Loading...
HomeMy WebLinkAboutINDIANA STEEL FABRICATING, INC.- 153- 1/5/2011 Indiana Steel Fabricating, Inc Check: 153 4545 West Bradbury Ave Date: 1/5/2011 Indianapolis, IN 46241 Vendor: INDSTEEL Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 6 90,000.00 90,000.00 0.00 0.00 90,000.00 App 6 on P7c-3 90,000.00 90,000.00 0.00 0.00 90,000.00 153 1/5/2011 **********90,000.00 THE SUM OF NINETY THOUSAND DOLLARS AND NO CENTS ******************************************* Indiana Steel Fabricating, Inc 4545 West Bradbury Ave Indianapolis, IN 46241 Indiana Steel Fabricating, Inc Check: 153 4545 West Bradbury Ave Date: 1/5/2011 Indianapolis, IN 46241 Vendor: INDSTEEL Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 6 90,000.00 90,000.00 0.00 0.00 90,000.00 App 6 on P7c-3 90,000.00 90,000.00 0.00 0.00 90,000.00 APPLICATION AND CERTIFICATION. FOR PAYMENT AIA DOCUMENTG702 PAGE ONE OF 1 PAGES1 . TO OWNER: Carmel Theater Development Corp.,LLC PROJECT: VOG-Parcel 7-C-1 Theater APPLICATION NO: S I X Distribution to: 11711 North Pennsylvania Street-Suite 200 3rd Avenue SW OWNER Carmel, Indiana 46032 Carmel,Indiana 46032 ARCHITECT PERIOD TO: . .• 11/30/2010 CONTRACTOR • -. 1) , FROM CONTRACTOR: Indiana Steel Fabricating,Inc. VIA ENGINEER: Pedcor Design Group,LLC • 4545 West Bradbury Ave. 355 City Center Drive Indianapolis,Indiana 46241 Carmel,Indiana 46032 PROJECT NO: 12012 (317)247-4545 CONTRACT DATE: 4/14/2010 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM $ 1,378,300.00 2. Net change by Change Orders $ (10,480.00) CONTRACT iI ' DIANA STEEL FABRICATING,INC. 3. CONTRACT SUM TO DATE(Line 1±2) $ 1,367,820.00 ' 4. TOTAL COMPLETED&STORED TO DATE $ 1,230,086.25 A By: 'I/ I� , Date: November 17,2010 5. RETAINAGE: Ste.'en V.Dowden,Vice-President a. 10 %of Completed Work $ 123,008.63 Subscribed. . sworn to before me this 17TH day of NOVEMBER,2010 (Column D+Eon G703) b. 10 %of Stored Material .$ 0.00 1, (Column F on G703) Benja n D.Strange, otary Public My Commission Expires: 8/11/2018 Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 123,008.63 ENGINEER'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 1,107,077.63 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Engineer certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Engineer's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) $ 1,017,077.63 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE $ 90,000.00 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 260,742.38 (Line 3 less Line 6) AMOUNT CERTIFIED $ q 1 V� CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs front the amount applied.Initial all figures on this Total changes approved Application and onthe Continuation Sheet that are changed to conform with the amount certified.) in previous Change Orders $0.00 $0.00 ENCI•NEE'I :G I•- -‘ ('e f Total approved this Change Order . $0.00 $10,480.00 By: ,//lam l /-c:,%7 Date: /2/3/, V TOTALS $0.00 $10,480.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance,payment and acceptance of payment are without NET CHANGES by Change Order ($10,480.00) prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT•1992 EDITION AIA -©1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401 -Certification of Document's Authenticity from the Licensee. G703 CONTINUATION SHEET Page 1 of 2 • To: From: Project: Application No. . _ S I X Signature Construction, LLC Indiana Steel Fabricating, Inc. VOG - Parcel 7-C-I Theater Building Application Date: 11/17/10 - 720 Third Avenue, SW 4545 West Bradbury Avenue 3rd Avenue SW Period To: 11/30/10 Carmel, Indiana 46032 Indianapolis, Indiana 46241 Carmel, Indiana 46032 Engineer's Project No. : 12012 A B C C Changes D