Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
W R DUNKIN & SON, INC.- 001466- 12/17/2010 (2)
CARMEL REDEVELOPMENT COMMISSION 001466 W R Dunkin & Son, Inc. Check: 1466 Date: 12/17/2010 Anderson, IN 46018 A Box 2247 Vendor: DUNKINW1 IN Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 21-2 51 55,181.00 55,181.00 0.00 0.00 55,181.00 Application 21 . 32A 35 137,733.00 137,733.00 0.00 0.00 137,733.00 Application 32A 192,914.00 192,914.00 0.00 0.00 192,914.00 • lat. Carmel Redevelopment Commission 00146,6 30 West Main Street A REGIONS 20-1421!140 Suite 220 3�ST0.1GS`°""E` Carmel, IN 46032 1466 DATE AMOUNT • 12/17/2010 *`********192,914.00 . • PAY THE SUM OF ONE HUNDRED NINETY TWO THOUSAND NINE HUNDRED FOURTEEN DOLLARS . TO THE ORDER OF - W R Dunkin & Son, Inc. . PO Box 2247 ,49EN3,.. • Anderson, IN 46018 z — 4. %,AEa rt�& 000 / 466e C740 /42 / 31: 0087504i / iv CARMEL REDEVELOPMENT COMMISSION 001466 Check: 1466 W R Dunkin 4& Son, Inc. Date: 12/17/2010 Anderson,non,, IN 46018 PO e Vendor: DUNKINW1 IN Prior Invoice P,O. Num. Invoice Amt Balance Retention Discount Amt. Pal 21-2 51 55,181.00 55,181.00 0.00 0.00 55,181.0 Application 21 32A 35 137,733.00 137,733.00- 0.00 0.00 137,733.0 Application 32A 192,914.00 192,914.00 0.00 0.00 192,914.0 v AIA Document G702/CMa - 1992 taw 51 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A,#5010 Cannel APPLICATION NO: 021 Distribution to: Commission Performing Arts OWNER:X One Civic Square 777 3rd Ave S.W. Cannel,IN 46032 Carmel,IN 46032 PERIOD TO:November 311,2010 CONSTRUCTION MANAGER:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shiel Sexton Co., Inc. CONTRACT DATE: February 23, 2009 ARCHITECT:C OR X CONTRACTOR: PO Box 2247 MANAGER: CONTRACTOR Alderson,IN 46018 PROJECT NOS:2531011/<695/501(1/2695 FIELD: CONTRACT FOR: Bid Pkg#5010 VIA ARCHITECT: CSO Architects OTHER: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractors knowledge, information and belief the Work covered by this Application for Payment 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 been paid by the Contractor for Work for which previous Continuation Sheet.MA Document G703,is attached. Certificates for Payment were issued an ayments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 1,480.000.00 payment shown herein is low due. / 2.NET CHANGE BY CHANGE ORDERS $ -81,040.00 Ce• .:`.°c-. W ,/DUNK t. S i N, I y 3.CONTRACT SUM TO DATE(Line I t 2) $ 1,398,960.00 1 Aill .fl assf _ tc: Nov:Wier 22,2010 0o Slat of:Indiana - off` °OO. MAN I 11 A.CARPENTER 4.TOTAL COMPLETED&STORED TO DATE(Column G on(1703) $ 1.337.__8.00 z�`6 NOTARY PUBLIC 5.RETAINAGE: County of:Madison / ` V? STATE OF INDIANA a. 5 %of Completed Work Subscribed and sworn to before -ecsaft My Commission Expires 1-8-17 (Column I)+E on G703) S 69.948.00 me this 22nd day of Novembe 2010 /J � b. 0 %of Stored Material Notary Public:Martha A. Carpenter .._..../„K �' (Column F on G703) $ 0.00 My Commission expires:January 08,2017 Total Retainage(Lines 5a+5b or Total in Column I of 6703) $ 69.948.00 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 1.267,280.00 In accordance with the Contract Documents, based on on-site observations and the data comprising (Line 4 Less Line 5'I-oral) this application. the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 1.212.099.00 knowledge, infirmtat ion 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 the AMOUNT (Line 6 from prior Certificate) CERTIFIED. AM' II 8.CURRENT PAYMENT DUE $ 55,181.00 AMOUNT CERTIFIED $ 55 16l,,,,„+ 9, BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified diflers m the amount applied. Initial all figures on this Application and on the Continuation Sheet t .e changed to conform with the amount certified.) (Line 3 less Line 6) $ 131.680.00 CONS RUCTION i NA R: /q By. -aS 4.. r ;F r _ Date: f 2. /0 CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHI •• Total changes approved in previous months by Owner$ 0.00$ 81,040.00 Bv: '' Date: I I,� 1+�+ Total approved this Month $ 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED) is payable ono • to the Contractor TOTALS $ 0.00$ 81.040.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of — --- the Owner or Contractor miler this Contract. NET CHANGES by Change Order $ -81,040.00 AIA Document G7021CMam—1992.Copyright 0 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 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 10:25:10 on 11/22/2010 under Order No.0168420739_1 which expires on 05/1012011.and is not for resale. User Notes: (1664318072) tAIA Document G703r" - 1992 Continuation Sheet ALA Document,G702m1-1992, Application and Certification for Payment, or G736TM-2009. APPLICATION NO:021 Project Application and Project Certificate for Payment.Construction Manager as Adviser Edition, APPLICATION DATE: 11/15/2010 containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars. PERIOD TO: 11/30/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 25310H A B C D E F G H 1 WORK COMPLETED TOTAL MA'T'ERIALS ('Ot,9P1.IiTED BALANCE TO RETAINAGE AND STORED TO ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY % (IF VARIABLE NO. WORK VALUE PREVIOUS THIS PERIOD STORED DATE (�;-C') FINISH(C-G) RATE) APPLICA'T'ION (NOT IN D OR E) (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 2,640.00 Mobilize/ 01015 Demobilize 8,000.00 6,000.00 2,000.00 0.00 8,000.00 100.00% 0.00 400.00 Supervision/ 01020 Coordination 8.7,000.00 82,500.00 3,500.00 0.00 86,000.00 98.85% 1,000.00 6,600.00 General Conditions- _01025 M 30,000.00 28,700.00 1,300.00 0.00 30,000.00 100.00% 0.00 2,440.00 General Conditions- 01026 L 34.000.00 31.800.00 2200.00 0.00 34,000.00 