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HomeMy WebLinkAboutHAGERMAN CONSTRUCTION CORP- 001429- 12/2/2010 t v CARMEL REDEVELOPMENT COMMISSION 001429 Hagerman Construction Corp Check: 1429 10315 Allisonville Road Date: 12/2/2010 Fishers, IN 46038-2016 Vendor: HAGEERM1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 20 59 15,480.00 15,480.00 0.00 0.00 15,480.00 Application 20 15,480.00 15,480.00 0.00 0.00 15,480.00 AMMIMIERTMEMITHISTCNECKliASTATCOILORED;BACKGROUNDTANDICONTAINSIMMTIRCEMECURITYAEATURESIIISEMACKtE,ORMETAIIISIEMINEMEMES ,1 sic, Carmel Redevelopment Commission 0 014 2 9 130 West Main Street xA REGIONS Suite 220. 20-1421/740 CARMEL 4.,STRIC1 Carmel, IN 46032 1429 DATE AMOUNT 12/2/2010 ************15,480.00 PAY THE SUM OF FIFTEEN THOUSAND FOUR HUNDRED EIGHTY DOLLARS TO THE ORDER OF Hagerman Construction Corp 10315 Allisonville Road ,z,EE"S'T� „ Fishers,IN 46038-2016 m.A � 11°00142911° 1:0740L42L31: 008 ? SOLI LLLi” CARMEL REDEVELOPMENT COMMISSION 001429 Hagerman Construction Corp Check: 1429 10315 Allisonville Road Date: 12/2/2010 Fishers, IN 46038-2016 Vendor: HAGEERM1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 20 . 59 15,480.00 15,480.00 0.00 0.00 15,480.0C Application 20 15,480.00 15,480.00 0.00 0.00 15,480.00 •AIA TM Document G702ICMa - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition s-9 TO OWNER: p1#OJECT: Regional Performing APPLICATION NO: APP#:00020 Distribution.to: CARMEL REDEVELOPMENT COM � Carmel Re Tonal Performin Art 211 City Center Drive Carmel. IN 46032 PERIOD TO: 10/31/2010 OWNER ❑X CONSTRUCTION MANAGER ❑X FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: CONTRACT DATE: 1/30/2008 ARCHITECT ❑X Hagerman Construction Corp Dave Brewer P.O. Box 10690 Shiel Sexton PROJECT NOS: 08-2619-1/ I CONTRACTOR ❑ Fort Wayne, IN 46853-0690 VIA ARCHITECT: Brandon Rogan INVOICE NO: 9996 FIELD ❑ CSO Architects Inc CONTRACT FOR: Masonry ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and Application is made for payment,as shown below, in connection with the Contract. belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1.ORIGINAL CONTRACT SUM $ 6.126.000.00 payment shown herein is now due. 2. Net change by Change Orders $ 934.223.15 CONTRACT)"• Hagerman Construction Corp ,yi lilifi1IPI/ 7,060,223.15 // O W. 3.CONTRACT SUM TO DATE(Line I ±2) $ By: O Date: 0 ss,i •r r,;0 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 7,054,223.15 State of: Indiana Theresa.,Lann qg, Treasurer ,0 •v 5.RETAINAGE: County of: Allen °"4"-�'rv$+ 1f'v�' %'(f). a. 5.00%of Completed Work Subscribed and sworn to before w d � * o o M V. •(Column D+E on G703) $ 353,01 1.16 me this 27th day of Oct O 2010 b. %of Stored Material Notary Public: David C.Tho %'),% NOTfIdYScAL � `* (Column F on G703) $ My Commission expires: '1,,90,Y/1 �wACZ'd9.(, '` ( ) Y P 12 16 2015 .{ a `,:.tki y,0 oA .. Total Retainage(Lines 5a+Sb or Total in Column I of G703).. $ 353,011.16 1.16 CERTIFICATE FOR PAYMENT 'Ile.S•«‘ „ In accordance with the Contract Documents, based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE $ 6,701,21 1.99 this application,the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 6,685,731.99 accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT (Line 6 from prior Certificate) CERTIFIED. 8.CURRENT PAYMENT DUE $ 15,480.0 AMOUNT CERTIFIED $ 15,480.00 9.BALANCE TO FINISH,INCLUDING RETAINAGE (Attach explanation if amount certified differs - ,the amount applied. Initial all figures on this Application and o he Continuation Sheet tl t ar changed to conform with the amount certified.) (Line 3 less Line 6) $ 359,011.16 CONS -UCTI• / er R: Dave"ewer- S 'el Sexton BY: �::. i:.I Ar a,. ∎/ • Date: i0 �� s'0• CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC CT: ' i .., CSO Architects Inc Total changes approved in previous months by Owner $ 939,223.1 -5,000.00 By: i' " - Date: 1 er[VI \14,9( Total approved this Month $ $ This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 939,223.l -5,000.00 named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 934,223.15 the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702/CMaTM—1992.Copyright ©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 prosecuted to the maximum extent possible under the law. ,.. Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. 471. ' =A IA Document G702/CMaTM - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in AIA Document A201/CMa,General Conditions of the Contract for Construction,Construction Manager-Adviser Edition,1992 Edition. B.Reproductions This document is a copyrighted work and may not be reproduced or excerpted from without the express written permission of the AIA.There is no implied permission to reproduce this document,nor does membership in The American Institute of Architects confer any further rights to reproduce this document. The AIA hereby grants the purchaser a limited license to reproduce a maximum of ten copies of a completed G702/CMa,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license for reproduction granted above,except upon written request and receipt of written permission from the AIA. Rights to reproduce the document may vary for users of AIA software.Licensed AIA software users should consult the End User License Agreement(EULA). To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. C.Completing the G702/CMa Form After the Contractor has completed AIA Document G703,Continuation Sheet,summary information should be transferred to AIA Document G702/CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. The Contractor should sign G702/CMa,have it notarized and submit it,together with G703,to the Construction Manager and Architect. The Construction Manager and Architect should review G702/CMa and G703 and,if they are acceptable,complete the Certificate for Payment on G702/CMa.The Construction Manager and Architect may certify a different amount than that applied for pursuant to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G702/CMa and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702/CMa and G703 should be forwarded to the Owner. D.Completing the G703 Form Heading:This information should be completed to be consistent with similar information on AIA Document G702/CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition. Columns A,B&C:These columns should be completed by identifying the various portions of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the commencement of the Project or as subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Project.Multiple pages should be used when required. Column C should be subtotaled at the bottom when more than one page is used and totaled on the last page.Initially,this total should equal"the original Contract Sum. The total of column C may be adjusted by Change Orders during the Project. Column D:Enter in this column the amount of completed work covered by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from the previous application should not be entered in this column. Column E:Enter here the value of Work completed at the time of this application,including the value of materials incorporated into the project which were listed on the previous application under Materials Presently Stored(column F). Column F:Enter here the value of Materials Presently Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stored for which payment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materials does not result in a deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into column E(Work Completed-This Period). Column G:Enter here the total of columns D,E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difference between column C(Scheduled Value)and column G(Total Completed and Stored to Date). Column I:This column is normally used only for contracts where variable retainage is permitted on a line-item basis.It need not be completed on projects where a constant retainage is withheld from the overall contract amount. Change Orders:Although Change Orders could be incorporated by changing the schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own G703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the G702/CMa form. Construction Change Directives:Amounts not in dispute that have been included in Construction Change Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A201/CMa. E.Making Payment • - The Owner should make payment directly to the Contractor based on the amount certified,by the Construction Manager and Architect on AIA Document G702/CMa, Application and Certificate for Payment,Construction Manager-AdviserEdition.The completed form contains the name and address of the Contractor.Payment should • not be made to any other party unless specifically indicated on G702/CMa :: ? : AIA Document G702/CMa TM-1992.Copyright ©1992 by The American Institute of Arbhitects:All rights reserved.WARNING:This AlA® Document is protected by U.S. Copyright Law and International Treaties.Unauthorized reproduction or distribution ofthis 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.Purchasers are permitted to reproduce ten(10)copies of this document when completed. To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. CONTINUATION SHEET AIA DOCUMENT G703 PAGE I oF2 PAGES ALA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 00020 containing Contractor's signed Certification,is attached. APPLICATION DATE: In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 10/31/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: 082619A A B C D E F G H I WORK COMPLETED MATERIALS TOTAL t3ALANCE PRESENTLY COMPLETED REfAINAGE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS V. TO IF VARIABLE) NO. VALUE STORED AND STORED FINISH RATE APPLICATION THIS PERIOD (NOT IN TO DATE (G=C) (C-G) (D+ht _ D OR E) (D+E=r) 00000 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 000000 0000010 GENERAL CONDITION 0000020 Bonding&Insurance $56,000.00 $56,000.00 $0.00 $0.00 $56,000.00 100.000 $0.00 $0.00 0000030 Submittals $10,000.00 S10,000.00 $0.00 $0.00 $10,000.00 100.000 $0.00 $0.00 0000040 Project Meetings $10,000.00 $10,000.00 $0.00 $0.00 $10,000.00 100.000 $0.00 $0.00 0000050 Mobilization $28,000.00 S28,000.00 $0.00 $0.00 $28,000.00 100.000 $0.00 $0.00 10000060 Demobilization $25,000.00 $22,500.00 $2,500.00 $0.00 $25,000.00 100.000 $0.00 $0.00 0000070 Contract Close Out $6,000.00 $3,000.00 $0.00 $0.00 $3,000.00 50.000 $3,000.00 $0.00 0000080 Allowance#4-As-builts $5,000.00 $5,000.00 $0.00 $0.00 $5,000.00 100.000 $0.00 $0.00 0000100 EXTERIOR MASONRY 0000110 CMU North Labor $30,000.00 $30,000.00 $0.00 $0.00 $30,000.00 100.000 $0.00 $0.00 0000120 CMU East Labor $25,000.00 $25,000.00 $0.00 $0.00 $2.5,000.00 100.000 $0.00 $0.00 0000130 CMU South Labor $37,000.00 $37,000.00 $0.00 $0.00 $37,000.00 100.000 $0.00 $0.00 0000140 CMU West Labor $25,000.00 $25,000.00 $0.00 $0.00 $25,000.00 100.000 $0.00 $0.00 0000150 Ctv1U Drum Labor $39,000.00 $39,000.00 $0.00 $0.00 $39,000.00 100.000 $0.00 $0.00 0000160 CMU North Materials $9,000.00 $9,000.00 $0.00 $0.00 $9,000.00 100.000 $0.00 $0.00 0000170 CMU East Materials $7,000.00 $7,000.00 $0.00 $0.00 $7,000.00 100.000 $0.00 $0.00 0000180 CMU South Materials $10,000.00 $10.000.00 $0.00 $0.00 $10,000.00 100.000 $0.00 $0.00 0000190 CMU West Materials $7,000.00 $7,000.00 $0.00 $0.00 $7,000.00 100.000 $0.00 $0.00 0000200 CMU Drum Materials $12,000.00 $12,000.00 $0.00 $0.00 $12,000.00 100.000 $0.00 $0.00 0000210 Vapor Barrier Labor $162,000.00 $162,000.00 $0.00 $0.00 $162,000.00 100.000 $0.00 $0.00 0000220 Vapor Barrier Materials $98,000.00 $98,000.00 $0.00 $0.00 $98,000.00 100.000 $0.00 $0.00 t 0000240 EXTERIOR VENEER 0000250 Granite Labor $205,000.00 $205,000.00 $0.00 $0.00 $205,000.00 100.000 $0.00 $0.00 0000260 Granite Materials $504,000.00 $504,000.00 $0.00 $0.00 $504,000.00 100.000 $0.00 $0.00 0000270 1 Limestone North Labor $878,000.00 $878,000.00 $0.00 $0.00 $878,000.00 100.000 $0.00 $0.00 0000280 Limestone North Materials $126,000.00 S126,000.00 $0.00 $0.00 $126,000.00 100.000 $0.00 $0.00 0000290 Limestone East Labor $734,000.00 $734,000.00 $0.00 $0.00 $734,000.00 100.000 $0.00 $0.00 0000300 Limestone East Materials $107,000.00 $107,000.00 $0.00 $0.00 $107,000.00 100.000 $0.00 $0.00 0000310 Limestone South Labor $890,000.00 $881,100.00 $8,900.00 $0.00 $890,000.00 100.000 $0.00 $0.00 0000320 Limestone South Materials $132,000.00 $130,680.00 $1,320.00 $0.00 $132,000.00 100.000 $0.00 $0.00, AlA DOCUMENT G7D30 APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • MAT)• ©1992 • THE AMERICAN INST1THTE OF ARCHITECTS,1735 NEW YORK 6703-1992 _ AVENUE,N.W.,WASHINGTON,D.C. 200(x_5292 • WARNING: Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution, 'This document has been reproduced 0.oclronicatty with the perm:sslon of i he American Institute of Arr;nlocts under License 97003 to Primavera Systems,Inc.Repleductiion of thr,document without proja;l specific infut mutton is not permitted.Contecl The American institute of Architects to verify the comsat version of lets document end license statcS" CONTINUATION SHEET AIA DOCUMENT G703 PAGE2OF2PAGES AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 00020 containing Contractor's signed Certification,is attached. APPLICATION DATE: In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 10/31/2010 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: 0826(9A A H C D E P G H 1 1 WORK COMPLETED MATERIALS TOTAL BALANCE PRESENTLY COMPLET'LD RETAINACE ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS % TO IF VARIABLE) NO. VALUE STORED AND STORED 'FINISH APPLICATION THIS PERIOD (NO] IN TO DATE (GC) RATE 1 (0+F) 0 OR E) (D+E±F) (C G) 0000330 Limestone West Labor $734,000.00 $734,000.00 S0.00 $0.00 $734,000.00 100.000 $0.00 $0.00 0000340 Limestone West Materials $107,000.00 $107,000.00 $0.00 $0.00 $107,000.00 100.000 $0.00 $0.00 0000350 Cast Stone Drum Labor $249,000.00 $2.49,000.00 $0.00 $0.00 $249,000.00 100.000 $0.00 $0.00 0000360 Cast Stone Drum Materials $330,000.00 $330,000.00 $0.00 $0.00 $330,000.00 100.000 $0.00 $0.00 0000370 Cleaning&Caulking Labor $288,000.00 $282,240.00 $2,760.00 $0.00 $285,000.00 98.958 $3,000.00 $0.00 0000380 Cleaning&Caulking Materials $241,000.00 $241,000.00 $0.00 $0.00 $241,000.00 100.000 $0.00 $0.00 0000400 CHANGE ORDERS 0000410 CO#1 -Limestone Field Stone 0000420 Limestone Field Labor $480,000.00 $480,000.00 $0.00 $0.00 $480,000.00 100.000 $0.00 $0.00 0000430 Limestone Field Material $250,000.00 $250,000.00 $0.00 $0.00 $250,000.00 100.000 $0.00 $0.00 0000450 CO#2-Drum Veneer 0000460 Drum Veneer Labor $110,000.00 $110,000.00 $0.00 $0.00 $110,000.00 100.000 $0.00 $0.00 0000470 Drum Veneer Materials $90,000.00 $90,000.00 $0.00 $0.00 $90,000.00 100.000 $0.00 $0.00 0000490 CO#3-PAC 0251 -Granite Jointing 0000500 Granite Labor $492.14 $492.14 $0.00 $0.00 $492.14 100.000 $0.00 $0.00 0000510 Granite Material $7,150.00 $7,150.00 $0.00 $0.00 $7,150.00 100.000 $0.00 $0,00 0000530 CO#4-Granite Door Jamb 0000540 Granite Labor $41.01 $41.01 $0.00 $0.00 $41.01 100.000 $0.00 $0.00 0000550 Granite Material $1,540.00 $1,540.00 $0.00 $0.00 $1,540.00 100.000 $0.00 $0.00 0000570 CO#6-Delete Allowance 3110A 0000580 As-Built/CAD ($5,000.00) ($5,000.00) $0.00 $0.00 ($5,000.00) 100.0001 $0.00 $0.00 $7,060,223.15 $7,038,743.15 $15,480.00 $0.00 $7,054,223.15 99.92% $6,000.00 $0.00 AIA DOCUMENT G703•APPLICATION AND CERTIFICATE FOR PAYMENT • 1992 EDITION • AIA • (01992 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK G703-1992 AVENUE,N.W.,WASIIINV rON,D.C. 20006-5292 • WARNING: Unlicensed photocopying violates U.S.copyright laws and will subject the violator to legal prosecution. "TMs document has beer reproduced electronically with the permission of 7 he American tnntilote of Architects under License 97003 to Primavera Systems,!tic.Reproduction of Iris document without Pclecfaoecitic Information is not permitted.Contact The American Institute of Architects to verify the Current vetalon of tale document and iicense status' t. ' PAYROLL CER'1'1rICATION • PROJECT NO. HCC Job #2619 ' #2695 I CERTIFY THAT THE PAYROLL RECORDS FOR . Hagerman Construction Corporation (Contractor) PAY PERIOD FROM i_ TO /D aL` E`.TRUE AND CORRECT, TO THE BEST OF MY KNOWLEDGE AND BELIFF AND THE WAGE SCALE AS REQUIRED BY I.C. 5-16-7-1 HAS BEEN ADHERED TO. STATE OF Indiana ) ) SS: COUNTY OF Allen ) BEFORE ME, THE UNDERSIGNED, A NOTARY PUBLIC, PERSONALLY APPEARED ti 614 ARt '.5_ ,.