I E F G H I Work Completed Materials Total Presently Completed Balance Retainage Item Scheduled Change From Previous Stored and Stored % To If # Description of Work Value Orders Application This Period (Not in To Date (G/C) Finish Variable D or E) (D+E+F) (C-G) 105-1000 Structural Steel 683,000.00 0.00 614,706.25 68,293.75 0.00 683,000.00 100% 0.00 68,300.00 105-1001 Steel Joist 21,985.00 0.00 21,985.00 0.00 0.00 21,985.00 100% 0.00 2,198.50 105-1002 Steel Deck 41,170.00 0.00 41,170.00 0.00 0.00 41,170.00 100% 0.00 4,117.00 105-1003 Grating 39,000.00 0.00 39,000.00 0.00 0.00 39,000.00 100% 0.00 3,900.00 105-1004 Steel Stairs and Rails 31,800.00 0.00 31,800.00 0.00 0.00 31,800.00 100% 0.00 3,180.00 105-1005 Miscellaneous Metals 81,045.00 0.00 0.00 0.00 0.00 0.00 0% 81,045.00 0.00 105-1006 Structural Steel Erection 380,000.00 0.00 324,120.00 40,706.25 0.00 364,826.25 96% 15,173.75 36,482.63 105-1007 Miscellaneous Steel Erection 40,000.00 0.00 20,000.00 0.00 0.00 20,000.00 50% 20,000.00 2,000.00 105-1008 Performance and Payment Bond 10,300.00 0.00 10,300.00 0.00 0.00 10,300.00 100% 0.00 1,030.00 105-1009 Allowance 50,000.00 0.00 27,005.00 1,480.00 0.00 28,485.00 57% 21,515.00 2,848.50 105-1010 Change Order Number: 43 (Tax Exemption) (10,480.00) 0.00 0.00 (10,480.00) 0.00 (10,480.00) 100% 0.00 (1,048.00) 1,367,820.00 0.00 1,130,086.25 100,000.00 0.00 1,230,086.25 90% 137,733.75 123,008.63 G703 CONTINUATION SHEET Page 2 of 2 ' To: From: Project: Application No. . S I X Signature Construction, LLC Indiana Steel Fabricating, Inc. VOG - Parcel 7-C-i Theater Building Application Date: 11/17/10 720 Third Avenue, SW 4545 West Bradbury Avenue 3rd Avenue SW Period To: 11/30/10 Carmel, Indiana 46032 Indianapolis, Indiana 46241 Carmel, Indiana 46032 Engineer's Project No. . 12012 A B C C Chanqes D 1 E F G H I Work Co'•leted Materials Total Presently Completed Balance Retainage Item Scheduled Change From Previous Stored and Stored % To If 6 Description of Work Value Orders ' Application This Period (Not in To Date (G/C) Finish Variable D or E) (D+E+F) (C-G) Change Order Number: 3 - PR.02 2,575.00 0.00 2,575.00 0.00 0.00 2,575.00 100% 0.00 257.50 Change Order Number: 5 - PR.03 4,455.00 0.00 4,455.00 0.00 0.00 4,455.00 100% 0.00 445.50 Change Order Number: 14 - PR.05 12,215.00 0.00 12,215.00 0.00 0.00 12,215.00 100% 0.00 1,221.50 Change Order Number: 15 - PR.06 3,205.00 0.00 3,205.00 0.00 0.00 3,205.00 100% 0.00 320.50 Change Order Number: 18 - PR.07 3,620.00 0.00 0.00 0.00 0.00 0.00 0% 3,620.00 0.00 Change Order Number: 26 - Floor Frames 1,005.00 0.00 1,005.00 0.00 0.00 1,005.00 100% 0.00 100.50 Change Order Number: 34 - PR.011 3,550.00 0.00 3,550.00 0.00 0.00 3,550.00 100% 0.00 355.00 Change Order Number: 39 - PR.012 4,795.00 0.00 0.00 0.00 0.00 0.00 0% 4,795.00 0.00 Change Order Number: 41 - RFI.117 2,570.00 0.00 0.00 2,570.00 0.00 2,570.00 100% 0.00 257.00 Change Order Number: 57 - PR.014 (1,090.00) 0.00 0.00 (1,090.00) 0.00 (1,090.00) 100% 0.00 (109.00) 50,000.00 0.00 27,005.00 1,480.00 0.00 28,485.00 57% 8,415.00 2,848.50 • PRIME CONTRACTOR'S SWORN STATEMENT OF INDEBTNESS &WAIVER OF LIEN STATE OF Indiana COUNTY OF Hamilton Stephen V. Dowden Being duly sworn upon his/her oath disposes and says that: 1. He/she is Vice-President (inserting sole proprietor, partner or corporate office held, as the case maybe), of Indiana Steel Fabricating, Inc. hereafter called the "Prime Contractor". He/she is over the age of twenty-one. He/she is authorized to make this affidavit on behalf of Prime Contractor. 