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Home My WebLink AboutMAXWELL ELECTRIC- 165- 1/5/2011 Maxwell Electric Check: 165 - Date: 1/5/2011 Vendor: MAXWELL Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3266-4 17,483.40 17,483.40 0.00 0.00 17,483.40 App 3266-4 on Black Box Theate 17,483.40 17,483.40 0.00 0.00 17,483.40 165 1/5/2011 **********17,483.40 THE SUM OF SEVENTEEN THOUSAND FOUR HUNDRED EIGHTY THREE DOLLARS AND 40 CENTS*************** Maxwell Electric Maxwell Electric Check: 165 Date: 1/5/2011 Vendor: MAXWELL Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 3266-4 17,483.40 17,483.40 0.00 0.00 17,483.40 App 3266-4 on Black Box Theate 17,483.40 17,483.40 0.00 0.00 17,483.40 f F . AIA Type Document Application and Certification for Payment Page 1 of 2 TO(OWNER):Black Box Theater Core PROJECT:Black Box Theater Core&Shell APPLICATION NO: 3266-4 • DISTRIBUTION 3rd Ave SW&City Center Dr t c e. .411-Me-•" -m CARMEL, IN 46032-4559 Py� ` it C r to PERIOD TO:11/15/10 TO: MEL, I 460 4159 _ARCHITECT FROM(CONTRACTOR): MAXWELL ELECTRIC NOV 2 O 2010 _CONTRACTOR VIA(ARCH T): ARCHITECT'S 2601 N ARLINGTON AVE I —./ PROJECT NO: 12012 INDIANAPOLIS,IN 46218 By CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The Undersigned Contractor certifies that to the best of the Contractor's knowledge,information and belief the work covered by this application for Payment has been completed in accordance with the Application is made for Payment,as shown below,in connection with the Contract. Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Continuation Sheet,AIA Type Document is attached. Certificates for Payment were issued and payments received from the owner,and that current payment shown herein is now due. 1.ORIGINAL CONTRACT SUM $ 191,240.00 2.Net Change by Change Orders $ 0.00 CONTRACTOR: 1 ELL ELECTRIC .01 N ARLINGTON AV INDIANAPOLIS, IN 46218 3.CONTRACT SUM TO DATE (Line 1 +2) $ 191,240.00 i �r 4.TOTAL COMPLETED AND STORED TO DATE $ 184,890.00 / 1 / it�/� --/C)By: A/' _1 ' Date: Paul Hood / Vice President 5.RETAINAGE: State of:IN a. 10.00%of Completed Work $ 18,489.00 County of: Marion b. 0.00%of Stored Material $ 0.00 i .. Subscribed and Sworn t. .efore me this ::�;of1 &C2o 16 Total retainage(Line 5a+5b) $ 18,489.00 Notary Public: " ",,- 6(-9-41 r My Commission Expires: ' �+ *' b& 6.TOTAL EARNED LESS RETAINAGE ihy. /2/1 (Line 4less Line 5 Total) $ 166,401.00 ARCHITECT'S CER 1: ICATE FOR `,AYIVIENT 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Do. -nts, based on on-site observations and the data corn- (Line 6 from prior Certificate) $ 148,917.60 prising the above application, the Architect certifies to owner that to the best of the Architect's knowledge,information and belief the Work has progressed as indicated,the quality of the work 8.CURRENT PAYMENT DUE $ 17,483.40 is in accordance with the Contract Documents, and the Contractor is entitled to payment of the 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED. (Line 3 less Line 6) $ 24,839.00 AMOUNT CERTIFIED $ r 74/K3 10 (Attach explanation if amount certified differs from the amount applied. Initial all figures on this CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Application and on the Continuation Sheet that are changed to conform to the amount certified.) Total changes approved in (rdws,_ar previous months by Owner 0.00 0.00 By: _., r"Sy,L , ^ Date: /.2.