100.00% 0.00 2,520.00 1400A Organ Facade Pipes 200.000.00 200,000.00 0.00 0.00 200.000.00 100.00% 0.00 8,672.00 Carpentry Labor 1400B Hours 32.000.00 32.000.00 0.00 0.00 32,000.00 100.00% 0.00 3,200.00 Provide Tie-Off _14000 Points at Balconies 25,000.00 6,688.00 0.00 0.00 6,688.00 26.75% 18,312.00 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 1,500.00 16'X16'Temporary 1400E Overhead Door 6,000.00 6,000.00 0.00 0.00 6,000.00 100.00% 0.00 600.00 Temporary OHD Enclosure and 1400F Insulation 10,000.00 1.644.00 0.00 0.00 1,644.00 16.44% 8.356.00 164.40 1000 SY of BX 1200 1400G Tensar Geogrid 17.000.00 4,1 17.00 0.00 0.00 4,1 17.00 24.22% 12,883.00 411.70 1400H 350 CY of#2 Stone 18,200.00 5,718.00 0.00 0.00 5,718.00 31.42% 12,482.00 571.80 AIA Document G703T"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe 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 10:28:36 on 11/22/2010 under Order No.0168420739 1 which expires on 05/10/2011,and is not for resale. User Notes: (1733509699) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY 970 NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G-C) FINISH OF VARIABLE APPLICATION DATE (C G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 1400J 200 CY of 1453 Stone 10.000.00 1,746.00 0.00 0.00 1.746.00 17.46% 8.254.00 174.60 1400K General Allowance 75,000.00 72.864.00 651.00 0.00 73,515.00 98.02% 1,485.00 5,000.00 CAD As-Built 1400L Allowance 5,000.00 5,000.00 0.00 0.00 5,000.00 100.00% 0.00 500.00 General Clean Up- 01560 M 4.000.00 3,800.00 200.00 0.00 4,000.00 100.00% 0.00 140.00 01561 General Clean Up- L 25,000.00 24,000.00 1.000.00 0.00 25,000.00 100.00% 0.00 1,130.00 Final Cleaning(Items 01562 in BP 5010 10,000.00 7.500.00 2,500.00 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 1,850.00 Dewatering for 9 02111 Months- L-Eq 28,000.00 28.000.00 0.00 0.00 28,000.00 100.00% 0.00__ 2,800.00 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 _ 2,100.00 Interior Metal Fabrications- 05504 Submittals 6200.00 6,200.00 0.00 0.00 6,200.00 100.00% 0.00 620.00 Interior Metal Fabrications- 05505 Materials 86.500.00 86,500.00 0.00 0.00 86,500.00 100.00% 0.00 8,650.00 Interior Metal 05506 Fabrications-Erection 24,000.00 24,000.00 0.00 0.00 24,000.00 100.00% 0.00 2,400.00 Miscellaneous Metals 05511 - M 5,640.00 5.640.00 0.00 0.00 5,640.00 100.00% 0.00 564.00 Miscellaneous Metals 05512 - I. 2,500.00 2,500.00 0.00 0.00 2,500.00 100.00% 0.00 250.00 Interior Rough 06100 Carpentry- M 28,000.00 28.000.00 0.00 0.00 28,000.00 100.00% 0.00 2,660.00 Interior Rough 06101 Carpentry- L 36,500.00 36,500.00 0.00 0.00 36500.00 100.00% 0.00 3,199.50 07810 Skylight Shade-M 62,000.00 62.000.00 0.00 0.00 62,000.00 100.00% 0.00 6,200.00 AIA Document G703Th-1992.Copyright®1963, 1965,1966.1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe 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 2 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 10:28:36 on 11/22/2010 under Order No.0168420739 1 which expires on 05/1012011,and is not for resale. User Notes: (1733509699) A B C D E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RET.4INAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY °o NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G_C) FINISH (IF VARIABLE APPLICATION (NOT IN D ORE) DATE (C-G) RATE) (D+E) (D+L'+F) Skylight Shade- 07811 Installation 29,500.00 29,500.00 0.00 0.00 29,500.00 100.00% 0.00 2,950.00 07910 Joint Sealants-M 48,000.00 46,000.00 2,000.00 0.00 48,000.00 100.00% 0.00 760.00 07911 Joint Sealants-L 24,500.00 23,830.00 670.00 0.00 24,500.00 100.00% 0.00 420.00 08810 Interior Glazing 42,000.00 4.340.00 37,660.00 0.00 42,000.00 100.00% 0.00 84.00 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 1,000.00 10210 Toilet Compartments 44,000.00 44,000.00 0.00 0.00 44,000.00 100.00% 0.00 0.00 Back fold Door 10220 Tracks-NI 5.000.00 5.000.00 0.00 0.00 5.000.00 100.00% 0.00 500.00 Backfold Door 10221 Tracks- L 4,560.00 4,560.00 0.00 0.00 4,560.00 100.00% 0.00 456.00 10222_Operable Partition 21,000.00 21,000.00 0.00 0.00 21,000.00 100.00% 0.00 320.00 10223 \Vire Mesh Partitions 9500.00 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 3,400.00 Toilet Accessories- 10225 L 28,000.00 28,000.00 0.00 0.00 28.000.00 100.00% 0.00 100.00 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 2,000.00 1,500.00 0.00 3,500.00 100.00% 0.00 0.00 17001 Changr Order No.01 -81,040.00 -80,000.00 0.00 0.00 -80,000.00 98.72% -1,040.00 -8,000.00 GRAND TOTAL $1,398,960.00 $1,282,047.00 $55,181.00 $0.00 $1.337,228.00 95.59% $61,732.00 $69,948.00 AIA Document G703"1-1992.Copyright®1963,1965,1966,1967,1970,1978, 1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAe Document,or any portion of R.may result in severe civil and criminal penalties,and will be 3 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 10 28:36 on 11/22/2010 under Order No.016 84 2 07 3 9_1 which expires on 05/10/2011,and is not for resale. User Notes: (1733509699) AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X ] PARTIAL [ ] PAYMENT TO FOLLOW State of Indiana. County of Madison. SS Bradley Tyler , being duly sworn states that he is the Project Manager of W. R. Dunkin & Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Bid Package 5010-Interior Finishes for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Application for Payment # 17 has been received for work performed through 07/31/10. (PARTIAL WAIVER)that there is due from the contractor the sum of Two Hundred Thirty-five Thousand Two Hundred ninety-five dollars and 00/cents ($ 235,295.00) Application for Payment #_ has been received for work performed through (FINAL WAIVER)that the final balance due from the Owner is the sum of dollars and 00/cents($ 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 lien on account of any work perforated or material furnished to the undersigned for said project, and within e scope i idaa d waiver. iskr W. R. Dunkin& Son. Inc Title: Project Manager V WITNESS MY HAND AND NOTARIAL SEAL,this 22" day of November ,2010 i (Notary Publi My Commission Expires: January 08, 2017 Printed Martha A. Carpenter • P MARTHA A.CARPENTER Residing in Madison County NOTARY PUBLIC `41/4 STATE OF INDIANA My Commission ExpIrss 1-8-17 AFFIDAVIT AND WAIVER OF LIEN [ FINAL [ X I PARTIAL [ ) PAYMENT TO FOLLOW State of Indiana.County of Madison. SS Bradley Tyler , being duly sworn states that he is the Proiect 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 # 18 has been received for work performed through 08/3 [/10. (PARTIAL WAIVER)that there is due from the contractor the sum of Forty-nine Thousand Five Hundred Eighteen dollars and 00/cents (S 49,518.00) Application for Payment # has been received for work performed through (FINAL WAIVER)that the final balance due from the Owner is the sum of dollars and 00/cents(S 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 lien on account of any work performed or material furnished to the undersigned for said project,and within th= cope of of 'avit an/ aiver. W. R. Dunkin& Son, Inc. war L a • Title: Project Manager WITNESS MY HAND AND NOTARIAL SEAL, this Lrd day of November ,2010 Aelgt (Notary Publi / My Commission Expires:January 08,2017 Printed Martha A. Carpenter Residing in Madison County MAMA A.CARPENTER • I y: NOTAAYPUIII.IC 1 STAT E OF INDIANA My Commission Expires .847 AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X] PARTIAL [ ] 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 # 19 has been received for work performed through 09/30/E0. (PARTIAL WAIVER)that there is due from the contractor the sum of One Hundred Forty-two Thousand Three Hundred Fifty dollars and 00/cents ($ 142350.00) Application for Payment ti has been received for work performed through (FINAL WAIVER)that the.final balance due from the Owner is the sum of dollars and 00/cents ($ 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 lien on accoun of any wor. .erformed or material furnished to the undersigned for said pro ect,and" within .cope o'ft3-.avit any er. W. R. Dunkin& Son, Inc_ / Title_ Project Manager WETNESS MY HAND AND NOTAR AL SEAL,this 22nd day of November ,2010 . a (Notary Publi My Commission Expires: January 08,2017 Printed Martha A. Carpenter Residing in Madison County �r a MARTHA A.CPARPENTER o�'♦� NOTARY UBF.IC ,�,r y DIAVA mC ix&ExPIrR i I AIA A Document G702ICMar" — 1992 35 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: Carmel Redevelopment PROJECT: Parcel 7A.#4050 Cannel APPLICATION NO:032 R Distribution to: Commission Perfbnning Arts OWNER:X One Civic Square 777 3rd Ave. S.W. CONSTRUCTION MANAGER:X Carmel,IN 46032 Carmel,IN 46032 PERIOD TO:November 30,2010 ARCHITECT:X FROM W.R.Dunkin&Son,Inc. VIA CONSTRUCTION Shicl Sexton Co.,Inc. CONTRACT DATE: May 08, 2008 CONTRACTOR: X CONTRACTOR: PO Box 2247 MANAGER: PROJECT NOS:2531012695-405012695 FIELD: Anderson, IN 46018 OTHER: CONTRACT FOR: BP-44050 General Trades VIA ARCHITECT: CSO Architects CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,intbrmation and belief the Work covered by this Application for Payment has been completed in accordance tt'ith the Application is made for payment,as shown below=in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet.AIA Document 6703,is attached. Certificates for Payment were issued and .aytncnts received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ Q966,300.00 payment shown herein is now due 2. NET CHANGE BY CHANGE ORDERS $ -60,864-00 CON'I.7�aY W /'1UNK • -ON NC. 3.CONTRACT SUM TO DATE(Line I +2) $ 9,905,436.00 By: �_re A — Dare---i e, ,,iber22. 2010 4.TOTAL COMPLETED&STORED TO DATE(Column(i on 0703) $ 9,281,083 00 Stet fG Indiana /rt`r°4o MARTHA A.CARPENTER x°��n NOTARY PUBLIC 5.RETAINAGE: County of.-Madison 5,a 4/ STATE OF INDIANA a. 5 %of Completed Work Subscribed and sworn to before 1-Grotte My Commission EMplre51-8-17 (Column D fS E on G703) $ 49!,833.80 me this 22nd day of Nov e e 2010 �� b. 0 %of Stored Material Nolan'Public:c:Martha A.Carpenter i ..�v (Column F on 0703) $ 0.00 My Commission expires:January 08.2017 Total Retainage(Lines 5a+5h or Total in Column 1 of 0703) $ 491,833.80 CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE 5 8.789,249 20 In accordance with the Contract Documents, based on on-site observations and the data comprising '(Line 4 Less line 5 Total) this application,the Construction Manager and Architect ceniF'to the Owner that to the best of their 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 8.651,516.20 knowledge, infilrmauon and belief the Work has progressed as indicated,the quality of the Work is in accordance with the Contract Documents and the Contractor is entitle{to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 7�7 �J 55�' B.CURRENT PAYMENT DUE $ 1.37.733.011 AMOUNT CERTIFIED $ 1 7 { l 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach erplarwrron if amount certified differs from the amount applied. Initial ail Jigures on this Application and on the Continuation Sheet%he l or hanged to corforut with the amount certified)1 (Line 3 less Line 6) $ 1,116.186.80 CON ,RUCTION M•Iii•GER- l BY: 1%-v._'---- /�� =1 . • Date: II/2-/t'J CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCH `rII �r� Total changes approved in previous months by Owner $ 699,466.00 $ 760,330.00 By: /I Date: ` ii 30]Cx+ Total approved this Month 5 0.00$ 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only o the Contractor !'OPALS $ 699.466.00 $ 760.330.