2. Prime Contractor is the Structural/Misc. Steel Prime Contractor for the construction of the development known as VILLAGE ON THE GREEN — PARCEL 7C1 — THEATER BUILDING located in 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. This affidavit is made for the express purpose of inducing and CARMEL THEATER DEVELOPMENT CORPORATION, LLC., to make payment to Prime Contractor of the invoice submitted herewith for labor and materials furnished pursuant to said Contractor. Upon receipt of said payment the Prime Contractor hereby waives any lien rights to which Prime Contractor is entitled for labor or materials furnished for the development to the date hereof. 4. Listed below are all suppliers or other persons who either has furnished or might furnish the Prime Contractor with materials, appliances, machinery, fixtures or furnishing placed upon or installed on the development. Mark (X) in the appropriate column for EACH supplier listed. Place an (X) in column: 1) If a waiver of lien by supplier conditioned by payment of a specified amount is attached hereto. (In this case also show the amount owed the supplier). 2.) If a FULL (final) lien release has been signed and delivered to the Owner. 3.) If the initial delivery has not been made. Supplier List (Add List if Necessary) 1. Amount Owed 2. 3. Millennium Steel, Inc. 40,706.25 New Millennium Building Systems X Canam Steel Corporation X American Stair Corporation X Indiana Gratings, Inc. X #1 and 2 correspond to the same numbered choices on the waiver format. CARMEL THEATER DEVELOPMENT CORPORATION, LLC. is hereby authorized to make payment to each such unpaid creditor either directly or by check jointly payable to Prime Contractor and such creditor, as CARMEL THEATER DEVELOPMENT CORPORATION, LLC. shall determine. 5. There are no bills, charges, costs or expenses for labor or material which could now or hereafter result in lien being filed against the Development or a claim being asserted against the Owner except the persons or businesses named in Paragraph 4 above. IN WITNESS WHERE OF, affiant has signed this document o •e - . the prime Contractor this 17TH day of NOVEMBER , 20 10 . Stephen V. Dowden, Vice-President County of MARION State of INDIANA Subscribed and sworn to before me, a Notary Public in and for said County and State, This 17TH Day of N V MRFR , 2010 . (Notary Public) Benjamin D. Strange My Commission Expires: 8/11/2018 NOTARY SEAL MUST APPEAR ON THIS FORM. 1 STATE OF: MISSOURI MARYLA4iv 1� COUNTY OF: F?E.Dt'frcR SUBCONTRACTOR'S AND SUPPLIER'S AFFIDAVIT AND UNCONDITIONAL FINAL WAIVER OF LIEN The undersigned, /6`,./fly Ro,,�ea , being first duly sworn on his oath, states that: 1.51-le is the Cry /fa�a r of CANAM STEEL CORPORATION (hereinafter called "Company"), and is familiar with the facts herein stated and makes this affidavit for and on behalf of himself and the Company, being duly authorized to bind the Company by the statements herein contained. 2. The Company has performed work and labor or furnished materials, supplies or equipment for INDIANA STEEL FABRICATING, INC. in the construction of certain improvements on the real estate commonly known as VOG- PARCEL 7-C-1 THEATER and located at 775 3RD AVENUE SW in CARMEL, HAMILTON COUNTY, INDIANA ,which real estate is owned by CARMEL THEATER DEVELOPMENT CORP., LLC (hereinafter called "Owner"). 3. Company has paid for all work, labor, materials, equipment and supplies performed or furnished by it and by its subcontractors, materialmen and suppliers upon such premises or in connection therewith:and no person, other than Company, has any claim or right to a lien for any work, materials or services on account of any transaction undertaken by Company with respect to said premises. 