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MAXWELL ELECTRIC- 001928- 3/16/2011
Maxwell Electric Check: 1928 Date: 3/16/2011 Vendor: MAXWELL Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 6 178,464.12 178,464.12 0.00 0.00 178,464.12 App 6 on VOG 178,464.12 178,464.12 0.00 0.00 178,464.12 1928 3/16/2011 ********178,464.12 THE SUM OF ONE HUNDRED SEVENTY EIGHT THOUSAND FOUR HUNDRED SIXTY FOUR DOLLARS AND 12 CENTS******* Maxwell Electric Maxwell Electric Check: 1928 Date: 3/16/2011 Vendor: MAXWELL Prior Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid 6 178,464.12 178,464.12 0.00 0.00 178,464.12 App 6 on VOG 178,464.12 178,464.12 0.00 0.00 178,464.12 � � o RECEIVED „L AIA TM - JAN 1 9 2 011 Document 6702 1992 Application and Certificate for Payment Per TO OWNER: Carmel Theater Development PROJECT: Village On The Green APPLICATION NO: 6 Distribution to: Corporation LLC 3rd Ave SW PERIOD T0:January 15,2011 OWNER: 11711 North Pennsylvania Street Suite Carmel In 46032 200 ARCHITECT: Carmel In 46032 CONTRACT FOR: General Construction CONTRACTOR: FROM Maxwell Electric VIA Pedcor Design Group,LLC CONTRACT DATE:June 23,2010 CONTRACTOR: 2601 N Arlington Ave ARCHITECT: 355 City Center Drive PROJECT NOS: / 12012/ FIELD: Indianapolis In 46218 Carmel In 46032 OTHER: 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 Document G703,is attached. Certificates for Payment were issued and payments received from the Owner, and that current 1. ORIGINAL CONTRACT SUM $ 1,429,142.00 payment sho herein is now due, 2. NET CHANGE BY CHANGE ORDERS $ -45,454.00 CONTRA O�R��1r 3. CONTRACT SUM TO DATE(Line 1 ±2) $ 1,383,688.00 By: CG �/ ( --Date: January 14,2011 4. TOTAL COMPLETED & STORED TO DATE(Column G on G703) $ 552,214.29 State of:Indiana 5. RETAINAGE: County of:Marion .,..,,�- is a. 10 %of Completed Work Subscribed and sw rn to bef• e (Column D+Eon G703) $ 55,235.51 me this % day,o / , ,, 0 on'fi _k /' \ ' b. 0 %of Stored Material � e«�`. �' (Column F on G703) $ 0.00 Notary Public ,� dilf- �>.':: ry My Commission ex ire's:March 1,201 '� 4. Total Retainage(Lines 5a+Sb or Total in Column I of G703) $ 55,235.51 y p ;"4,r�,,�, •, 6. TOTAL EARNED LESS RETAINAGE $ 496,978.79 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 Less Line 5 Total) In accordan �v th-the Contract Documents,based on on-site observations and the data comprising 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 318,514.67 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 accordance (Line 6 from prior Certificate) with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT 8. CURRENT PAYMENT DUE $ 178,464.12 CERTIFIED. / 9. BALANCE TO FINISH, INCLUDING RETAINAGE AMOUNT CERTIFIED $ 178,464.12 `/ (Line 3 less Line 6) $ 886,709.22 (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and on the la inuatio Sheet that are changed t confor with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: 1, .,04 �� Total changes approved in previous months by Owner $ 0.00$ 45,454.00 By: AillIlIllhjt 6■11...... Date: itt.T 11 Total approved this Month $ 0.00$ 0.00 TOTALS $ 0.00$ 45,454.00 This Certi ate is of negotiable. The AMOUNT CERTIFIED is payable only o the Contractor named herein. ssuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Change Order $ -45,454.00 the Owner or Contractor under this Contract. AIA Document G702T"—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 Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to 1 „( the maximum extent possible under the law.This document was produced by AIA software at 14:45:44 on 01/17/2011 under Order No.2064228033_1 which expires on 04/14/2011,and is not for resale. �\ User Notes: (1715828067) ..,............. AT ® I TM ,,_ ‘6,14,, d Document 6703 ® 1992 Continuation Sheet AIA Document, G702TM-1992,Application and Certification for Payment,or G736T"'f-2009, APPLICATION NO:006 Project Application and Project Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE:01/14/2011 containing Contractor's signed certification is attached. In tabulations below,amounts are in US dollars. PERIOD TO:01/15/2011 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: A B C D E F G H I WORK COMPLETED TOTAL MATERIALS FROM COMPLETED BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (C'-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 1 126-1000 Bonding 19,200.00 19,200.00 0.00 0.00 19,200.00 100.00% 0.00 0.00 2 126-1001 Submittals 6,800.00 6,120.00 0.00 0.00 6,120.00 90.00% 680.00 0.00 126-1002 Switch 3 Gear Mateial 216,800.00 104,064.00 43,360.00 0.00 147,424.00 68.00% 69,376.00 0.00 126-1003 Switch 4 Gear Installation 98,555.00 25,624.30 28,580.95 0.00 54,205.25 55.00% 44,349.75 0.00 126-1004 Lighting 5 Protection Material 18,685.00 4,671.25 0.00 0.00 4,671.25 25.00% 14,013.75 0.00 126-1005 Lighting Protection 6 Installation 9,400.00 • 940.00 �0.00 0.00 940.00 10.00% 8,460.00 0.00 126-1006 Light Fixtures Material 1st 7 Floor 128,000.00 51,200.00 5,120.00 0.00 56,320.00 44.00% 71,680.00 0.00 126-1007 Light Fixtures Material 2nd 8 Floor 78,400.00 25,872.00 7,056.00 0.00 32,928.00 42.00% 45,472.00 0.00 126-1008 Light Fixtures Material 3rd 9 Floor 20,177.00 6,456.64 2,017.70 0.00 8,474.34 42.00% 11,702.66 0.00 126-1009 Light Fixtures Installation 10 1st Floor 42,000.00 5,040.00 0.00 0.00 5,040.00 12.00% 36,960.00 0.00 126-1010 Light Fixtures Installaton 11 2nd Floor 50,990.00 5,099.00 0.00 0.00 5,099.00 10.00% 45,891.00 0.00 AIA Document G703TM-1992.Copyright m 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale 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 1 the maximum extent possible under the law.This document was produced by AIA software at 14:44:20 on 01/17/2011 under Order No.2064228033_1 which expires on 04/14/2011,and is not for resale. User Notes: (1196187981) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED e/e BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY NO. WORK VALUE PREVIOUS AND STORED TO FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED DATE (G-C) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 126-1011 Light Fixtures Installation 12 3rd Floor 97,000.00 3,880.00 0.00 0.00 3,880.00 4.00% 93,120.00 0.00 126-1012 Lighting 13 Hoist Material 98,660.00 0.00 93,727.00 0.00 93,727.00 95.00% 4,933.00 0.00 126-1013 Lighting 14 Hoist Installation 25,600.00 0.00 2,560.00 0.00 2,560.00 10.00% 23,040.00 0.00 126-1014 Fire Alarm 15 Material 1st Floor 29,880.00 8,366.40 1,494.00 0.00 9,860.40 33.00% 20,019.60 0.00 126-1015 Fire Alarm 16 Material 2nd Floor 8,724.00 2,093.76 0.00 0.00 2,093.76 24.00% 6,630.24 0.00 126-1016 Fire Alarm 17 Material 3rd Floor 8,251.00 1,815.22 577.57 0.00 2,392.79 29.00% 5,858.21 0.00 126-1017 Fire Alarm 18 Installation 1st Floor 17,440.00 3,313.60 1,395.20 0.00 4,708.80 27.00% 12,731.20 0.00 126-1018 Fire Alarm 19 Installation 2nd Floor 9,880.00 