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HomeMy WebLinkAboutLAFEVER ELECTRIC, INC.- 001486- 12/17/2010 CARMEL REDEVELOPMENT COMMISSION 001486 La Fever Electric, Inc. Check: 1486 131 N Range line Road Date: 12/17/2010 Carmel, IN 46032 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid See Transmittal Sheet for check detail. 46,097.83 46,097.83 aoo 0.00 46,097.83 WV5Villif6MailliaTHISICHECIVHAVATCOILOREDIBACKGROUNDTANDICONTAINSWUliTIRIlE1SECURITNEEATURESSISEEMACIVEORiDETAILMUIStal Carmel Redevelopment Commission 001486 4. 30 West Main Street art :12 Suite 220 ' A REGIONS 20-1421/740 AZA,c-c Carmel, IN 46032 1486 DATE AMOUNT 12/17/2010 ************46,097.83 PAY THE SUM OF FORTY SIX THOUSAND NINETY SEVEN DOLLARS AND 83 CENTS TO THE ORDER OF LaFever Electric, Inc. 131 N Rangeline Road i,sENs„. Carmel, IN 46032 . , .. 7444WA TO/ -------- - - --- ------------------ ------ ----------------- 11°0 0 L L,a lie 1:0740 Lli 2 L 31: 0013 7 504 L L Lio CARMEL REDEVELOPMENT COMMISSION 001486 LaFever Electric, Inc. Check: 1486 131 N Rangeline Road Date: 12/17/2010 Carmel, IN 46032 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid See Transmittal Sheet for check detail. 46,097.83 46,097.83 _ 0.00 0.00 46,097.83 Transmittal Sheet Page 1 Carmel Redevelopment Comm LaFever Electric, Inc. Check: 1486 131 N Rangeline Road Date: 12/17/2010 Carmel, IN 46032 Vendor: LAFEVER1 Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 2 17,100.00 17,100.00 0.00 0.00 17,100.00 work thru 10/25/2010 P47 2 2 19,277.73 19,277.73 0.00 0.00 19,277.73 P47 alternate 3-3 6,214.90 6,214.90 0.00 0.00 6,214.90 Parcel 47 Service app3 3-4 3,505.20 3,505.20 0.00 0.00 3,505.20 Parcel 47 alternate 46,097.83 46,097.83 0.00 0.00 46,097.83 .4, . _ . ...TitA :,...„....... IA MIME Document G702TM - 1992 Application and Certificate for Payment•TO OWNER: Carmel Redevelopment Comm. PROJECT: Parcel 47 Alternate APPLICATION NO: 2 Distribution to: , '30 West Main Street,#220 1st Street NW PERIOD TO: 10/25/2010 OWNER ❑ Carmel, Indiana 46032 Carmel, Indiana 46032 CONTRACT FOR: ARCHITECT ❑ FROM CONTRACTOR;ever Electric, Inc. VIA ARCHITECC8O CONTRACT DATE: CONTRACTOR ❑ 131 N. Rangeline Road 280 East 96th Street, Suite 100 PROJECT NOS: 1140 / FIELD ❑ Carmel, Indiana 46032 Indianapolis, Indiana 46240 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet,AIA Document G703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 35,052.00 that current payment shown herein is now due. 2.Net change by Change Orders $ 0.00 CONT TO Le ectric, Inc. 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 35,052.00 By: ` � �, v El. Date: 10/25/2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 35,052.00 State of: Indiana Michael A. LaFever,Vice-President 5.RETAINAGE: County of: HamiltO,,�\�s `Y',rrr�r�o,,i,,��� a. 10 %of Completed Work Subscribed and sworn t $ie e:.•••••• e� '�, (Column D+Eon G703) $ 3,505.20 me this 25th day* C O per 10 , b. 10 %of Stored Material .• Colleen S. Marvel (Column F on G703) $ 0.00 , 'Notary Pu lie:: , � � E 2018•3,505.20 My Commis.'t 1 - i e • , Total Retainage(Lines 5a+5b or Total in Column I of G703) $ ,. 6.TOTAL EARNED LESS RETAINAGE $ 31,546.80 ARCHITECT'S ay} Bl .OR PAYMENT p g (Line 4 Less Line 5 Total) In accordance with the Con ieloi t1`�s,based on on-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 12,269.07 this application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE $ 19,277.73 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ Qb) Z'11.13 (Line 3 less Line 6) $ 3,505.20 (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application at t the Cot 'nuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC Total changes approved in previous months by Owner $ 0 $ 0 By: Date: t0 'r.S lD Total approved this Month $ 0 $ 0 / This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor • TOTALS $ 0 $ 0 named herein:Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 0 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 G702TM—1992.Copyright ©1953,1963,1965,1971,1978, 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 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. \' Director of Redevelopment/y��eg" } * ATA® TM Document G702 - 1992 Instructions Application and Certificate for Payment GENERAL-INFORMATION Purpose and:Related Documents AIA Document 6702,Application and Certificate for Payment, is to be used in conjunction with AIA Document G703,Continuation Sheet.These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201, General Conditions of the Contract for Construction. Use of Current Documents Prior to using:any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. 