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Home My WebLink AboutSIGNATURE CONSTRUCTION, LLC- 001502- 12/17/2010 CARMEL REDEVELOPMENT COMMISSION 001502 Signature Construction, LW Check: 1502 720 3rd Ave., SW Date: 12/17/2010 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paic 112 3,305.15 3,305.15 0.00 . 0.00 3,305.1E P111 thru 10/2512010 111-12 8,208.60 8,208.60 0.00 0100 8,208.6C P111 waterproofing 11,513.75 11,513.75 0.00 0.00 11,513.7E fa'-.gnome` IOREDISACKGROUNDIANDICONTAINSIMULTIPLEZEOURIVATEATURESMSEEIBACK:FOR.DETAA:521MIZOMMIIIMIN ZO 'S%c 6 sg °E'ici, Carmel Redevelopment Commission 001502 30 West Main Street A. REGIONS Suite 220 - 2G-14211740 °sraY Carmel, IN 46032 • • - 1502 DATE AMOUNT 12/17/2010 ******"****11,513.75 PAY THE SUM OF ELEVEN THOUSAND FIVE HUNDRED THIRTEEN DOLLARS AND 75 CENTS TO THE ORDER OF Signature Construction, LLC 720 3rd Ave., SW ic 5E14N • Carmel, IN 46032 94,,, • 11'00 & 50211' 1:07403' 2 / 3': 00875041 & &11' CARMEL REDEVELOPMENT COMMISSION 001502 Signature Construction, LLC Check: 1502 720 3rd Ave., SW Date: 12/17/2010 Carmel, IN 46032 Vendor: SIGNATO1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 112 3,305.15 3,305.15 0.00 0.00 3,305.15 P111 thru 10/25/2010 111-12 8,208.60 8,208.60 _ 0.00 0.00 8,208.60 P111 waterproofing 11,513.75 11,513.75 0.00 0.00 11,513.75 V.tl:691 T11 en...nin..cam Grme n....e... rexn axx.cxoi u[ne'rnn APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES2 TO OWNER Carmel Theater Development Coin PROJECT: Cartel City PHI WaterprootinAPPLICATION NO Invoice H 12 I Distribution to: - One Civic Square Smock Signature costs OWNER Carmel Indiana 46032 „ARCHITECT PERIOD TO: 11292010 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services TLC 720 3rd Avenue S.W. PROJECT NOS: Cannel,Indiana 46032 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT .11.e.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 Slices,ALA Document G703,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 doe- 1. 011 IGINAI•CON'T'RACT(SUM $ 80,586.00 2. Net chance by Change Orders $ 090 CONTRACTOR_ 3. CONTRACT SUM TO DATE(Line I+2) $ 8C,586.0C 4, '10'I AL COMPLETED K STORED TO $ 15,079.51 `I By: , r. /_�� Date: //,�FLct 5. RETAINAC,L: I' mas E.154Intz,President /✓c'✓. ty .c. / a. 0%of Completed Work 5 0 Subs(' bed ands m to before me this )" day of DLLtuihts 009 (Column D+ - • Eon 6703) \\ - -_ LINDA BUCHANAN b. %of Stored Material $ `¢ ..,„r '4 Hancock County (Column F on 6703) s,&.L . My Commission Expires Total Retainage(Lines 3a+5b or , :u9 „+,`-I • a t Total in Column 1 of G703) S 0-00 ARCHITECT'S CERTIFICATE FOR PAY — -- - .. 6 TOTAI,EARNED LESS RE'I'AINAGE $ 15,079.51 in accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less l.,ine 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 from prior Certificate) $ 6,870.91 the quality of the Work is in accordance with the Contract Documents,and the Contractor S. CURREN I PAYMENT DUE $ .8,208 60 is entitled to payment of the AMOUNT CERTIFIED. 9- BALANCE TO FINISH,INCLUDING RETAINAGE $ 65,506 49 (Line 3 less Line 6) AMOUNT CERTIFIED $ 8,'-O 17,(v d - CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation ifumoun certified d&rsfronl the amount applied Initial atlfigurec on this Total changes approved Application and(nlHe C- motion Sheet that are changed to conform with the amount cer4ficd.) in previous months by Owner ARCH ITECE, Total approved this Month _ By: e 4101/4.---- Date: Uf'sofin TOTALS $000 $D 00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance,payment mu acceptance of payment arc without NET CHANGES by Change Order I 50.00 prejudice to any rights of the Owner or Contractor under this Contract. ATV,DOCUMENT G702 APPLICATION-NO CERTIFICATION FOR PAYMENT 1902 EDITION AIA 01992 THE AMERICAN INSTITJTS OF ARCHITECTS,1735 NEWYORKAVE.,NW,WASHINGTON.EC 209106-52•2 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 / Lig i B so 5 , 4 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 eight thousand two hundred eight dollars and sixty cents ($8,208.60) 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 oma- . Koontz, President Subscribed and sworn to before me this: 1-1a'✓ 143 J✓'e, Notary Public: 'p��; LINDA BUCHANAN : Hancock County SEAL My Commission Expires August 20,2011 " . SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 _ I I I I Invoice # 12 11/29/10 Carmel City P111 Waterproofing-SMOCK Carmel , Indiana I I I I Total Work RETAINAGE 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 0.00 0% 0.00 Project Management 0.00 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 0.00 _ 0% 0.00 Design Drawings 0.00 0.00 0.00 0.00 0.00 0% 0.00 Temporary Electric 