__ wTcZiue.S r� )- , WHO. .. (Name) (Title) ACKNOWLEDGED EXECUIION OF THE ABOVE CERTIFICA'1ION THIS oZ72Y OF , c.Qo1fl. / ".re . `ooN......O`,, - ....4/, 1 0 ,--!—tea A/. o.•�pVMISS/p ..?' _ 1* ite°er 49 S.%(cn . NOTARY PUBLIC (Signature) : ' em n'�. 54%-C"IiSek°& ft4T'{ •� navid r Thom '-'1 -7-4T,, . ,..1��' :- \ NAME (Printed) MY COMMISSION EXPIRES: RESIDING IN Allen COUNTY 12/16/15- REV 2/98 • S.OBC-7 WAIVER OF LIEN The undersigned is the duly authorized officer of Hagerman Crnst-n,c't-ion Corporatism ,the general contractor,.. (Name of Company) subcontractor;materialman or other person furnishing the services, labor, material or equipment indicated below in the construction of improvements upon real estate located in Hamilton County, State of Indiana , commonly known as Cpl Regicnal Perfc ruing Arts ,which real estate is owned bye of c srTml Re zais m=xii- ("Owner"). center M3scrny Oinmssicn INCONSIDERATIONofthesumaf Six million seval ene th arrl to mar la, nerd 9a/lcD DOLLARS($ 6,701,211.99 ),receipt of which is hereby acknowledged, and in order to procure one or more payments for services, labor,material or equipment provided in such construction,the Company does hereby waive, release and quit claim in favor of the Owner of the real estate and the lender or lenders providing funds with which payment of construction costs is or is to be made,and their assigns,all liens or claim or right to liens upon the land or improvements above described, which the Company may now have for services,labor,material or equipment furnished in respect of such land or improvements to and including the date hereof. The undersigned warrants that the Company has not and will not assign any claim for payment nor any right to perfect a lien against the real estate, and that he has the right to execute this waiver and release of liens on behalf of himself(herself) and the Company. The undersigned further warrants and represents that the Company has the right to transfer and does hereby transfer title to the services, labor, material or equipment to the Owners or lenders named above in consideration of the payment received hereunder. The undersigned further states that the consideration received hereunder is the sole-consideration received by the Company for said services,labor,material or equipment furnished to date,and that the Company has neither received nor made any security interest,title retention interest or lien rights in the said services,labor,material or equipment other than that released and transferred hereby. The material, labor,services or equipment furnished are more particularly described in the affidavit for payment submitted of even date herewith. The undersigned further warrants and represents that the Company has complied with all prevailing wage requirements under applicable law or as may be set forth in the contract documents. WITNESS the execution hereof this 27th day of October , 2010 . . Title Theresa Lanning Treasurer Hagerman Construction Corporation (Name of Company) State of Indiana , County of Allen , SS: Before me, the undersigned, a Notary Public in and for said County and State, personally appeared Theresa Lanninq the treasurer , of Harman CnnSt-nintion rorporation , who acknowledged (Title) (Name of Company) the execution of the foregoing Waiver of Lien on behalf of such Company and that the same is the free act and deed of such Company and the free act and deed of said officer. WITNESS my hand and notarial seal this 27th day of October 2010 DAI �i' �� My Commission Expires: Y'`NtiiO ,� 12/16/15 fie® e,, Notary Notary Public O "''�� A d • - c • My County of Residence: • c'.%.. "41.. �•• 9 David C. Thomas 9f4.."t ,�` a.�° (Printed Name of Notary Public) Allen