIAI, 14,000.00 11,000.00 0,00 0.00 14,00000 100% 0,00 1,10,00
COMMERCIAL ELECTRIC WATER IIFATTER
122-1006 LABOR
122- 4,000.1 0.00 0.00 0.00 0.00 0% 0,000.1 0.00 0%100] MATF.RIAI, 5,000,00 0,00 0,00
PLUMBING FIXTURES 0,00 0.00 0% 5,000.00 0.00
122-1008 LABOR 85,000.00 0.00 0,00
132-1009 MATERIAL 0.00 0.00 0% 25,000,00 0.00
30,000.00 0,00 0,00 0.00 0.00 0% 30,000.00 000
123-1000 ADRLSI"LNG AND BALANCING 15,000,00 0.00 0.00
0.00 0.00 0% 15,000.00 0.00
TEMPERATURE:CONTROLS
123-1001 ENGINF,F.RING/AU'1'OCAD 28,000.00 23,000.00 0.00
123-1002 MATERIAL. 0.00 59,850,00 100% 0.00 5,91,00
59,500.00 29.625.00 0.00 3,950.00
123-1003 INSFALIATIO.Y 0.00 59,650.1 100% 000
123-1004 14,500.00 29,630.00 6.525.00 0.00 39,500.00 100% 5.00 1,652.1
PNOGRASINIINGISFANT-LIP 14500.00 O.On 6,525.1 0.1 6,525.00 45% 7,9]5.1
NYDROWC PIPING 653.50
123-1005 LABOR 45,000,00 33,750,00 9,000,00 0.00 42,750,00 95%
1311006 MATF,RIAI. 30,01,1 30,000.00 0,00 0.00 30,000,00 100% 2'250.00 3,000.00
IIT'DRONIC SPECIALTIES 0.00 3,10,00
123-117 LABOR 18,00,00 13,500.00 3,600,00 0.00 17,100,00 95% 900.00 1,71000
113-1008 MATERI.\I. 20,000.00 20,000,00 0.00 0.00 20,000,00 100%
BVAC PUMPS 0.00 2,000.00
121,101 LABOR 4.500.00 4,500,00 0,00 0,00 4,500,00 11X
123-1010 MATERIAL 0.00 150.00
10,01,1 10,000.00 0.00 0.1 10,000,1 100% 0.1 1,0110.00
6703 CONTINUATION SHEET
rage l of
To: From: Project: Application No.: D
c
Cannel neater Development Corporation,I.LC Sullivan&Poore Village on the Gram Application Date: 5/15/11
11711 North Penm2tvenu St,Suite 200 1015 East 42nd Steen,P.O.Box 55101 Parcel 70-Theater Period To: 561/11
Carmel,IN 46032 B Indianapolis,IN 46205 Carmel IN 46032 Eng.Prot II 12012
A
C D E F G R
Work Completed Materials Total
Item Presently Completed Balance Rerainage
Scheduled From Previous Stored and Stored % To If
8 Description of Work Value Application Thit Period (Not in Ta Date (GIC) Finish Variable
0 or F.) (D+F,.F)
I. (GG)
SHEFTSIETA
MATERIAL
123.1011 LOWER LEVEL 5,777.00 5.777.00 0.00 0.00 5,777.00 100% 0.00 577.70
123-1012 LSE FLOOR 43,638.00 41,638.00 0.00 0.00 43.63800 100% 0.00 4,36180
1 3-1013 2210 FLOOR 61,644.00 61,641.00 0.00 0.00 61,644.00 100% 0.00 6,164.40
123-1014 3RD FLOOR 115.643.00 115,643.00 0.00 0.00 115,613.00 100% 0.00 11,564.30
SHOP LABOR
123-1015 LOWER LE%T.L 11,058.00 11,058.00 0.00 0.00 11,058.00 100% 0.00 1,105.80
123.1016 1ST FLOOR 33,867.00 33,867.00 0.00 0.00 33,867.00 100% 0.00 3,386.70
123-1017 2ND FLOOR 36,706.00 36,706.00 0.00 0.00 36,70600 100% 0.00 3,670.60
123.1018 3RD FLOOR 63,322.00 63,322.00 0.00 0.00 63,322.00 100% 0.00 6,332.20
FIELD LABOR
123-1019 LOWER LEVEL 9312.00 9.312.00 0.00 0.00 9.312.00 100% 0.00 931.20
123-1020 1ST FIAOR 32.074.00 32,074,00 0.00 0.00 32,07400 100% 0.00 3,207.40
1211021 2ND FLOOR 28.476.00 28,476,00 0.00 0.00 28,476.00 100% 0.00 2,847.60
1211022 3RD FLOOR 82,445.00 82,445.00 0.00 0.00 82,415.00 100% 0.00 8.244.50
TF.NNA.NT ELMS!!