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of- the Owner or Contractor under this Contract. NET CI IANOES by Chunge Order $ -60.864.00 AIA Document G7021CMa" —1992.Copyright to 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIAe Document is protected by D.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 1 under the law.This document was produced by AIA software at 14.07:30 on 11/22e2010 under Order No.0168420739 1 which ergrires on 05/10/2011.and is not for resale. User Notes: (1146770908) • $?4AIA Document G703T" - 1992 Continuation Sheet AIA Document,6702""-1992, Application and Certification for Payment, or G7361'm-2009, APPLICATION NO: 032 A Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 11/15/2010 containing Contractor's signed certification is attached. In tabulations below, amounts are in US dollars. PERIOD TO: 11/30/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 25310 A B C D E F 0 H I WORK COMPLETED TOTAL MATERIALS CO,MPLETI?D BALANCE.' R"'AIN.4GE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY PREVIOUS STORED AND STORED TO FINISH (IF VARIABLE NO. WORK VALUE THIS PERIOD DATE (G+C) (C-G) KATE) APPLICATION (NOT IN D OR E) (D+E+F) +E) D+E+F) PERFORMANCE 01010 BOND 106.000.00 106,000.00 0.00 0.00 106,000.00 100.00% 0.00 10,600.00 MOBILIZE/DEMOB 01015 1LIZE 29,000.00 22,000.00 4,000.00_ 0.00 26,000.00 89.66% 3,000.00 1,500.00 SUPERVISION/CO 01020_ORDINATION 361,000.00 356,900.00 3.000.00. 0.00 359,900.00 99.70% 1,100.00 28,480.00 GENERAL 01025 CONDITIONS-NI 380,000.00 378.000.00 2,000.00 0.00 380,000.00 100.00% 0.00 27.000.00 GENERAL 01026 CONDITIONS-L 98,000.00 97,500.00 500.00 0.00 98,000.00 100.00% 0.00 7,000.00 GENERAL 01027 CONDITIONS-O 262,990.00 261,800.00 1.190.00_ 0.00 262,990.00 100.00% 0.00 0.00 ALLOWANCE- STONE . 140A0 WALKWAY 8.500.00 0.00 0.00 0.00 0.00 0.00% 8,500.00 0.00 ALLOWANCE: TEMPORARY 140130 HANDRAIL 38.000.00 37,039.00 0.00 0.00 37,039.00 97.47% 961.00 2.776.90 ALLOWANCE- TEMPORARY DOORS/FRAMES/H 14000 ARDWARE 10,000.00 5,972.00 0.00 0.00 5,972.00 59.72% 4,028.00 0.00 140D0 ALLOWANCE-ICE 13,500.00 2,943.00 0.00 0.00 2,943.00 21.80% 10,557.00 207.10 ALLOWANCE- 140E0 SECURITY 31,000.00 45.186.00 12.928.00 0.00 58,114.00 187.46% -27,114.00 0.00 140F0 ALLOWANCE- 191,700.00 110,304.00 6,210.00 0.00 116,514.00 60.78% 75,186.00 3,987.90 AIA Document G7031'-1992.Copyright ilft 1963,1965,1966.1967,1970.1978, 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 NA° 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 14:09:16 on 11/22/2010 under Order No.0168420739_1 which expires on 05/1012011,and is not for resale. User Notes: (1215788361) • A B C D E F G H I WORK COMPLETED TOTAL MATERIALS CODINLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G*C) FINISH (11'VARIABLE APPLICATION DATE (C-G) RAPE) (D+E) (NOT IN D OR E) (D+E+F) DUMPSTERS ALLOWANCE- TRAILER 14000 CONNECTOR 34,000.00 33,482.00 18.00 0.00 33,500.00 98.53 % 500.00 2,200.90 ALLOWANCE- TRAILER 140H0 CLEANING 19,169.00 15,720.00 0.00 0.00 15,720.00 82.01 % 3.449.00 1,066.10 ALLOWANCE-SITE 14010 SIGNAGE/SAFETY 22,000.00 11,623.00 0.00 0.00_ 11,623.00 52.83% 10,377.00 1,055.90 ALLOWANCE- 14010 GENERAL LABOR 320,000.00 321,844.00 6,129.00 0.00 327,973.00 102.49% -7.973.00 594.40 ALLOWANCE- TEMPORARY FENCE: 140K0 MODIFICATIONS 5,000.00 4,008.00 0.00 0.001 4,008.00 80.16% 992.00 400.80 ALLOWANCE-#2 140L0 OR#53 STONE 37,900.00 48,226.00 0.00 0.00 48,226.00 127.25% -10.326.00 1,885.60 ALLOWANCE- \VA REHOUSE 140M LEASE/LAYDOWN 0 /PARKING 500,000.00 500.000.00 0.00 0.00_ 500,000.00 100.00% 0.00 942.70 ALLOWANCE- PARKING LOT INSTALL/MAINTAI I 140N1 N 100,000.00 80.324.00 0.00 0.00 80,324.00 80.32% 19,676.00 5.532.40 ALLOWANCE- . MAINT.-OFF SITE STAGING/PARKIN I40N2 G 35,000.00 22,320.00 2,380.00 0.00 24,700.00 70.57% 10.300.00 685.50 ALLO WANC E- PARK ING LOT REMOVE/REFURBI 14000 SH 100.000.00 2,745.00 0.00 0.00 2.745.00 2.75% 97,255.00 274.50 AlA Document G703"-1992.Copyright B 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AEA° Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAe 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 14:09:16 on 1122/2010 under Order No.0166420739_1 which expires on 05/10/2011,and is not for resale. User Notos: (1215788361) A B C D E F G H 1 _ WORK- COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRE AND STORED TO % FINISH IF VARIABLE NO. WORK. VALUE PREVIOUS THIS PERIOD (G-C) APPLICATION (NOT IN D OR E) DATE (C-G) RATE) (D+E) (D+E+F) ALLOWANCE- HAUL/DISPOSE UNSUITABLE 140P0 MATERIAL 25,000.00 14,794.00 0.00 0.00 14,794.00 59.18% 10,206.00 1,479.40 ALLOWANCE-6 OZ. GEOTECH 140Q1 FABRIC 4.700.00 0.00 0.00 0.00 0.00 0.00% 4,700.00 320.70 ALLOW ANCE- I40Q2 TENSAR CEOGRID 8,500.00 8,126.00 0.00_ 0.00 8,126.00 95.60% 374.00 0.00 ALLOWANCE-#2 140R0 STONE 26,200,00 23,580.00 0.00 0.00 23,580,00 90.00% 2.620.00 1,027.50 ALLOWANCE- CABLE PASS- 140S0 THRU(FOE]) 6,456.00 6,456,00 0.00 0.00 6,456.00 100.00% 0.00 0.00 ALLOWANCE- CABLE PASS- 140T0 THRU(BOIT) 5,165.00 5,165.00 0.00 0.00 5,165.00 100.00% 0.00 0.00 ALLOWANCE- 140U CABLE PASS- 0 THRU(FLOOR) 17 217.00 17,217.00 0.00 0.00 17,2 1 7.00 100.00% 0.00 0.00 - ALLOWANCE- - TEMPORARY ELEVATOR 140V0 USAGE 200.000.00 136,439.00 16.645,00 0.00 (53,084.00 76.54% 46,916.00 0.00 ALLOWANCE- 140W DONOR 0 RECOGNITION 100,000.00 100,000.00 0.00 0.00 100,000.00 100.00% 0.00 0.00 GENERAL 140X0 ALLOWANCE 400,000.00 400,848.00 44,623.00 0.00 445,471.00 111.37% -45,471.00 598.00 ALLOWANCE-AS- 140V0 BUILD/CAD 