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, 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 reportcopyright violations of AIA Contract Documents, e-mail The American Institute of Architects'legal: counsel,copyright @aia.org.• . COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703,Continuation Sheet, summary information should be transferred to AIA Document G702,Applicatiori-and Certificate for Payment. The Contractor should sign G702,have it notarized, and submit it, together with G703,to the Architect. - The Architect should review G702 and G703 and, if they are acceptable,complete the Architect's Certificate for Payment on G702. The Architect may certify a different amount than that applied for,pursuant to Sections 9.5 and 9.6 of A201.The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA DocumeneG702, Application and Certificate for Payment.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. EXECUTION OF THE DOCUMENT • Persons executing the document should indicate the capacity in which they are acting(i.e.,president, secretary, partner,etc.)and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm,or entity should be attached. • AIA Document G702TM—1992.Copyright©1953,1963,1965,:1971, 1978,1983-and 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 Ale 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. JOB NAME Parcel 47 Alternate APPLICATION DATE 10/25/2010 PAGE NUMBER 1 APPLICATION NUMBER 2 PERIOD TO 10/25/2010 A B C D I E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 1 Conduit M 1,000.00 350.00 650.00 - 1,000.00 100 - 100.00 - - L 3,200.00 1,120.00 2,080.00 3,200.00 100 - 320.00 2 Directional Bore @ Main&2nd Ave 8,350.00 - 8,350.00 8,350.00 100 - 835.00 3 Directional Bore @ Main& 1st Ave 10,705.00 - 10,705.00 10,705.00 100 - 1,070.50 4 Directional Bore @ 1st St& 1st Ave 8,550.00 8,550.00 - 8,550.00 100 - 855.00 5 Payment and Performance Bond 400.00 400.00 - 400.00 100 - 40.00 4 Change Order#1 2,847.00 2,562.30 284.70 2,847.00 100 - 284.70 - - L - - - - - - - M - - - - - - - - L - - - - - - - - M - - - - - - - - - L - - - - - - - M - - - - - - - - L - - - - - - - M - - - - - - - - L - - - - - - - M - - - - - - - - - L - - - - - - - - M - - - - - - L - - - - - - - - M - - - - - - - L - - - - - - - M - - - - - - - - - L - - - - I _ 35,052.00 12,982.30 22,069.70 - 35,052.00 - 3,505.20 WAIVER OP LIEN TO DATE State Of Indiana ss . County of Hamilton I File#_ TO WHOM IT MA.Y CONCERN: WHEREAS dm undersigned has bets employed by LaFever Electric,Inc. Raxrf�..t�ff7Mrr451/•Ot•r11ar.• A to lhtntsh Elgclrical Work for the premises described es Parcel 47 Alternate Maw UawJFerbete lItW kcal of which Carmel Redevelo s ment Commission Ia the own I\Encteen Thousan Two Hundred Seventy-seven Dollars and Seventy-three Cents - une arced.for o m colekensttan of (S 19.2 77.73 )Dollars,and other good and vatuabie consideration,the receipt whereof is her ivy a;knowledged,doles)hereby waive and releese any and all lien or claim or right of Ben under the Settocs of the State wherein the laud is located,relating to I dacha:d 's mfl5,on the above described premises and Improvements thereon,sod on the rnaues or althea considerations clue or to become due from the owner,on acorn cot of labor or services,material,fixtures or modem heatothre tlmrtr led to chic data by the uederaigned for the Aerie described p utnfeee. signed Ibis 25th day October zo 10 _ . a �(f �`v, Michael A. LaFever, Vice-President _....._. see NOTE:Ali waivers meet be iyr the fort amount paid.If waiver is for a corporation,oarporate name shorild be teed,corporate seal affixed and flits ofoff car slating waiver should be set(only If waiver Is for a partnerthip,the partnership name should be cored.partner should atpn and designate Mursdf err Darns•. CONTRACTOR•S AFFiOAVif State of Indiana )ss County of Hamilton TO WHOM IT MAY CONCERN: TIM undersigned.being duly sworn,,deposes and says that he Is Vice-President of LaFever Electric,Inc. _ who Is the contractor for Hoe Electrical Work : work on the building located at Tsftreet NW,Carmel,Indiana 46032 owned by acme 'e•eve o•ment omm-mssion That he total amount of the contract htdeding extras is$ 35,052.00 on I uhiah he has rnoolved payment of g 0.00 _ prior to this payment.Tbnt all waivers are hue correct and Aemtine and defile rod unconditionally and that there is to claim either legal or equitable to de€eat the validity of said waivers.That the following