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Home My WebLink AboutSIGNATURE CONSTRUCTION, LLC- 001405- 11/18/2010 . CARMEL REDEVELOPMENT COMMISSION 001405 Signature Construction, LLC Check: 1405 720 3rd Ave., SW Date: 11/18/2010 Carmel, IN 46032 • Vendor: SIGNATO1 Prior Invoice P.O. Num, Invoice Amt Balance ' Retention Discount Amt. Paid 2-6 3,565.76 3,565.76 0.00 0.00 3,565.76 App 6 for p5 Waterproofing 3,565.76 3,565.76 0.00 0.00 3,565.76 PpZSHUEy.�C, Carmel Redevelopment Commission 00.1.405 • 30 West Main Street A REGIONS Suite 220 20.1421/740 OCAflMEL` Carmel, IN 46032 . 1405 DATE AMOUNT 11/18/2010 3,565.76 PAY THE SUM OF THREE THOUSAND FIVE HUNDRED SIXTY FIVE DOLLARS AND 76 CENTS TO THE ORDER OF • Signature Construction, LLC 720 3rd Ave., SW `SENs„ " Carmel, IN 46032 i a 46032 '‘, 4C 11'00 140511' 1:0740 i4 2131: 0087504 l l LP CARMEL REDEVELOPMENT COMMISSION 001405 Signature Construction, LLC Check: 1405 720 3rd Ave., SW Date: 11/18/2010 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2.6 3,565.76 3,565.76 0.00 0.00 3,565.76 App 6 for p5 Waterproofing 3,565.76 3,565.76 0.00 0.00 3,565.76 APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT 6702 PAGE ONE OF 2 PAGES 2 TO OWNER Cannel Theater Development Colnl PROJECT: Cannel City PI 11 Waterproofine APPLICATION NO Invoice#6 I Distribution to: One Civic Square Signature costs _ OWNER Cannel Indiana 46032 jARCIi1TECT PERIOD TO: 09/24/2010 L X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: I'edcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Carmel_.Indiana 46032 CONTRACT FOR: 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 belief the 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 5 80,586.00 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. COMI'RAC'r SUM TO DATE(Line I • 2) $ 80.586.00 4. TOTAL COMPLETED&STORED TO S 3,565 76 By: ` r Date: 9/7//o 5. RETAINAGE: Thoth? .Koontz,President kJ., 9G/7U 7'7 a. 0 %of Completed Work $ 0 Stibscribed a c sworn to before me this 7 day of D..,.,.d.i.2067 (Column 17+E on G703) LINDA BUCHANAN h. °,i,of Stored Material $ ?�,;,, ?`+ Hancock County (Column I'on 0703) sic.: My Commission Expires Total Retainage(Lines 5a+5h or ''.'*i.' August 20,2011 Total in Column I of 0703) $ 0.00 E - ' •R • . 6. 101 AL EARNED LESS RETAINAGE S 3,565.76 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5'total) comprising the application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 front prior Certificate) $ 0.00 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE 5 3,565.76 F is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE.TO FINISH,INCLUDING RETAINAGE $ 77,020 24 (Line 3 less Line 6) AMOUNT CERTIFIED $ 3 546.710, CHANGE ORDER SUMMARY ADDEIIONS DEDUCTIONS (4naclr explanation ifa au certified differs flow the amount applied.Initial all figures on this Total changes approved Application and mu •C nianm - 1 Sheet that are changed to con farm with the amount certified.) in previous months by Owner ARCI Il'l'ECT: .//'�^ Total approved this Month By: V`��--� 6 Date: 7/ //0 TOTALS $0.00 $0.00 This Certificate is not negotiable The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance,payment anti acceptance of payment are wtttiout NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT'1992 EDITION-MA '01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,NW.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. Director of Redevelopment / GS C tics- SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. _ Carmel, Indiana 46032 1 I I 1 I Invoice # 6 9/24/10 Carmel City Pill Waterproofing-SMOCK Carmel, Indiana 1 I 1 1 Total Work RETAINAG£ 1 BALANCE Scheduled Completed WITHHELD PREVIOUS TOTAL COMPLETED TO DESCRIPTION Value This period THIS PERIOD APPLICATIONS TO DATE 1 % FINISH General Conditions: SMOCK FANSLER Testing and Inspecting 0.00 0.00 0.00 0.00 0% 0.00 Project Management 0.00 0.00 0.00 0.00 0% 0.00 Site Supervision 40,293.00 0.00 0.00 0.00 0.00 0% 40,293.00 Site Safety Director 0.00 0.00 0.00 0.00 #DIV/0! 0.00 Design Drawings 0.00 0.00 0.00 0.00 #DIV/0! 0.00 Temporary Electric 0.00 0.00 0.00 0.00 #DIV/0! 0.00 Office Supplies 0.00 0.00 0.00 0.00 NDIV/0! 0.00 Tools and Equipment 0.00 0.00 0.00 0.00 _ HDIV/0! 0.00 Field Engineering and Surveying 0.00 0.00 0.00 0.00 #DIV/0! 0.00 Construction Management Fee 40,293.00 3,565.76 0.00 0.00 3,565.76 9% 36,727.24 80,586.00 3,565.76 0.00 0.00 3,565.76 4% 77,020.24 CONDITIONAL AFFIDAVIT AND WAIVER OF LIEN STATE OF INDIANA COUNTY OF HAMILTON ) Thomas E. Koontz being duly sworn states that he is the President of Signature Construction, LLC having contract to furnish certain materials and! or labor as follows: Construction Management Services for a project known as Carmel City Center P111, 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 three thousand five hundred sixty-five dollars and seventy-six cents ($3,565.75) 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 Thome E. Koo , President Subscribed and sworn to before me this: 117774 Notary Public: • LINDA BUCHANAN Hancock County My Commission Expires 't' 'aa'.'?itC: August 20,2001