5,000,00 4,242.00 0.00 0.00 4,242.00 84.84% 758.00 0.00 FIELD 01501 OFFICE/STORAGE 16,400,00 16,400.00 0.00 0.00 16,400.00 100.00% 0.00 1,320.00 AIA Document G703'"-1992.Copyright®1963,1965,1966, 1967,1970,1973, 1963 and 1992 by The American Institute of Architects.All opts reserved.WARNING:This AlAe 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 3 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14'.09:16 on 11/22(201C under Order No.0168420739_1 which expires on 051101201 5,and is not for resale. User Notes: (1215788361) • A B C D E F G 1-I I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE 1'RL•VIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (G_C) (C-G) RATE) (D+E) (D+E+F) TRAILER-M FIELD OFFICE/STORAGE 01502 TRAILER-L 5,500.00 5,500.00 0.00 0.00 5,500.00 100.00% 0.00 405.00 TEMPORARY TOILETS/WA SHIN 01503 G STATIONS-M 41,800.00 41,800.00 0.00 0.00 41,800.00 100.00% 0.00 2,860.00 TEMPORARY TOILETS/WASHIN 01504 G STATIONS-L 7,600.00 7,600.00 0.00 0.00 7.600.00 100.00% 0.00 555.00 FIRE PROTECTION/EME 01505 RG.STATIONS-M 19,300.00 19,300.00 0.00 0.00 19,300.00 100.00% 0.00 1,930.00 FIRE PROTECTION/EME 01506 RG.STATIONS-L 4,000.00 4.000.00 0.00 0.00 4,000.00 100.00% 0.00 310.00 FURNISH/MA I NTA 01507 IN TRASH CANS-M 6,000.00 6,000.00 0.00 0.00 6,000.00 100.00% 0.00 600.00 FURNISH/MAINTA 01508 IN TRASH CANS-L 40,000.00 40,000.00 0.00 0.00 40,000.00 100.00% 0.00 2,350.00 TEMPORARY ROAD/MAINTENA 01510 NCE 148,000.00 148,000.00 0.00 0.00 148,000.00 100.00% 0.00 12,220.00 TEMPORARY FENCING- REMOVE/RELOCA 01520 TE 15,800.00 15,800.00 0.00 0.00 15,800.00 100.00% 0.00 1.580.00 TEMPORARY -- - 01521 FENCING-GATES 6,500.00 6,500.00 0.00 0.00 6,500.00 100.00% 0.00 650.00 TEMPORARY FENCING- 01522 SCREENING 8.744.00 8,744.00 0.00 0.00 8,744.00 100.00% 0.00 874.40 AIA Document G703T-1992.Copyright®1963, 1965.1966,1967,1970,1978.1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlAe Document,or any portion of it,may result in severe civil and criminal penalties,and will be 4 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:09:16 on 11/22/2010 under Order No.0168920739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1215788361) • A B C D E F G H 1 WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RE"I'AWAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE, PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (['-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) TEMPORARY 01523 BARRIERS-M 6,800.00 6,800.00 0.00 0.00 6.800.00 100,00% 0.00 680.00 TEMPORARY 01524 BARRIERS-L 7,500.00 7,500.00 0.00 0.00 7,500.00 100.00% 0.00 750.00 TEMPORARY 01530 ENCLOSURES-M 10,800.00 I0,800,00 0.00 0.00 10,800.00 100.00% 0.00 1,050.00 TEMPORARY 01531 ENCLOSURES-L 14,000.00 [4,000.00 0.00 0.00 14,000,00 100.00% 0.00 1,360.00 SCAFFOLDING- SET UP/CONSUMABLE 01540 S 308,000.00 398,000.00 0.00 0.00 398,000.00 100.00% 0.00 37,620.00 SCAFFOLDING- MONTHLY RENTAL/INSPECT] 0154] ONS 228.000.00 228,000.00 0.00 0.00 228,000,00 100.00% 0.00 10,450.00 SCAFFOLDING- DISMANTLE/REM 01542 OVE 55,000.00 55,000.00 0.00 0.00 55,000.00 100.00% 0.00 0.00 STAIR TOWERS- 01543 SETUP 54,000.00 54,000.00 0.00 0.00 54,000.00 100.00% 0.00 1,800.00 STAIR TOWERS- MONTHLY 01544 RENTAL 28,500.00 28.500.00 0.00 0.00 28,500.00 100.00% 0.00 350.00 STAIR TOWERS- 01545 DISMANTLE 6,700.00 6,700.00 0.00 0.00 6,700.00 100.00% 0_00 0.00 HOIST-EXTERIOR- 1546.1 SET UP 14,300.00 0.00 0.00 0.00 0.00 0.00% 14,300.00 0.00 [10IST-EXTERIOR- RENTAL/OPERAT' 1546.2 ON 139,040.00 0.00 0.00 0.00 0.00 0.00% 139,040.00 0.00 HOIST-EXTERIOR- 1546.3 DISMANTLE 8,000.00 0.00 0.00 0.00 0.00 0.00% 8,000.00 0.00 AIA Document G703"'-1992.Copyright @ 1963, 1965.1966.1967,1970,1978.1983 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 5 prosecuted to the maximum extent possible under the law.This document was produced'by AlA software at 14:09:16 on 11/22/2010 under Order No_0168420739_1 which expires on 05!1012011,and is not for resale. User Notes: (1215788351) A B C D I E E G H I WORK COMPLETED TOTAL - - MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO (G-C) FINISH (IF VARIABLE APPLICATION (NOT IN D ORE) DATE (C- G) RATE) (D+E) (D+E+F) HOIST-STAIR2-SET 1547.1 UP 14,300.00 0.00 0.00 0.00 0.00 0.00% 14,300.00 0.00 HOIST-STAIR 2- RENTAL/OPERATI 1547.2 ON 139,040.00 0.00 0.00 0.00 0.00 0.00% 139,040.00 0.00 HOIST-STAIR 2- 1547.3 DISMANTLE 8,000.00 0.00 0.00 0.00 0.00 0.00% 8.000.00 0.00 HOIST-ROOM 100- 1548.1 SETUP 95,000-00 95,000.00 0.00 0.00 95,000.00 100,00% 0.00 9,500.00 HOIST-ROOM 100- RENTAL/OPERATI 1548.2 ON _ 21 1,000.00 211,000.00 0.00 0.00 211,000.00 100.00% 0.00 16,975.00 HOIST-ROOM 100- 1548.3 DISMANTLE 2,500.00 2,500.00 0.00 0-00 2,500.00 100.00% 0.00 0.00 - HOIST- ALLOWANCE-SET 1549.1 UP 9,830.00 0.00 0.00 0.00 0.00 0.00% 9,830.00 0.00 HOIST- ALLO WANCE- RENTAL/OPERATI 1549.2 ON 97,500.00 20,971.00 0.00 0.00 20,971.00 21.51 % 76,52900 0.00 HOIST- ALLOWANCE- 1549.3 DISMANTLE. 2,500-00 0.00 0.00 0.00 0-00 0.00% 2,500.00_ 0.00 v 01556 TRASH CHUTES-M 52,000.00 52,000.00 0.00 0.00 52,000.00 100.00 % 0.00 4,490.00 01557 TRASH CHUTES-L 58,000.00 58,000.00 0.00 0.00 58,000.00 100.00 % 0.00 2,500.00 GENERAL CLEAN 01560 UP-M 5,000.00 4,940.00 60.00 0.00 5,000 00 100.00 % 0.00 314.00 GENERAL CLEAN 01561 UP-L 60,000.00 59,600.00 400.00 0.00 60,000.00 100.00% 0.00 3,560.00 01562 FINAL CLEANING 65,000.00 50,750.00 14,250.00_ 0.00 65,000.00 100.00% 0.00 0.00 02110 EXCAVAT1ON/BA 12,019.00 12,019.00 0.00 0.00 12,019.00 100.00% 0.00 1,201.90 AIA Document G703TM-1992.Copyright 01963, 1965,1966,1967,1970,197S,1983 and 1992 by The American Institute at Architects.All rights reserved.WARNING:This AIAe Document is protected by D.