are the names of ail parties who have ttrrnisbcd menial or lobar,or both,thr said work and all parties having contracts or subaorurama fir spedflo portions of said worts or for material a alart:rg into fie cortrt ruction tact eotand din mourn One or a become due to each,and that the,trans mattteead included all labor and material ed m , said work aocotdatg to less and Nang , 4, PTO OP W0 "" > `-•Y Bt itif f iJ:ri • . arm :orenro ( /) 1• - *tree ions :oruii 27,60_.11 0 11 �1� IIII - rru tea I'MAT/tietro T4In€ t%y •1 11 tIT1Tf1• net deco we no other coot/acts fur said work outstanding,trod alert there i•nothing doe or to became due to any panto r •• material,labor or other work, any kind done o e to be done upon or in cormeation with said work other than shove stated. Signed this 25th day of October ,2n 10 �„_"•,,, �lyl�"^ wY 4t jit, el A. LaFever ice- esidt .. .. era• , Si ua lbed and sworn to bcfvre toe thla 25th day of October °2 10 else �S. • a e TS{CD1606I07f2007 ' , -r I ftrittltli ititll"' y'• Document G7O2TM 1992 Application and Certificate for Payment TO OWNER: Carmel Redevelopment Comm. PROJECT: Parcel 47 Service APPLICATION NO: • 2 Distribution to: 30 West Main Street, #220 1st Street NW PERIOD TO: 10/25/2010 OWNER ❑ Carmel, Indiana 46032 Carmel, Indiana 46032 CONTRACT FOR: ARCHITECT ❑ FROM CONTRACTOR.:. VIA Electric, Inc. VIA ARCHITEC�SO CONTRACT DATE: CONTRACTOR 131 N. Rangeline Road 280 East 96th Street, Suite 100 PROJECT NOS: 1740 / FIELD ❑ Carmel, Indiana 46032 Indianapolis, Indiana 46240 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet,AIA Document G703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 63,149.00 that current payment shown herein is now due. 2.Net change by Change Orders $ (1,000.00) CONTRACTOR" 77...Electric, Inc.3.CONTRACT SUM TO DATE(Line I +2) $ 62,149.00 By: !/1UIts a , Date: 10/25/2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 62,149.00 State of: Indiana • Michael A. LaMeiri Vice-President 00 Hamilton 5.RETAINAGE: County of: o P \'( Ptj6 a. 10 %of Completed Work Subscribed and sworn to before • .,.• (Column D+Eon G703) $ 6,214.90 me this 25th .;.. if October,..?.-4,.• `•.C) b. 10 %of Stored Material •S --'--—tplIeen S. Marvel (Column F on G703) $ 0.00 Notary Public: • Apr s' y.�1 , ., • 'i-7 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 6,214.90 My Commissio -.I' -s: y 6.TOTAL EARNED LESS RETAINAGE $ 55,934.10 ARCHITECT'S CERTIFICATE FO ��r 1 i., (Line 4 Less Line 5 Total) In accordance with the Contract Documents,based on'dis/N f�lB'6'tservations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 38,834.10 this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE $ 17,100.00 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ 111 WO_00 (Line 3 less Line 6) $ 6,214.90 (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Applicat• h a d on the ntinuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARC ECT Total changes approved in previous months by Owner $ 0 $ 0 By: Date: 1Ol Zg`j0 Total approved this Month $ 0 $ 1000.00 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0 $ 1000.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ -1000.00 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. It AIA Document G702TM—1992.Copyright ©1953,1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA® Document is protected by U.S.Copyright Law 4 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 Americ n Institute of Architects'legal counsel,copyright @aia.org. Director of Redevelopment J /6O 5 y C VI/4 w.r.vverz A Document G702"- 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose and:Related Documents AIA Document'G702, Application and Certificate for Payment,is to be used in conjunction with AIA Document G703, Continuation Sheet. These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A20I, General Conditions of the Contract for Construction. .4 • Use of Current Documents Prior to using any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. 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, 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. COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703,Continuation Sheet, summary information should be transferred to AIA Document G702,Application and Certificate for Payment. The Contractor should sign G702,have it notarized; and submit it, together with G703,to the Architect. The Architect should review G702 and G703 and, if they are acceptable, complete the Architect's Certificate for Payment on G702. The Architect may certify a different amount than that applied for,pursuant to Sections 9.5 and 9.6 of A201.The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702~and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702, Application and Certificate for Payment. 