-/3// Total approved this Month 0.00 0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance,Payment and acceptance of payment are without prejudice to any 0/ TOTALS 0.00 0.00 rights of the Owner or Contractor under this Contract. NET CHANGES by Change Order 0.00 P AIA Type Document Application and Certification for Payment Page 2 of 2 TO(OWNER):Black Box Theater Core PROJECT: Black Box Theater Core&Shell APPLICATION NO: 3266-4 DISTRIBUTION 3rd Ave SW&City Center Dr Black Box Theater Core TO: CARMEL, IN 46032-4559 3rd Ave SW&City Center Dr PERIOD TO:11/15/10 OWNER _ CARMEL, IN 46032-4559 _ARCHITECT _CONTRACTOR FROM(CONTRACTOR): MAXWELL ELECTRIC VIA(ARCHITECT): ARCHITECTS 2601 N ARLINGTON AVE PROJECT NO: 12012 INDIANAPOLIS,IN 46218 CONTRACT FOR: CONTRACT DATE: SCHEDULE PREVIOUS COMPLETED STORED COMPLETED ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED % BALANCE RETAINAGE 1 Light Fixtures 66,000.00 56,100.00 9,900.00 0.00 66,000.00 100.00 0.00 6,600.00 2 Lights Fixture Installation 26,000.00 18,200.00 3,900.00 0.00 22,100.00 85.00 3,900.00 2,210.00 3 Switch Gear/Panels 13,700.00 13,700.00 0.00 0.00 13,700.00 100.00 0.00 1,370.00 4 Switch Gear/Panel Installation 16,300.00 16,300.00 0.00 0.00 16,300.00 100.00 0.00 1,630.00 5 Fire Alarm 6,600.00 3,960.00 1,980.00 0.00 5,940.00 90.00 660.00 594.00 6 Fire Alarm Installation 3,000.00 1,140.00 1,560.00 0.00 2,700.00 90.00 300.00 270.00 • 7 General Material 29,800.00 26,224.00 2,086.00 0.00 28,310.00 95.00 1,490.00 2,831.00 8 General Material Installation 29,840.00 29,840.00 0.00 0.00 29,840.00 100.00 0.00 2,984.00 REPORT TOTALS $191,240.00 $165,464.00 $19,426.00 $0.00 $184,890.00 96.68 $6,350.00 $18,489.00 APPLICATION FOR PAYMENT PARTIAL WAIVER OF LIEN Aeo. Contractor: a . _ �� , 1„.4_ Add ress: '15 P6111., &// �S dimmatawsir Project Name and Address: II . �/� t!(,L� I _ <2,0, Period to: I I-I c- IO Job#: lqoca The Undersigned has been contracted by REI Construction, LLC as a Contractor in connection with construction of the Project owned by Owner and located as indicated above. The Undersigned, for and in consideration of any and all amounts paid to the Undersigned up to and including the date of execution hereof and other good and valuable consideration, the receipt whereof is hereby acknowledged, waives and releases any and all liens, notices of liens or of character, against, on or relating to or connected with the above-described Project and improvements located thereon and related thereto, on account of labor or services, materials, equipment, tools, machinery or apparatus furnished or leased, or which may be furnished or leased by, or at the request of, the Undersigned for the Project. The Undersigned hereby warrants that the Project cannot be made subject to any valid lien or claim by anyone who furnished or leased labor or services, materials, equipment, tools, machinery or apparatus to, or at the request of, the Undersigned for use in the Project. This instrument, and the waiver, release and representations hereunder, are for the benefit of, and may be relied upon by, the Owner, its successors, assigns and mortgagees, the above-named General Contractor or Construction Manager, and any other person by or through whom payments have been made to the Undersigned. p f�l U The undersigned, for and in consideration of the total payments in the sum of $ / / / (J Oc�. the receipt of which is hereby acknowledged, does hereby waive, release remise and relinquish any and all right to claim any lien or liens for work done or materials furnished, or any kind or class of lien whatsoever for said building or premises or project Dated this �o/O day of O�Qr "—�)Ct ik , Cn:npanvN a L � _ BY: (�'l TITLE: NAME: `11C d STATE OF COUNTY 0 Subscrib / "rtd`7�wo n o bef re me, a Notary Public in and for said County and State, this day of 0 V ! lrei f ,200 f P My commission expires ° - `_ y p ( ;.,My county residence is ak 1 • (SEAT Notary �� rinted K\L( ,�__