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAI Document,or any portion of it,may result in severe civil and criminal penalties,and will be 6 prosecuted to the maximum extent possible under the law.This document was produced by AlA software at 14.09:16 on 11/22(2010 under Order No.0168420739 5 which expires on 05!1012011,and is not for resale. User Notes: (1255738361) A B C I) I E F G H I WORK C:OMPLETED TOTAL. MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (C'-C) (C-G) RATE) (D+E) (NOT IN D OR E) (Di.E+F) CKFILL-SUMPS-M EXCAVATION/BA CKFILL-SUMPS-L 021 1 1 EQ 25,000.00 25,000.00 0.00 0.00 25,000.00 100.00% 0.00 2.500.00 02240 SHORING 209.800.00 209.800.00 0.00 0.00 209.800.00 100.00% 0.00 20,980.00 CAST IN PLACE 03301 CONCRETE-M 12,000.00 12.000.00 0.00 0.00 12.000.00 100.00% 0.00 1,000.00 CAST IN PLACE 03302 CONCETE-L 40,000.00 40.000.00 0.00 0.00 40,000.00 100.00% 0.00 3.500.00 PRECAST PLANKS-12" 03410 HOLLOW CORE 161,000.00 161,000.00 0.00 0.00 161,000.00 100.00% 0.00 16,100.00 PRECAST PLANKS-12" 03411 SOLID 898,000.00 898,000.00 0.00 0.00 898,000.00 100.00% 0.00 89,800.00 PRECAST 03412 PLANKS-6" SOLID 107,000.00 107,000.00 0.00 0.00 107,000.00 100.00% 0.00 10,700.00 PRECAST 03413 TRUCKING 82.000.00 82.000.00 0.00 0.00 82,000.00 100.00% 0.00 8,200.00 PRECAST 03414 ERECTION 186,000.00 186,000.00 0.00 0.00 186,000.00 100.00% 0.00 18,600.00 INTERIOR METAL FABRICATIONS- 05504 SUBMITTALS 102.000.00 102,000.00 0.00 0.00 102,000.00 100.00% 0.00 10,200.00 STEEL STAIRS 05505 WITH RAIL-M 179,000.00 179,000.00 0.00 0.00 179,000.00 100.00% 0.00 14,857.00 STEEL STAIRS 05506 WITH RAIL-L 80.000.00 80,000.00 0.00 0.00 80,000.00 100.00% 0.00 6,600.00 05507_LADDERS-M 26,000.00 26,000.00 0.00 0.00 26,000.00 100.00% 0.00 2,600.00 05508 LADDERS-L 12,500.00 12,500.00 0.00 0.00 12,500.00 100.00% 0.00 1,220.00 CATWALK 05509 FRAMING-M 63.000.00 63,000.00 0.00 0.00 63,000.00 100.00% 0.00 6,300.00 AIA Document G703"'-1992.Copyright 1963, 1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIAe 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 7 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:09:16 on 11/22/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1215788361) A __ B C D I E F 0 H I WORK COMPLETED TOTAL MATERIALS COMPLE"I'L"D BALANCE TO REI-AiNAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO ((__C) FINISH (IF VARIABLE APPLICATION (NOT IN D OR E) DATE (C-G) RATE) _ (D+E) (D+E+F) CATWALK -- --- 05510 FRAMING-L 28.000.00 28.000.00 0.00 0.00 28,000.00 100.00% 0.00 1,710.00 MISCELLANEOUS 05511 METALS-NI 441.000.00 441,000.00 0.00 0.00 441,000.00 100.00% 0.00 13,615.00 MISCELLANEOUS 05512 METALS-L 275,000.00 275,000.00 0.00 0.00 275,000.00 100.00% 0.00 8,094.30 INTERIOR ROUGH - - 06100 CARPENTRY-M 31,000.00 31,000.00 0.00 0.00 31,000.00_ 100.00% 0.00 372.00 INTERIOR ROUGH 06101 CARPENTRY-L 44,000.00 44,000.00 0.00 0.00 44,000.00 100.00% 0.00 484.00 FOUNDATION WATERPROOFING 07110 -M 5,100.00 5,100.00 0.00 0.00 5,100.00_ 1 00.00% 0.00 510.00 FOUNDATION WATERPROOFING 071 I 1 -L 6,600.00 6.600.00 0.00 0.00 6,600.00 100.00% 0.00 660.00 07210 DUCT LINERS-M 97,000.00 97,000.00 0.00 0.00 97.000.00 100.00% 0.00 9,700.00 07211 DUCT LINERS-I. 28,000.00 28,000.00 0.00 0.00 28,000.00 100.00% 0.00 1,120.00 07810 FIRESTOPPING-M 24.000.00 24,000.00 0.00 0.00 24,000.00 100.00% 0.00 1,680.00 07811 FIRESTOPPING-L 16,000.00 16,000.00 0.00 0.00 16,000.00 100.00% 0.00 1,220.00 JOINT SEALANTS- 07910 M 35,000.00 28,000.00 7.000,00 0.00 35,000.00_ 100.00% _ 0.00_ 0.00 JOINT SEALANTS- 0791 1 L 80,000.00 64,000.00 16,000.00 0.00 80,000.00 100.00% 0.00 0.00 STEEL DOORS 8c 08110 FRAMES-M 0.00 0.00 0.00 0.00 0.00% 0.00 STEEL DOORS& 108111 _FRAMES-L 0.00 0.00 0.00 0.00 0.00% 0.00_ FLUSH WOOD 08140 _DOORS-M 0.00 0.00 0.00 0.00 0.00% 0.00 FLUSH WOOD 08141 DOORS-L 0.00 0.00 0.00 0.001 0.00% 0.00 AIA Document G703'M-1992.Copyright 01963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAe Document,or any portion of it,may result in severe civil and criminal penalties,and will be 8 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:09:16 on 11/22/2010 under Order No.016 84 20 7 3 9_1 which expires on 05/10/2011.and is not for resale. User Notes: (1215788361) • A B C D I E F G H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS STORED AND S"1'OREDTO G-C FINISH (IF VARIABLE APPLICATION THIS PERIOD (NOT DA'Z'E ( ) (C-G) RATE) (D+E) (NOT N DORIs) (D+E+F) STILE& RAIL 08143 WOOD DOORS-M 0.00 0.00 0.00 0.00 0.00% 0.00 STILE& RAIL 08144 WOOD DOORS-L 0.00 0.00 0.00 0.00 0.00% 0.00 SOUND CONTROL DOORS& 08347 WINDOW'S-M 0.00 0.00 0.00 0.00 0.00% 0.00 SOUND CONTROL DOORS& 08348 WINDOWS-L 0.00 0.00 0.00 0.00 0.00% 0.00 OVER COILING 08355 DOORS-NT 0.00 0.00 0.00 0.00 0.00% 0.00 OVERHEAR 08356 COILING DOORS-L 0.00 0.00 0.00 0.00 0.00% 0.00 ALUM.FRAMED ENTRANCES/STOR 08410 EFRONTS-M 0.00 0.00 0.00 0.00 0.00% 0.00 ALUM.FRAMED ENTRANCES/STOR 08411 EFRONS-L 0.00 0.00 0.00 0.00 0.00% 0.00 INTERIOR ALUM. DOORS& 08413 FRAMES-M 0.00 0.00 0.00 0.00 0.00% 0.00 INTERIOR ALUM. DOORS& 08414 FRAMES-L 0.00 0.00 0.00 0.00 0.00% 0.00 REVOLVING - - - DOOR 08423 ENTRANCES-M 0.00 0.00 0.00 0.00 0.00% 0.00 REVOLVING DOOR 08424 ENTRANCES-L 0.00 0.00 0.00 0.00 0.00% 0.00 08440 GLAZED ALU,. 