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. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting(i.e.,president, secretary. partner,etc.)and the authority under which they are executing the document. Where appropriate,a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. • AIA Document G7O2TM—1992.Copyright©1953,1963, 1965,1971,1978,1983 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 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. JOB NAME Parcel 47 Service APPLICATION DATE 10/25/2010 PAGE NUMBER 1 APPLICATION NUMBER 2 PERIOD TO 10/25/2010 A B C D I E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 1 Conduit M 4,000.00 4,000.00 - - 4,000.00 100 - 400.00 - - L 10,340.00 10,340.00 - 10,340.00 100 - 1,034.00 2 Wire M 14,800.00 - 14,800.00 - 14,800.00 100 - 1,480.00 - L 4,600.00 - 4,600.00 4,600.00 100 - 460.00 3 Termination Cabinet M 4,200.00 - 4,200.00 - 4,200.00 100 - 420.00 - - L 600.00 - 600.00 600.00 100 - 60.00 4 Excavation 15,000.00 15,000.00 - 15,000.00 100 - 1,500.00 5 Payment and Performance Bond 600.00 600.00 - 600.00 100 - 60.00 6 Allowance 5,000.00 5,000.00 - 5,000.00 100 - 500.00 7 Change Order#1 4,009.00 4,009.00 - 4,009.00 100 - 400.90 8 Change Order#2 (1,000.00) - (1,000.00) (1,000.00) 100 - (100.00) - - L - - M - - - - - - - - L - - - - M - - - - - - - - - L - M - - - - - - L - - - M - - - - - - - - - L - - - - - - M - - - - - - - L - - M - - - L - - 62,149.00 38,949.00, 23,200.00 - 62,149.00 - 6,214.90 WAIVER OF LIEN TO DATE State of Indiana C ss ounty of Hamilton i Pile#: • TO WHOM IT MAY C('iCERrci WHEREAS the undersigned has been employed by LaFever Electric,Inc. m.d.9.,asmitur+raanateeer to Amish El c cal Work for the premises described as Parcel 47 Service amnia Ashin,.rtp}tf.aetantansa '••�• of which Carmel Redevelopment Commission Ir the oqMe NOM MOVINtr 'ME undersigned ieadin Seven on fThousand One Hundred Dollars and No Cents (g 17,100.00 )Dollars,and ether good and valuable aonsidaation,the rtoeipt whereof is het Eby acknowledged,dotes)hereby waive and telO$O airy and all lien or claim or right of flea wider the Stamtet pf the State wherein the land is loaded,relating to I&.hordes liens.on the above described premises end improvements thereon,end on the monies or other considerations due or to bean=duo horn the owner.on aoecr an of labor or aerateea,material,frames or elitioretel heretofore flmelrlted to tilt dote by the undersigned for the above desirited peumtee,. signed this 25th divot October ZA 10 714 via 0 Michael A. LaFever, Vice-President Sul "WI All waivers mast be for the fad amount paid.If waiver is for a corporation,corporate none should be used,corporate seal affixed and title of officer sboning waiver should be set fonts:IT waiver is for a whirrs/tip,the partnership none should he need.partner sizoeld Aga and designate htmadf as partner. CONTRACTOR'S AFFIDAVIT State of Indiana )ss County of Hamilton TO WHOM IT MAY CONCERN: Wg andes;gn]_being duly sworn,deposes and says that he Is Vice-President of LaFever Electric,Inc. who is the contractor for the Electrical Work work on the bantling located at treet W, Carmel,Indiana 46032 owned by arme e eve o e meat .ommissron • That the total=Mint of the contract Inotading extras is fi 62.149.00 'shish he hes received payment of g 0.00 prior to this payment.That all lMIAMIs arc our;correct and genuine and delivered unconditionally and that them Is no claim either legal or equitable to defeat the validity of said waivers.That the following are the names of all parties who have Vanished material or tabor,or both,for said work and all patties having contracts or saboo'rents 1br specific portions afsaid work or for material Mmtng Into me natal ruction manor and the renotmt ens yr w become due to each,and that the items toenti`oned inelnded all labor and material reed to cm Said work aecotdafa to 1Iana and atlons; �. roc f Y. muss � , ,� nctunopt>r�tet � �i''Ir�yr�ri�_-- Mahurm :orepro :. - !tree Iona :orutg 15,01 1.11 1 NOMO.Klie ill TOTAL-CAMP AND sta1nAL TO Ci a " Efigamaall11111111X1111111111 That ih rc arc eo ahei cpntracrr fur said wodc outstanding,wallet that is nathieg doe or to bosoms a to any petit;.