0.00 0.00 0.00 0.00 0.00 0% 0.00 Office Supplies 0.00 0.00 0.00 0.00 0.00 0% 0.00 Tools and Equipment 0.00 0.00 0.00 0.00 0.00 0% 0.00 Field Engineering and Surveying 0.00 0.00 0.00 0.00 0.00 0% 0.00 Construction Management Fee 40,293.00 8,208.60 0.00 6,870.91 _ 15,079.51 37% 25,213.49 80,586.00 8,208.60 0.00 6,870.91 15,079.51 19% 65,506.49 APPLICATION AND CERTIFICATION FOR PAYMENT ALel DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER Carmel Theater Development Com PROJECT: Cannel City I'I I I Waterproofing APPLICATION NO Invoice# I I I Distribution to: • One Civic Square Signature costs OWNER Carmel Indiana 46032 L ARCHITECT PERIOD TO: 10/25/2010 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedeor Design Signature Construction Services LLC 720 3rd Avenue S.W. I'IUJJIiC'I'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. intonation 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 S 50,586.00 2. Net change by Change Orders 5 U.W CONT'RAC'TOR: 3. CONTRACT SUM TO DATE(Line 1+2) 5 su,a86.0u 4. I UI Al.COMPLETED k STORED TO S 6,870.91 Q BY: ' . / ,�J Date: /lc Z_Y--- V 5. RETAINAGE: homas It ontz,President YJ— ory.De, o ' a. 0 %of Completed Work S 0 Sub toed and ow to hetore me this 2 day of A....,.b.. ' (Lolumn D+Eon G703) LINDA BUCHANAN b. %of Stored Material 5 `?;cr ?"- ( nEon 0703) a%AL 'Cl Pty Commission Expires I oral Ketamage tunes as*an or .< <^!` AI net on 2011 Total in Column I of G703) $ 0.00 ARCM! IELI SCtNIIFICAIt FOR PAYMLNI---- .o 6. TOTAL EARNED LESS RETAINAGE S b,8/U.91 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 hest of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) 5 3,565.76 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE S i,30a_La is entitled to payment ofthc AMOUNT CERTIFIED, 9. BALANCE TO FINIS'',INCLUDING RETAINAGE S /D,/I).99 (Line 3 less Line 6) - AMOUNT CER'T'IFIED $ 3 0515 CHANGE ORDER S UNIMAK? AUDII IONS DriJUL I IONS (Attach eaplanalion if amount certified dii(Jersframthe annum applied.Initial a//figures on this I otal changes approved dpplieation and ont ;nntinualion.5'heet shot are changed ro cor jure:with the mown certified.) in previous months by Owner ARCHITECT' //////�/7 Total approved this Month By: .{..� "'� Date: 49/Z afip TOTALS 50.00 50.00 This Canifieate is not negotiable. The AMOUNT CERTIFIED is payable only to the L ontractor nameu nerem_Issuance,payment ano acceptance of payment are wlmout NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. AU DOCUMENT 0)02-APPLICATION AND CERTIFICATION FOR PAYMENT•1993 EDITION'AIA•e1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W..WASHINGTON,DC 20006.5293 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. �� u 5 Director of Redevelopment/IM flphi SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 l 1 I I I I I Invoice # 11 10/25/10 Carmel City P111 Waterproofing-SMOCK Carmel, Indiana I I I 1 I Total Work RETAINAGE 1 BALANCE Scheduled Completed WITHHELD PREVIOUS TOTAL COMPLETED TO DESCRIPTION Value This period THIS PERIOD APPLICATIONS TO DATE I % FINISH General Conditions: SMOCK FANSLER Testing and Inspecting 0.00 0.00 0.00 0.00 0.00 0% 0.00 Project Management _ 0.00 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 0.00 0% 0.00 Design Drawings 0.00 0.00 0.00 0.00 0.00 0% 0.00 Temporary Electric 0.00 0.00 0.00 0.00 0.00 0% 0.00 Office Supplies 0.00 0.00 0.00 0.00 0.00 0% 0.00_ Tools and Equipment 0.00 0.00 0.00 0.00 0.00 0% 0.00 Field Engineering and Surveying 0.00 0.00 0.00 0.00 0.00 0% 0.00 Construction Management Fee 40,293.00 3,305.15 0.00 3,565.76 6,870.91 17% 33,422.09 80,586.00 3,305.15 0.00 3,565.76 6,870.91 94I 73,715.09 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 Pill, 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 three hundred five dollars and fifteen cents ($3,305.15) the payment of which has been promised as the sole consideration for this Affidavit and Conditional Waiver of Lien which is given to and for said amount, effective upon receipt of such cash payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all line or claim whatsoever on the above-described property and improvements thereon on account of labor or material or both, finished by the undersigned thereto, and further certifies that no other party has any claim or right to a lien on account of any work perform or material furnished to the undersigned for the said project, and within the scope of this affidavit and waiver. SIGNATURE CONSTRUCTION, LLC a / omas V"oontz, •resident �$ bscribed and sworn to before me this: __25 Qc Y . /"G Notary Public:y a ,,Sletch.----- "�'� e'... LINDA BUCHANAN o..a ': Hancock County ` "2a' _? My Commission Expires ":`.:.7 August 20,2011