325,000.00 325,000,00 0.00 0.00 325,000.00 100.00%n 0.00 11,375.00 AIA Document G703T"-1992.Copyright 12 1963,1965,1966,1967,1970.1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlAt Document,or any portion of It,may result in severe civil and criminal penalties,and will be 9 prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 14:09:16 on 11/22/2010 under Order No.01 6 84 207 3 9_1 which expires on 05/10/2011,and is not for resale. User Notes: (1215788361) A B C D E F 0 H I WORK COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED FROM PRES LY ENT NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD (NOT DATE (G_C) (C-G) RATE) (D+E) (NOT IN 0 OR E) (D+E+F) CURTAIN WALLS- M GLAED ALUM. CURTAIN WALLS- 08441 L 148.000.00 146,000.00 0.00 0.00 146,000.00 98.65 % 2,000.00 0.00 08710 HARDWARE 525,000.00 525,000.00 0.00 0.00 525,000.00 100.00 % 0.00 18,800.00 INTERIOR 08810 GLAZING-NI 11,000.00 11,000.00 0.00 0.00 11,000.00 100.00% 0.00 22.00 INTERIOR 08811 GLAZING-L 8,000.00 8,000.00 0.00 0.00 8,000.00 100.00% 0.00 0.00 FIRE PROTECTION 10440 SPECIALTIES-M 7.580.00 7,580.00 0.00 0.00 7.580.00 100.00 % 0.00 0.00 FIRE PROTECTION 10441 SPECIALTIES-L 1,890.00_ 1,400.00 400.00 0.00 1,800.00 100.00% 0.00 0.00 10450 KNOX BOX 650.00_ 650.00 0.00 0.00 650.00 100.00% 0.00 0.00 LOADING DOCK. 11130 EQUIPMENT-M 18,500.00 18,500.00 0.00 0,00 18,500.00 100.00% 0.00 1,647.50 LOADING DOCK 1 1 131 EQU1PMENT-L 3,800,00 3,800.00 0.00 0.00 3,800.00 100.00% 0.00 220.00 ELEC.TRACTION ELEVATORS- 14210 ENGINEERING 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 ELEC.TRACTION ELEVATORS- MATERIAL/EQUIP 14211 MENT 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 ELEC.TRACTION 14212 ELEVATORS-L 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 HYDRAULIC ELEVATOR- )4241 ENGINEERING 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 14242 HYDRAULIC 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 MA Dacument G703T"-1992.Copyright*1963,1965, 1966,1967,1970, 1978,1983 and 1992 by The American Institute cf Architects.All rights reserved.WARNING:This ALAS Document is protected by U.S.Copyright haw 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 10 prosecuted to the maximum extent possible under the law.This document was produced by AlA software at 14:09:16 on 11/22/2010 under Order No,0168420739 1 which expires on 05/10/2011.and is not for resale. User Notes: (12157t5361) A B C D E F G H I WORK COMPLETED TOTAL MA'T'ERIALS COMPLETED BALANCE TO RETAINAGE PFEM DESCRIPTION OF SCHEDULED FROM PRESENTLY AND STORED TO °° FINISH OF VARIABLE NO. WORK VALUE PRF.VTOi1S THIS PERIOD STORED (0 C) (C -G) ( RATE) APPLICATION (NOT IN D OR E) DATE (D+ E) (D+E+F) ELEVATOR- MATERIAL/EQUIP MENT HYDRAULIC ELEVATOR- 14243 LABOR 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 WHEELCHAIR LIFT- MATERIAL/EQUIP 14421 MENT 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 WHEELCHAIR. 14422 LIFT-PERMITS 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 WHEELCHAIR 14423 LIFT-LABOR 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 CHANGE ORDER 17001 NO.01 228,000.00 228,000.00 0.00 0.00 228,000.00 100.00% 0.00 450.00 CHANGE ORDER 17002 NO.02 9,031.00 9,031.00 0.00 0.00 9,031.00 100.00% 0.00 0.00 CHANGE ORDER 17003 NO. 03 2,196.00 2,196.00 0.00 0.00 2,196.00 100.00% 0.00 30.00 17000 CHANGE ORDER 4 NO. 04 0.00 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 17000 CHANGE ORDER 5 NO. 05 98,741.00 98,741.00 0.00 0.00 98,741.00 100.00% 0.00 9,874.10 17000 CHANGE ORDER 6 NO. 06 17,527.00 17,527.00 0.00 0.00 17,527.00 100.00% 0.00 1,400.00 17000 CHANGE ORDER 7 NO. 07 11,292.00 11,292.00 0.00 0.00 11,292.00 100.00% 0.00 1,12930 17000 CHANGE ORDER 8 NO. 08 44,936.00 44,936.00 0.00 0.00 44,936.00 100,00% 0,00 4,493.60 17000 CHANGE ORDER 9 NO. 09 14,683.00 14,683.00 0.00 0.00 14,683.00 100.00% 0.00 0.00 AM Document G7031°-1992.Copyright Ch 1963,1965,1966, 1967,1970,1978,1983 and 1992 by The American Institute of Architects.Al rights reserved.WARNING:This AlAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAe Document.or any portion of it,may result in severe civil and criminal penalties,and will be I I prosecuted to the maximum extent possible under the law.This document was produced by AlA software at 14319:16 on 11/22/2010 under Order No.0168420739_1 which expires on 05/10/2011,and is not for resale. User Notes: (1215788361) A B C D E F 0 H I _ WORK.COMPLETED TOTAL MATERIALS COMPLETED BALANCE TO RETAINAGE - ITEM DESCRIPTION OF SCHEDULED FROM PRESENTLY NO. WORK VALUE PREVIOUS THIS PERIOD STORED AND STORED TO FINISH (IF VARIABLE APPLICATION DATE (G-4-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 17001 CHANGE ORDER 0 NO. 10 -760,330.00 -750,573-00 0.00 0,00 -750,573.00 98.72% -9,757.00 -38,016.50 17001 CHANGE ORDER 2 NO. 12 49,062.00 49,062.00 0.00 0.00 49,062.00 100.00% 0.00 2,45110 17001 CHANGE ORDER 3 NO. 13 3,801.00 3,801.00 0.00 0.00 3,801.00 100.00% 0.00 190.05 17001 CHANGE ORDER 4 NO. 14 787.00 787.00 0.00 0.00 787.00 100.00% 0.00 39.35 17001 CHANGE ORDER 5 NO. 15 34,158.00 34,158.00 0.00 0.00 34,158.00 100.00% 0.00 1,707.90 17001 CHANGE ORDER 6 NO, 16 7,529.00 7,529.00_ 0.00 0.00 7,529.00 100.00% 0.00 376.45 17001 CHANGE ORDER 7 NO. 17 7,083.00 7,083.00 0.00 0.00 7,083.00 100.00% 0.00 354.15 17001 CHANGE ORDER 8 NO. 18 22591.00 22,591.00 0.00 0.00 22,591.00 100.00% 0.00 1,129.55 17001 CHANGE ORDER 9 NO. 19 22,591.00 22,591.00 0.00 0.00 22,591.00 100.00% 0.00 1,129.55 17002 CHANGE ORDER 0 NO. 20 22,591.00 22,591.00 0.00 0.00 22,591.00 100.00% 0.00 1,129,55 17002 CHANGE ORDER I NO.21 22,591.00 22,591.00 0.00 0.00 22,591.00 100.00% 0,00 1,129.55 17002 CHANGE ORDER 2 NO. 22 68,760.00 68.760,00 0.00 0.00 68,760.00 100.00% 0.00 0.00 17002 CHANGE ORDER 3 NO. 23 4,562,00 4,562.00 0.00 0.00 4,562.00 100.00% 0.00 228.10 17002 CHANGE ORDER 4 NO. 24 6,954.00 6.954.00 0.00 0.00 6,954.00 100.00% 0.00 347.70 GRAND TOTAL $9,905,436.00 $9,143,350.00 $137,733.00 $0.00 $9,281,083.00 93,70% $624,353.00 $491,833.80 AIA Document G703W-1992.C[0091110 1963, 