$1 material,tabor or other wo*o any kind done or to be done upon or in cennetttlon with said work other then above stated, n Sited this 25th dq,of October —2n 10 ,o�` ►nY i P.0 1''<: . LaF `ce-Presi Subscribed and sworn to bcfpre me this 25th day or :1 tit TSI CD16 06/07noo7 4 'tea .. �s ,�� .... ® _ Rit-A „...,..,._ Document G702TM - 1992 Application and Certificate for Payment TO OWNER: Carmel Redevelopment Comm. PROJECT: Parcel 47 Alternate APPLICATION NO: 3 Distribution to: 30 West Main Street,#220 1st Street NW PERIOD TO: 10/25/2010 OWNER ❑ Carmel, Indiana 46032 Carmel; Indiana 46032 CONTRACT FOR: ARCHITECT ❑ FROM CONTRACTOR: VIA ARCHITECT LaFever Electric, Inc. SG CONTRACT DATE: CONTRACTOR ❑ 131 N. Rangeline Road 280 East 96th Street, Suite 100 PROJECT NOS: 17'40 / FIELD ❑ Carmel, Indiana 46032 Indianapolis, Indiana 46240 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet,AIA Document G703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 35,052.00 that current payment shown herein is now due. 2.Net change by Change Orders $ 0.00 CONTRA TOR / Fe r Electric, Inc. 3.CONTRACT SUM TO DATE(Line I ±2) $ 35,052.00 By: Y Vl `" ( Date: 10/25/2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 35,052.00 State of: Indiana 'Michael A. LaFever,Vice-President 5.RETAINAGE: County of: Hviti ""intro, a. %of Completed Work °� 't �e'� i0 10 P Subscribed ands o� �bcfore. . (Column D+E on G703) $ 0.00 me this 25t -,.. ''of • ' . er, 10 b. 10 •%of Stored Material Colleen S. Marvel (Column F on G703) $ 0.00 .., ... i . Notary Publi,' AlIii x _ ?:, L April 11, 018 My Commiss - - Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 0.00 '.a e__s;__— 6.TOTAL EARNED LESS RETAINAGE $ 35,052.00 ARCH ITE&1'S .¶ ctE� FOR PAYMENT • (Line 4 Less Line 5 Total) In accordance with�'t'�fo, Asuments,based on on-site observations and the data comprising this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 31,546.80 PP � g , (Line 6 from prior Certificate) information 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 8.CURRENT PAYMENT DUE RETAINAGE $ 3,505.20 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ 3t s05 /.,C7 (Line 3 less Line 6) $ 0.00 (Attach explanati amount certified differs from the amount applied. Initial all figures on this Application on he tinua 'on Sheet that are changed to conform with the amount certified.) • CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHIT T: Total changes approved in previous months by Owner $ 0 $ 0 By: , Date: if/500 Total approved this Month $ 0 $ 0 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0 $ 0 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ 0 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 G702TM—1992.Copyright ©1953,1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law Ot and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent �J 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. Director of Redevelopment /4/4/60S 1/ Document G7=02TM- 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose and Related Documents AIA Document G702,Application and Certificate for Payment, is to be used in conjunction with AIA Document G703,Continuation Sheet.. These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. procedures for their use are covered in AIA Document A201, General Conditions of the Contract for Construction Use of Current Documents Prior to usingany AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. 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, 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 violation of AIA Contract Docum ents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org.> COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be transferred to AIA Document G702,Application and Certificate for Payment. The Contractor should sign G702,have it notarized,and submit it, together with G703, to the Architect. _ The Architect should review G702 and G703 and, if they.are acceptable,complete the Architect's.CertifiJ to for Payment on G702. • The Architect may certify a different amount than that applied for,pursuant to Sections 9.5 and 9.6 of A201'.The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation. The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT The Owner should make payment directly to the Contractor based on the amount certified by the Architect on AIA Document G702, Application and Certificate for Payment. 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. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting(i.e.,president, secretary, partner,etc.)and the authority under which they are executing the document. Where appropriate,a copy of the resolution authorizing the individual to act on behalf of the firm.or entity should be attached. G!7 •3 °*. AIA Document G702TM—1992.Copyright©1953,1963,1965;::1971, 1978,1983 and 1992 by The American Institute ofachitects.All rights reserved. WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproguction 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.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. JOB NAME Parcel 47 Alternate APPLICATION DATE 10/25/2010 PAGE NUMBER 1 APPLICATION NUMBER 3 PERIOD TO 10/25/2010 A B C D ' E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 1.00 Conduit M 1,000.00 1,000.00 - - 1,000.00 100 - - - - L 3,200.00 3,200.00 - 3,200.00 100 - - 2.00 Directional Bore @ Main&2nd Ave M 8,350.00 8,350.00 - - 8,350.00 100 - - 3.00 Directional Bore @ Main& 1st Ave L 10,705.00 10,705.00 - 10,705.00 100 - - 4.00 Directional Bore @ 1st St&1st Ave M 8,550.00 8,550.00 - - 8,550.00 100 - - 5.00 Payment and Performance Bond L 400.00 400.00 - 400.00 100 - - 4.00 Change Order#1 M 2,847.00 2,847.00 - - 2,847.00 100 - - - L - - - - M - - - - - - - - - L - - - - - - - - M - - - - - - - - L - - - - - - - - M - - - - - - - - L - - - - - - - - M - - - - - - - - - L - - - - - - - M - - - - - - - L - - - - - - - M - - - - - - - - - L - - - - - - M - - - - - - - - - L - - - - - - - M - - - - - - L - - - - - - I 35,052.00 35,052.00 — 35,052.00 - - WAIVER OP LIEN TO DATE State Of Indiana ss County of Hamilton I Piled_ TO WHOM IT MAY CONCERN: WHEREAS the undersigned has been employed by LaFever Electric,Inc. to furnish Ele„cirical Work for the premises described es Parcel 47 Alternate Mime Ashirm.rIbbru anrrgnr ofwaineeh Carmel Redevelopment Commission is the mine THE undersigned ant T imo fsand Five Hundred Five Dollars and Twenty Cents (S 3,505.20 ?Dollars,and Other good and valuable consideration,die receipt whereof is hot tby acknowledged,dotes)hereby we and rele=any and ell lien or claim or right of lien under the Statutes of the Stan whereto the land is located,relating to I rterdfardc's liens.on the above described premier and improvements thereon,and on the monies or ether considerations due or to become due from the owner,on stow tat of labor or eerricea,mairial,fixtures or annenratua home i imisbed to thk data by the undersigned Car the above daaarlbod pramtaee. Willed obis 25th doy cif October zo 10 VII Michael A. LaFever, Vice-President aant NO F;:All weevers meat be ibr the fart amount paid.If waiver is for a corporation,corporate same should be mud,corporate seal affixed and title of officer signing Waiver should be set fortbt If waiver is for a partnership,the partnership setae should be used.partner should do and designate himself as partner. CONTRACTORS AFFIDAVIt State of Indiana )SS County of Hamilton TO WHOM IT MAY CONCERN: l'Hg undersigned.being duty swam,deposes and says that he Is Vice-President of LaFever Electric,Inc. who Is the contractor Ibr die Electrical Work work on the bang located at st Street NW,Carmel,Indiana 46032 owned by .arose 'e•eve o sment ommission That the tots!amount of the contract metering extras Is E 35,052.00 on r*kb he has remind payment of s 0.00 prior to this payment.That all salvers we true;correct and genuine and drive red=conditionally and that theta Is no alahn either legal or equitable to defiant the validity of said waivers.That the following are the names of all parties who hove finntshcd material or lobar,or bath,for said work and all patties staving contracts or subcontracts Rs specific portions of said work or for material mitring into me cool ruction tntteof and me amount aae arse become due to each,and drat the keens taodioned included all labor and ttistetiai requited to can said work according to lace and a. one; • NAPES , KIND 0P WORK r�f� _, i_ Y • • T:orepro ;• -. ; tree ton. '.°nog .1 '• 1 i 0 1111FSEIMERIIIMUDIOIMI 07.1"-""; ilv.;.7riri11101•1111111•111 Wi •1 11 Illl1111(IIIII11111111111 That twro ate no other contract:fur said wore outstanding,end at there: t nothing due or to become due to any per co t >• material,tabor or other stark any kind done cc to be done upon cs in crameation with said wort other than above stated. Stored this 25th day of October 2n 10 . LA 4 J +++ru+Mn, .el A. LaFev,_Vice-Presi. . Subscribed and sworn to before me this ay October ......... • ''� t 25th d of • - -t a.6-_A `. 151 CD16061 7noo7 - � P%,,AND 4 \x%4. -,�'i�vr- Document G702" - 1992 Application and Certificate for Payment TO OWNER: Carmel Redevelopment Comm. PROJECT: Parcel 47 Service APPLICATION NO: 3 Distribution to: 30 West Main Street, #220 1st Street NW PERIOD.TO::.. 