4. The final amount due Company for said project is the sum of TWENTY ONE THOUSAND NINE HUNDRED EIGHTY FIVE AND NO/100 DOLLARS $21,985.00 , the receipt of which is hereby acknowledged as the sole consideration for this -- Affidavit and Final.Waiver of Lien. The Company hereby waives all liens and claims of rights to liens upon such premises under the Statutes of the State of Indiana relating to mechanic's liens and otherwise, on account of labor or materials or both furnished for said construction against the Owner, such premises and all property thereon. WITNESS the execution hereon this j"4 day of /f� lwr ,2010. CANAM STEEL CORPORATION By' ,t1Y�nn !�(�(� , 0126/1,0 fir✓ Subscribed and sworn to before me, a Notary Public, this o2 day of AjovepyIe,,2010. My Commission Expires: My County of Residence: N.dtary Public • LYNDA J. WARD Notary Public Frederick Co.,MD My Comm.Exps.Nov.26,2012 STATE OF: ILLINOIS COUNTY OF: 1.1 ji_L SUBCONTRACTOR'S AND SUPPLIER'S AFFIDAVIT AND UNCONDITIONAL FINAL WAIVER OF LIEN The undersigned, ROC co MA GC1 1 ® , being first duly sworn on his oath, states that: 1. He is the C014 TR DLL-ER of AMERICAN STAIR CORPORATION, INC. (hereinafter called "Company"), and is familiar with the facts herein stated and makes this affidavit for and on behalf of himself and the Company, being duly authorized to bind the Company by the statements herein contained. 2. The Company has performed work and labor or furnished materials, supplies or equipment for INDIANA fJ TEE L FABRICATING, INC. in the construction of certain improvements on the real estate commonly known as VOG - PARCEL 7-C-1 THEATER and located at 775 3RD AVENUE SW in CARMEL, HAMILTON COUNTY, INDIANA , which real estate is owned by CARMEL THEATER DEVELOPMENT CORP., LLC (hereinafter called "Owner"). 3. Company has paid for all work, labor, materials, equipment and supplies performed or furnished by it and by its subcontractors, materialmen and suppliers upon such premises or in connection therewith and no person, other than Company, has any claim or right to a lien for any work, materials or services on account of any transaction undertaken by Company with respect to said premises. 4. The final amount due Company for said project is the sum of THIRTY ONE THOUSAND EIGHT HUNDRED AND NO/100 DOLLARS $31,800.00 , the receipt of which is hereby acknowledged as the sole consideration for this Affidavit and Final Waiver of Lien. The Company hereby waives all liens and claims of rights to liens upon such premises under the Statutes of the State of Indiana relating to mechanic's liens and otherwise, on account of labor or materials or both furnished for said construction against the Owner, such premises and all property thereon. L WITNESS the execution hereon this / Sr day of 4/o fr " E4) , 2010. AMERICAN STAIR CORPORATION, INC. By: 1:407 Subscribed and sworn to before me, a Notary Public, this /S7 day of ®/ , 2010. My Commission Expires: to i L4/ 1 I A �_ My County of Residence: 1)v otary Public OFF C1AL SEAL JAN VI:SHAFFER NOTARY PUBLIC-STATE OF ILLINOIS MY COMMISSION EXPIRES JUN.04,2011 STATE OF: INDIANA COUNTY OF: MORGAN SUBCONTRACTOR'S AND SUPPLIER'S AFFIDAVIT AND UNCONDITIONAL FINAL WAIVER OF LIEN The undersigned, t q S. Leif\Qko — , being first duly sworn on his oath, states that: 1. He is the Cep Cep of INDIANA GRATINGS, INC. (hereinafter called "Company"), and is familiar with the facts herein stated and makes this affidavit for and on behalf of himself and the Company, being duly authorized to bind the Company by the statements herein contained. 