123.1023 LOWER LEVEL 4,896.00 4,406.40 489.60 0.00 4,896.00 100% 0.00 419.60
123-1024 1ST FLOOR 9,077.00 8,169.30 907.70 0.00 9,077.00 100% 0.00 907.70
123-1025 2ND FLOOR 10,398.00 9358.20 1,039.80 0.00 10,390.00 100% 0.00 1,039.80
123-1026 3RD FLOOR 7317.00 6,585.30 731.70 0.00 7 0.00 731.70
AIR HANDLING LINMIS 317.00 100%
123-1027 LABOR 9,000.00 9,000.00 0,00 0.00 9,00000 100% 0.00 900,00
123-1028 MATERIAL 170,000.00 170,000.00 0.00 0.00 170,000.00 100% 0.00 17,10000
121.1029 BOND 22.500.00 15,000.00 7,500.00 0.00 22,500.00 100% 0.00 2,250.00
123,1030 TEMPORARY HEAT 45,000,00 45,000.00 0.00 0.00 45,100.00 100% 0.00 4,500.00
123,1031 ALLOWANCE 45,000.00 35,973.00 0.00 0.00 35,973.00 80% 9,027.00 3,59730
123-1032 CO_3-Tat Exemption 125,061001 (25.061.00) 0.00 0.00 (25061.00) 100% 0,00
(2.506.10)
Total: 1,671 639.00 1,447,893.20 44,893.80 0.00 1,492,787.00 66% 179,152,00 149.278.70
G703 CONTINUATION SHEET
' • 'Fa:. Pane 2 o
Carmel Theater Development Corporation, From: Project:
pmen rporation,LW Sullivan&Poore Village 1 Application Date 3
en the Green
11711 North Pennsylvania St,Suite 200 Period To: Date: 915/11
1015 Fait 46105 P.O.Boo 55101 Parcel 7C1-Theater
Camel,INV 6e31 Indianapolis,IN 46205 Carmel,IN 46032 Period To: 512012
A Eng.Praj 9 12012
R C U E F G II Work Completed Materials 'Fatal
Presently Completed Balance Relainage
Item Scheduled From Previous Stored and Stored % To if
Or Description of Work Value Application This Period (Not in To Dale (G/CI Finish Variable
l Dor E) (DVE+P) IC-G)
ALLOWANCE 45,00)0.00
CO 61-PH.15 7,273.00 7,273.00 0.00 7,273.00 100%
CO.77-PR.09 12,936.00 12,936.00 0.00 12,936.00 100%
CO.89-P0.22 1,640.00 1,140.00 0.00 1,040.00 100%
CO.103-range Heat 12,100,00 12,100.00 0,00
CO.1094M-0151,Sprinkler Drains 1,124.00 1,124.00 0.00 1,124.00 100%
CO.136-PR 36R&042
6,906 1,824.00 1001%
0'00 0.00
Total: 2,121.00 35,973.00 0.00 0.00 35,973.00 0% 0.00 0.00
PRIME CONTRACTOR'S SWORN STATEMENT OF
INDEBTNESS 8 WAIVER OF LIEN
STATE OF Indiana
COUNTY OF Marion
Jeffrey A. Lusk
Being duly sworn upon his/her oath disposes and
says that:
1. He/she is Secretary/Treasurer , of Sullivan and Poore, Inc.
hereafter called the "Prime Contractor". He/she is over the age of twenty-one. He/she is authorized to
make this affidavit on behalf of Prime Contractor.
2. Prime Contractor is the Mechanical Prime Contractor for the construction of the development known
as VILLAGE ON THE GREEN — PARCEL 7C1 — THEATER BUILDING located in CARMEL (City),
INDIANA (state), hereafter referred to as the "Development", pursuant to the contract between the Prime
Contractor and CARMEL THEATER DEVELOPMENT CORPORATION, LLC., the Owner.
3. This affidavit is made for the express purpose of inducing and CARMEL THEATER DEVELOPMENT
CORPORATION, LLC., to make payment to Prime Contractor of the invoice submitted herewith for labor
and materials furnished pursuant to said Contractor. Upon receipt of said payment the Prime Contractor
hereby waives any lien rights to which Prime Contractor is entitled for labor or materials furnished for the
development to the date hereof.
4. Listed below are all suppliers or other persons who either has furnished or might furnish the Prime
Contractor with materials, appliances, machinery, fixtures or furnishing placed upon or installed on the
development. Mark (X) in the appropriate column for EACH supplier listed. Place an (X) in column: 1) If a
waiver of lien by supplier conditioned by payment of a specified amount is attached hereto. (In this case
also show the amount owed the supplier). 2.) If a FULL (final) lien release has been signed and delivered
to the Owner. 3.) If the initial delivery has not been made.
Supplier List(Add list if necessary 1. Amount Owed 2 3
#1 and 2 correspond to the same numbered choices on the waiver format. CARMEL THEATER
DEVELOPMENT CORPORATION, LLC.is hereby authorized to make payment to each such unpaid
creditor either directly or by check jointly payable to Prime Contractor and such creditor, as CARMEL
THEATER DEVELOPMENT CORPORATION, LLC. shall determine.
5. There are no bills, charges, costs or expenses for labor or material which could now or hereafter result
in lien being filed against the Development or a claim being asserted against the Owner except the
persons or businesses named in Paragraph 4 above.
IN WITNESS WHERE OF, affiant has signed this document on behalf of the Prime Contractor this 19th
day of April, 2011 .
4 r'
Jejyey`AOtok",, Secrets reasurer
County of Marion 7
State of Indiana
Subscribed and sworn to before me, a Notary Public in and for said County and State,
This 17th nay of May / , 2011 .
�.�.v lye lu/�c-vt�
(Notary Public)
Earl H. Duckwall
My Commission Expires: April 11, 2014
NOTARY SEAL MUST APPEAR ON THIS FORM.