10/25/2010 OWNER ❑ Carmel, Indiana 46032 Carmel, Indiana 46032 CONTRACT FOR: ARCHITECT ❑ FROM CONTRACTOR; VIA ARCHITEC CONTRACT DATE: CONTRACTOR » LaFever Electric, Inc. ISO 131 N. Rangeline Road 280 East 96th Street, Suite 100 PROJECT NOS: 1740 / FIELD ❑ Carmel, Indiana 46032 Indianapolis, Indiana 46240 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance Continuation Sheet,AIA Document G703,is attached. 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 1.ORIGINAL CONTRACT SUM $ 63,149.00 that current payment shown herein is now due. 2.Net change by Change Orders • $ (1,000A0) CONTRALTO/i;D LaFever Electric,anc. 3.CONTRACT SUM TO DATE(Line 1 ±2) $ 62,149.00 By: " 0 Date: 10/25/2010 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 62,149.00 State of: Indiana Michael A. LaFever, Vice-President 5.RETAINAGE: County of: Hamilton `0 10omthhuthrui,,,,„ a. 10 %of Completed Work Subscribed and sworn to bef■i \ V( P..Li . (Column:D+Eon G703) $ 0.00 me this 25t - C.3...s ctober; %of Stored Material \ Colleen S. Marvel (Column F on G703) $ 0.00 Notary Public:. t„..,,,„ il ',I;rIQ11;*6.8 Total Retainage(Lines 5a+5b or Total in Column I of 0703) $ 0.00 My Commis e expires: # r fl�J 6.TOTAL EARNED LESS RETAINAGE $ 62,149.00 ARCHITECT'S CER )F Tt . �' P,R., AYMENT (Line 4 Less Line 5 Total) In accordance with the Contract'ifly) in t 1, ��d on on-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 55,934.10 this application,the Architect certifies t e Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE RETAINAGE $ 6,214.90 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED sir r ILA-Yi0 (Line 3 less Line 6) $ 0.00 (Attach explanation ' amount certified differs from the amount applied. Initial all figures on this Application any on tl Continu . n Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITEC . Total changes approved in previous months by Owner $ 0 $ 1000.00 By: ,...0 -- Date: f(/ 0frI, Total approved this Month $ 0 $ 0 This Certificate is not negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTALS $ 0 $ 1000.00 named herein. Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract NET CHANGES by Change Order $ -1000.00 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 G702TM—1992.Copyright ©1953,1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law pc'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.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. Director of Redevelopment f lz/ 6.6'/Z Document G702 - 1992 Instructions Application and Certificate for Payment GENERAL:INFORMATION Purpose and Related Documents AIA Document G702,'Application and Certificate for Payment, is to be used in conjunction with AIA Document G703,Continuation Sheet. These documents are designed to be used on a Project where a Contractor has a direct Agreement with the Owner. Procedures for their use are covered in AIA Document A201,General Conditions of the Contract for Construction. Use of Current Document Prior to using,any AIA Contract Document, users should consult www.aia.org or a local AIA component to verify the most recent edition. 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, but only for use.in connection with a particular project.The ALA 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 ContractDocuments,e-mail The American Institute of Architects'legal - counsel,copyright @aia.org.• •COMPLETING THE G702 FORM After the Contractor has completed AIA Document G703, Continuation Sheet, summary information should be .transferred to AIA Document G702, Application-and Certificate for Payment. The Contractor should sign G702,have it notarized, and subniit it, together with G703, to the Architect. The Architect should review G702 and G703 and,.if they are acceptable,complete the Architect's Certificate for Payment on G702. • • • The Architect may certify a different amount than that applied for, pursuant to Sections 9.5 and 9.6 of A20 I. The Architect should then initial all figures on G702 and G703 that have been changed to conform to the amount certified and attach an explanation.The completed G702 and G703 should be forwarded to the Owner. MAKING PAYMENT • • The Owner should make payment directly to the Contractor based on the amount certified by the Architect;on AIA Document G702, Application and Certificate for Payment. The completed form contains the name and add4ess of the Contractor. Payment should not be made to any other party unless specifically indicated on G702. EXECUTION OF THE DOCUMENT Persons executing the document should indicate the capacity in which they are acting (i.e., president, secretary, partner,etc.)and the authority under which they are executing the document. Where appropriate, a copy of the resolution authorizing the individual to act on behalf of the firm or entity should be attached. • • 4 • AIA Document G702TM—1992.Copyright©1953,1963,1965,.i 971, 1978,1983 and 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.