2. The Company has performed work and labor or furnished materials, supplies or equipment for INDIANA STEEL FABRICATING, INC. in the construction of certain improvements on the real estate commonly known as VOG - PARCEL 7-C-1 THEATER and located at 775 3RD AVENUE SW in CARMEL, HAMILTON COUNTY, INDIANA , which real estate is owned by CARMEL THEATER DEVELOPMENT CORP., LLC (hereinafter called "Owner"). 3. Company has paid for all work, labor, materials, equipment and supplies performed or furnished by it and by its subcontractors, materialmen and suppliers upon such premises or in connection therewith and no person, other than Company, has any claim or right to a lien for any work, materials or services on account of any transaction undertaken by Company with respect to said premises. 4. The final amount due Company for said project is the sum of THIRTY NINE THOUSAND TWENTY TWO AND NO/100 DOLLARS $39,022.00 , the receipt of which is hereby acknowledged as the sole consideration for this Affidavit and Final Waiver of Lien. The Company hereby waives all liens and claims of rights to liens upon such premises under the Statutes of the State of Indiana relating to mechanic's liens and otherwise, on account of labor or materials or both furnished for said construction against the Owner, such premises and all property thereon. WITNESS the execution hereon this p2 el day of 0;6 , 2010. INDIANA GRATINGS, IN Q 01-APAA"-14:._ dEiWIt��� I1 .- ra t. �I; Subscribed and sworn to before me, a Notary Public, this g day of it ` , 2+J i 0 My Commission Expires: 67-aq- I q C.� 4 4 My County of Residence: yV\or• Y 1�p.... VICKEY L.BRUMMETT Vim e,kt L. 13 rumme Morgan County My Commission Expires "�' June 29,2014 STATE OF: INDIANA COUNTY OF: DEKALB SUBCONTRACTOR'S AND SUPPLIER'S AFFIDAVIT AND UNCONDITIONAL FINAL WAIVER OF LIEN The undersigned, 1-0/46 0600 , being first duly sworn on his oath, states that: 1$He is the ( tt.P/t of NEW MILLENNIUM BUILDING SYSTEMS, LLC (hereinafter called "Company"), and is familiar with the facts herein stated and makes this affidavit for and on behalf of himself and the Company, being duly authorized to bind the Company by the statements herein contained. 2. The Company has performed work and labor or furnished materials, supplies or equipment for INDIANA STEEL FABRICATING, INC. in the construction of certain improvements on the real estate commonly known as VOG - PARCEL 7-C-1 THEATER and located at 775 3RD AVENUE SW in CARMEL, HAMILTON COUNTY, INDIANA , which real estate is owned by CARMEL THEATER DEVELOPMENT CORP., LLC (hereinafter called "Owner"). 3. Company has paid for all work, labor, materials, equipment and supplies performed or furnished by it and by its subcontractors, materialmen and suppliers upon such premises or in connection therewith and no person, other than Company, has any claim or right to a lien for any work, materials or services on account of any transaction undertaken by Company with respect to said premises. 4. The final amount due Company for said project is the sum of FORTY TWO THOUSAND THREE HUNDRED SEVENTY SEVEN AND NO/100 DOLLARS $42,377.00 , the receipt of which is hereby acknowledged as the sole consideration for this Affidavit and Final Waiver of Lien. The Company hereby waives all liens and claims of rights to liens upon such premises under the Statutes of the State of Indiana relating to mechanic's liens and otherwise, on account of labor or materials or both furnished for said construction against the Owner, such premises and all property thereon. WITNESS the execution hereon this 4th day of November , 2010. NEW MILLENNIUM BUILDING SYSTEMS, LLC Be //// Subscribed and sworn to before me, a Notary Public, this 1 day of Wail , 2010. My Commission Expires: Agt „f ,wl// "' i My County of Residence: �; �L� Notary bliG✓ t • c. /, _