1966,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.NI rights reserved,WARNING:This AIA Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA5 Document,or any portion of it,may result in severe civil and criminal penalties,and will be 12 • prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 1409:18 an 1122/2010 under Order No.0166420739_1 which expires on 05/1012011,and is not for resale. User Notes: (1215786361) AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X ] PARTIAL [ ] PAYMENT TO FOLLOW State of Indiana, County of Madison. SS Bradley A. Tyler . being duly sworn states that he is the Project Manager of W. R. Dunkin & Son, Inc. having contracted with City of Carmel Redevelopment Commission to furnish certain materials and/or labor as follows: Bid Package 4050-General Trades for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Carmel, Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Application for Payment # 27A has been received for work performed through 07/31/10 . (PARTIAL WAIVER)that there is due from the contractor the sum of One Hundred Forty-Blur Thousand Five Hundred Ninety-six dollars and 45/cents ($ 144.596.45 ) Application for Payment # has been received for work performed through . (FINAL WAIVER)that the final balance due from the Owner is the sum of dollars and 00/cents($ ) 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 lien on gace s . t p ny work performed or material furnished to the undersigned for said pr ' •., . m t �ope sft 's ,'fidrnv't/and waiver. W. R. Dunkin& Son, Inc. kInr as Title: Project Manager r WITNESS MV HAND AND NOTARIAL SEAL,this 22nd day of November , 2010 L J 2 // / ;i (Notary Pub c) My Commission Expires: January 08, 2017 Printed Martha A. Carpenter Residing in Madison County ,r`P e° MRT�NA OAy C pNUD LNTIN C E&R t7, �`7 r✓IY Commtssbn E4 AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X] PARTIAL. [ ] PAYMENT TO FOLLOW State of Indiana, County of Madison. SS Bradley A. 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 4050-General Trades for a project known as Parcel 7A, Carmel Regional Performing Arts Center located at Cannel. Indiana and owned by City of Carmel and does hereby further state on behalf of the aforementioned Contractor. Application for Payment # 28A has been received for work performed through 08/31/10 . (PARTIAL WAVER)that there is due from the contractor the sum of Two Hundred Eighty-one Thousand Six Hundred Eight dollars and 001cents ($ 281,608.00 ) Application for Payment # 28B has been received for work performed through 08131/10. (FINAL WAIVER)that the final balance due from the Owner is the sum of Ninety-two Thousand Six Hundred Fifty dollars and 001cents(S 92,650.00 ) 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 a lien or accoyr�anx work performed or material furnished to the undersigned for said ro e tin t e sco e ft is fi tda t and waiver. W. R. Dunkin& Son. Inc. I / Title: Project Manager WITNESS MY HAND AND NOTARIAL SEAL,this 22"' day of November ,2010 (Notary PGblic) My Commission Expires:January 08.2017 Printed Martha A. Carpenter Residing in Madison County e a a MARTHA A.CARPENTER air n NOTARY PUBLIC yi,#10 STATE OF INDIANA 1AY CammbtWn E�Ires 1.6.17 AFFIDAVIT AND WAIVER OF LIEN [ ]FINAL [X] PARTIAL [ ] PAYMENT TO FOLLOW State of Indiana,County of Madison. SS Bradley A. 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 4050-General Trades for a project known as Parcel 7A, Cannel 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 # 29A has been received for work performed through 09/30/10 . (PARTIAL WAIVER)that there is due from the contractor the sum of Eighty-nine Thousand Seven Hundred thirty-one dollars and 00/cents ( S 89,731.00 ) Application for Payment # 29B has been received for work performed through 09/30110. (FINAL WAIVER)that the final balance due from the Owner is the sum of Four Hundred Seven Thousand One Hundred Forty dollars and 00/cents(5 407,140.00 ) "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 lien on accot of al yivork performed or material furnished to the undersigned for said pr ' hand-w1tfn' scope . tfttc a i aN nd'vaiver. v W. R. Dunkin &Son, Inc. By �d4fl �� Title: Project Manager WITNESS MY HAND AND NOTARIAL SEAL,this 22" day of November �,2010 (Notary P de-tic) My Commission Expires: January 08, 2017 Printed Martha A. Carpenter Residing in Madison County r P MAR11iA A•CARPENTER z�l*e Npy PUBLIC -fa STATE OF IND�N&17 My Cammisslon fxP AFFIDAVIT AND WAIVER OF LIEN I ]FINAL [X] PARTIAL [ ] PAYMENT TO FOLLOW State of Indiana, County of Madison.SS Bradley A. 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 4050-General Trades 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 # 30A has been received for work performed through 10/31/10 . (PARTIAL WAIVER) that there is due from the contractor the sum of Sixtv-eight Thousand Seven Hundred Sixty dollars and 00/cents ($ 68,76000 ) Application for Payment :0 OOB has been received for work performed through 00/0/10. (FINAL WAIVER)that the final balance due from the Owner is the sum of dollars and 00/cents(S 0.00 ) 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 lien on account of any work performed or material furnished ..dcar---fr to the undersigned for said project,and within the scope of this affidavit ate. waiver. % W. R. Dunkin&Son. Inc. -.•� A Title: Project Manager air WITNESS MY HAND AND NOTARIAL SEAL, this 22m day of November ,2010 (Notary Pt lic) My Commission Expires: January 08,2017 Printed Martha A. Carpenter Residing in Madison County t+Pre MARTHA A.CARPENTER .4_ a NOTARY PUBLIC ft STATE OF INDIANA ,er1' My Commheln Expires t-e-17