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Home My WebLink AboutHORNING ROOFING & SHEET METAL- 159- 1/5/2011 Horning Roofing & Sheet Metal Check: 159 1340 Enterprise Park Place Date: 1/5/2011 Suite A Vendor: HORNIN1 Indianapolis, IN 46218 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2-1 3,690.00 3,690.00 0.00 0.00 3,690.00 App 1 on OP7C-1 3,690.00 3,690.00 0.00 0.00 3,690.00 159 1/5/2011 ***********3,690.00 THE SUM OF THREE THOUSAND SIX HUNDRED NINETY DOLLARS AND NO CENTS **************** Horning Roofing & Sheet Metal 1340 Enterprise Park Place Suite A Indianapolis, IN 46218 Horning Roofing & Sheet Metal Check: 159 1340 Enterprise Park Place Date: 1/5/2011 Suite A Vendor: HORNIN1 Indianapolis, IN 46218 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2-1 3,690.00 3,690.00 0.00 0.00 3,690.00 App 1 on OP7C-1 3,690.00 3,690.00 0.00 0.00 3,690.00 APPI_IcAT!ON AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 (Instructions on reverse side) PAGE ONE OF TWO PAGES TO OWN ER: PROJECT: PROGRESSIVE BILLING NO. 1 Distribution to: ^ Carmel Theater Development Corp., LLC Village on the Green Parcel 7-C-1 PERIOD TO: 11/30/2010 OWNER 11711 N. Pennsylvania Street, Suite 200 Theater Building PROJECT NO.: 12012 ARCHITECT Carmel, IN 46032 INVOICE NO.: X CONTRACTOR " ' FROM CONTRACTOR: VIA ARCHITECT: Horning Roofing&Sheet Metal Co., LLC Pedcor Design Group, LLC 2340 Enterprise Park Place, Suite A 335 City Center Drive Indianapolis, IN 46218 Carmel,IN 46032 CONTRACT FOR: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,infor- Application is made for payment,as shown below,in connection with the contract. mation and belief the Work covered by this Application for Payment has been completed in Continuation Sheet,AIA Document G703,in attached. accordance with the Contract Documents,that all amounts have been paid by the Contractor 1 ORIGINAL CONTRACT SUM $ 203,500.00 for Work for wh' previous Certificates for Payment were issued and payments received form the Ow er and that current payment shown herein is now due. 2 Net change by change orders.. $ (6,390.00) CONT A OR: Horning Roofing&Sheet Metal Co., LLC 3 CONTRACT SUM TO DATE(line 1+2) $ 197,110.00 By. & DATE: 11/30/2010 4 TOTAL COMPLETED AND STORED TO DATE $ 4,100.00 Ron Phelps II, President (Column G on G 703) State of: Indiana 5 RETAINAGE: County of:Marion a. 10% of completed work $ 410.00 Subscribed and sworn to before (Columns D+Eon G 703) me this day of 1 1/30/2010 b. 10% of Stored Material $ - ... ^./ Arbiz, (Column F on G 703) Notory Public: Kevin L.Moore Total Retainage(Line 5a+5b or $ - My Commission expires: 02-02-11 Total in column I of G 703) ARCHITECT'S CERTIFICATE FOR PAYMENT 6 TOTAL EARNED LESS RETAINAGE $ 3,690.00 (Line 4 less line 5 total) In accordance with the Contract Documents,based on on-site observsations and the data 7 LESS PREVIOUS CERTIFICATES FOR PAYMENT $ - comprising this application,the Architect certifies to the Owner that to the best of the (line 6 from prior certificate) Architect's knowledge,information and belief the Work has progressesd as indicated,the 8 CURENT PAYMENT DUE $ 3,690.00 quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 9 BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ $ 3,690.00 (Line 3 less line 6) $ 193,420.00 (Attach explanation if amount certified differs from the amount applied for.Initial all figures on this Application and on the Continuotion Sheet that are changed to CHANGE ORDER SUMMERY ADDITIONS DEDUCTIONS conform to the amount certified.) Total changes approved in ^o ;-EST. -�^^g-r" F---or previous months by Owner By: ----------- --/ Date: / / / ) Total approved this month $ (6,390.00) This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Con- TOTALS tractor named herein. Issuance,payment and acceptance of the payment are without Net Changes by Change Order $ (6,390.00) prejudice to any rights of the Owner under this Contract. G702-1992 101°(/ , . CONTINUATION.,SHEET.,..