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. JOB NAME Parcel 47 Service APPLICATION DATE 10/25/2010 PAGE NUMBER 1 APPLICATION NUMBER 3 PERIOD TO 10/25/2010 A B C D I E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G=C) TO FINISH APPLICATION STORED AND STORED (C-G) (D+E) (NOT IN TO DATE D OR E) (D+E+F) 1.00 Conduit M 4,000.00 4,000.00 - - 4,000.00 100 - - - - L 10,340.00 10,340.00 - 10,340.00 100 - - 2.00 Wire M 14,800.00 14,800.00 - - 14,800.00 100 - - - - L 4,600.00 4,600.00 - 4,600.00 100 - - 3.00 Termination Cabinet M 4,200.00 4,200.00 - - 4,200.00 100 - - - - L 600.00 600.00 - 600.00 100 - - 4.00 Excavation M 15,000.00 15,000.00 - - 15,000.00 100 - - 5.00 Payment and Performance Bond L 600.00 600.00 - 600.00 100 - - 6.00 Allowance M 5,000.00 5,000.00 - - 5,000.00 100 - - 7.00 Change Order#1 L 4,009.00 4,009.00 - 4,009.00 100 - - 8.00 Change Order#2 M (1,000.00) (1,000.00) - - (1,000.00) 100 - - - - L - - - - - - M - - - - - - - L - - - - - - - - M - - - - - - - - - L - - - - - - M - - - - - - - L - - - - - - M - - - - - - L - - - - - - - - M - - - - - - - L - - - - - - - - M - - - - - - - - L - - - - - - 62,149.00 62,149.00 - - 62,149.00 - - WAIVER OP LIEN TO DATE Mats Of Indiana 1 ss County of Hamilton File : u TO WHOM IT MAI CONCERN: WHEREAS the untbsraigned ha been employed by LaFever Electric,Inc. ROSeer9WWICt.,tnntrtr•YtORna•r .mow to futnisb El-c t 'cal Work tar the premises described ea Parcel 47 Service Mime AilAn,.,W1 ie TV tIr of which Carmel Redevelopment Commission h the mule Rime(Omer Sig ou5and Two Hundred Fourteen Dollars and Ninety Cent THE undcrsi for and m cn or (S 6 214.90 )I1plbrs,and other good and valuable mnsidaation,the tecelpt wttano'is hat;by acknowledged,do(m)hereby waive and Ioleoe any and all lien or claim or right of Been under the Statutes of the State wherein the land is located,relating to l,Reerardc's Bent on the above described premises and improvements thereon,and on the monies or arbor considerations due onto o beam=due from the owner,on atom mt of labor or services,material,ftxtmes or Warmly hanstet we thudded m&it data by the undersigned ton the shawl described matins. signed ehia 25th day to October zo 10 Michael A. LaFever, Vice-President am 114O11tt All walvera meat be for the fon amount paid.if waiter is for a corporation,corporate name should be toed,corporate Real affixed and tide ofoftieer ailing Waiver should be set fortbt If waiver la ihr a partnership.the partnership none should he used,partner should ISO end designate himself as partner. CONTRACTOR'S AFFIOAVIf State of Indiana }ss County of Hamilton TO WHOM IT MAX CONCERN: Tttg endemism,.being duly sworn,deposes and says that he Is Vice-President sf LaFever Electric,Inc. who Is the contractor for the Electrical Work work on the banding located at —Ts tt'eet NW,Carmel, Indiana 46032 owned by .arme eve o a meet Commission That the total amount of the=tract Including extras Is S 62.149.00 oft t which he has received payment of S 0.00 _ prior to this payment.not ail waivers are Inn;correct and genuine and derive rod unconditionally and that than is no Clain either legal or eagoitable to defeat the validity of said waivers.That the following are the names elan parties who Iowa Ibmisiled material or labor,or both,for said work and all patties having contracts or s>tboontrasts for she portions of said work or for Material eatmir+g Into she construction thereof and the mount due err se become dire to each,and that the items mentioned melnded all labor and material required to ease said work acceud%to pane and atltms: NAVES MO OP WORK � 1 Pala r Trthiirm I orepro :. - P tree tuna :oruig 15,000.11 1.11 tl Ti-•r e.t_r: ,. n MA7LRIA '. ere;7 WEIND166161111111116116111111111 That limo are oo other contracts fur said work outstanding,tied that thetie npthies dos or to become due to any perlo h m Ii,tabor or other work. any kind done or to be Gone upon or in connection with said work other then above stated. Sighted this 25th day of October ,2n 10 11�i' .r A. LaFe er Vice-Presi. .. Sabsaribed sod sworn to before me this 25th day of 2+�:10 a laV� � TS' CD'160bAD712007 !`•�i-en arvel