—.. .. , ,.: AMA DOCUMENT G703 s.n Page..1:of.1,... Application No r Application Date: 11/16/20;0 JOB NAME VILLAGE ON THE GREEN THEATER BUILDING Period To 11/,/2010 HORNING JOB # 102527 Architect's Project No: pZU/a_ A B C D E F G H I Work Completed Materials Total Balance Retainage From Previous Presently Completed & to Finish Application Stored Stored to Date (G/C) Item# Description of Work Scheduled Value (D+E) _This Period (Not in D or E) (D+E+F) 107-2000 Safety/Start-Up $1,500.00 $0.00 $0.00 $1,500 00 $0.00_ 107-2001 Roofing Material $135,530.00 $0.00 $2,500.00 $2,500.00 $133,030.00 $250.00_ 102-2002 Roofing Labor $24,210.00 $0.00 $0.00 $24,210.00 $0.00_ 107-2003 Sheet Metal Material $24,520.00 $0.00 $0.00 $24,520 00 $0.00_ 107-2004 Sheet Metal Labor $12,140.00 $0.00 $0.00 $12,140 00 $0 00 107-2005 Submittals $2,500.00 $0.00 $0.00 $2,500.00 $0 00 _ 107-2006 Bond $1,600.00 $0.00 $1,600.00 $1,600.00 $0.00 $160.00 107-2007 Clean-up/Close-Out $1,500.00 $0.00 $0.00 $1,500 00 $0.00 _ 107-2008 Change Order-Tax Excemption ($6,390.00) $0.00 ($6,390.00) $0 00 $197,110.00 $0.00 $4,100.00 $0.00 $4,100.00 $193,010.00 $410.00 HORNING ROOFING & SHEET METAL CO, LLC AFFIDAVIT AND WAIVER OF LIEN INVOICE # 1 STATE: INDIANA FINAL PARTIAL X PAYMENT TO FOLLOW COUNTY OF: MARION _RON PHELPS II Being duly sworn that he is the President of_Horning Roofing&Sheet Metal Company, LLC contract with _Hagerman 0 to furnish certain materials and/or labor as follows: As Per Contract for a project known as as: Village on the Green Parcel 7-C-1 Theater Building located in: Carmel, IN and owned by_Carmel Theater Development Corporation, LLC and does hereby further state on behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) That there is due from the contractor the sum of: DOLLARS: $ 3,690.00 _ receipt of which is hereby acknowledged or X the payment of which has been promised as the sole consideration of the affidavit and Partial Waiver of Lien which is given solely with respect to said amount and which waiver shall be effective only upon receipt of payment thereof by the undersigned. (FINAL WAIVER) That there is due from the contractor the sum of: DOLLARS: receipt of which is hereby acknowledged or the payment of which has been promised as the sole consideration of the affidavit and Final Waiver of Lien which is shall become effective upon receipt of such payment. 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, in any, and further certified that no other party has any claim or right to lien on account of any work performed or material furnis ed to undersigned for said project and within the scope of this affidavit and wavier. _Horning Roofing&Sheet Metal Co.,LLC_By: 4/7 l / President i in Phelps II WITNESS MY HAND AND NOTARIAL SEAL THIS: 11/30/10 MY COMMISSION EXPIRES: 02-02-11 COUNTY OF RESIDENCE: Morgan 1V NOTARY Kevin L. Moore PRIME CONTRACTOR'S UNCONDITIONAL PROGRESSIVE WAIVER OF LIEN ' ate 40cr Being duly sworn upon his/her oath disposes and says that: 1. He/she is -Pr--P`j/C (inserting sole proprietor, partner or corporate office held, as the case maybe), of go A ' _ , hereafter called the "Prime Contractor". He/she is over the age of twenty-one.He/she is .fthorized to ma•'e this affidavit on behalf of Prime Contractor. 2. Prime Contractor is the /- hr)6S--.. Prime Contractor for the construction of the Village on the Green - Parcel 7C1 - Theater Building development, located 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. Prime Contractor hereby waives and releases any and all liens and rights to claim a lien to which Prime Contractor is or may be entitled for services, labor, and/or materials furnished for the Development for wnrlr covered by and ;217.1the date of the Prime Contractor's Application and Certification for Payment number a / dated/l-c. 4. There are no bills, charges, costs or expenses for services, labor, and/or material which could now or hereafter result in lien being filed, or a right to claim a lien, against the Development or a claim being asserted against the Owner for this work. 5. Prime Contractor has been paid in full, exclusive of retainage, for all services, labor, and materials furnished to, provided for, or used in connection with, the Development through the period noted above and acknowledges the receipt of , O 4p date. IN WITNESS WHERE 99F,affiant has signed this d.. � ent on behalf of the Prime Contractor this 7"3 day of /l�vf�/YlLt��` o �. (Author' d Representative of Prime Contractor, Title) County of WA, ',PI State of a i • c.. Subscribed and sworn to before me,a Notary Public in and for said County a and State,This ,-,23 Day of /1, .. 96,4e7 ,20 (Notary Public) KbuJAJ .1)00 QF My Commission Expires: 2- -.:20//(Printed Name) NOTARY SEAL MUST APPEAR ON THIS FORM.