1,580.80 790.40 0.00 2,371.20 24.00% 7,508.80 0.00 126-1019 Fire Alarm 20 Installation 3rd Floor 9,570.00 1,531.20 574.20 0.00 2,105.40 22.00% 7,464.60 0.00 126-1020 HAVC 21 Material 18,800.00 9,024.00 0.00 0.00 9,024.00 48.00% 9,776.00 0.00 126-1021 HAVC 22 Installation 26,979.00 8,633.28 0.00 0.00 8,633.28 32.00% 18,345.72 0.00 126-1022 General Rough Material 1st 23 Floor 46,410.00 22,276.80 1,856.40 0.00 24,133.20 52.00% 22,276.80 0.00 126-1023 General Rough Material 2nd 24 Floor 27,600.00 10,488.00 0.00 0.00 10,488.00 38.00% 17,112.00 0.00 126-1024 General Rough Material 3rd 25 Floor 29,491.00 11,206.58 1,769.46 0.00 12,976.04 44.00% 16,514.96 0.00 AIA Document G703 T"-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe 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 2 the maximum extent possible under the law.This document was produced by AIA software at 14:44:20 on 01/17/2011 under Order No.2064228033_1 which expires on 04/14/2011,and is not for resale. User Notes: (1196187981) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o/o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY NO. WORK VALUE PREVIOUS STORED AND STORED TO (G_C FINISH (IF VARIABLE APPLICATION THIS PERIOD DATE ( ) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) 126-1025 General Rough Installation 1st 26 Floor 68,690.00 28,849.80 3,434.50 0.00 32,284.30 47.00% 36,405.70 0.00 126-1026 General Rough Installation 27 2nd Floor 27,000.00 10,260.00 810.00 0.00 11,070.00 41.00% 15,930.00 0.00 126-1027 General Rough Installation 28 3rd Floor 45,510.00 14,563.20 3,185.70 0.00 17,748.90 3.9.00% 27,761.10 0.00 126-1028 General Finish Material 1st 29 Floor 10,400.00 0.00 0.00 0.00 0.00 0.00% 10,400.00 0.00 126-1029 General Finish Material 2nd 30 Floor 5,200.00 0.00 0.00 0.00 0.00 0.00% 5,200.00 0.00 126-1030 General Finish Material 3rd 31 Floor 3,200.00 0.00 0.00 0.00 0.00 0.00% 3,200.00 0.00 126-1031 General Finish Installation 1st 32 Floor 38,500.00 0.00 0.00 0.00 0.00 0.00% 38,500.00 0.00 126-1032 General Finish Installation 33 2nd Floor 17,300.00 0.00 0.00 0.00 0.00 0.00% 17,300.00 0.00 126-1033 General Finish Installation 3rd 34 Floor 10,050.00 0.00 0.00 0.00 0.00 0.00% 10,050.00 0.00 35 126-1034 Allowance 60,000.00 7,330.14 0.00 0.00 7,330.14 12.22% 52,669.86 0.00 126-1035 CO.031 39 V.E -12,166.00 -12,166.00 0.00 0.00 -12,166.00 100.00% 0.00 0.00 126-1036 7CI.CO 48 40 Tax Exempt -33,288.00 -33,288.00 0.00 0.00 -33,288.00 100.00% 0.00 0.00 - AIA Document G703T"-1992.Copyright O 1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale 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 3 the maximum extent possible under the law.This document was produced by AIA software at 14:44:20 on 01/17/2011 under Order No.2064228033_1 which expires on 04/14/2011,and is not for resale. User Notes: (1196187981) A B C D E F G H I WORK COMPLETED TOTAL FROM MATERIALS COMPLETED o BALANCE TO RETAINAGE ITEM DESCRIPTION OF SCHEDULED PRESENTLY /o NO. WORK VALUE PREVIOUS STORED AND STORED TO G_C FINISH (IF VARIABLE APPLICATION THIS PERIOD DATE ( ) (C-G) RATE) (D+E) (NOT IN D OR E) (D+E+F) GRAND TOTAL $1,383,688.00 $354,045.97 $198,309.08 $0.00 $552,355.05 39.92% $831,332.95 $0.00 AIA Document G703",—1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlAe 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 4 the maximum extent possible under the law.This document was produced by AIA software at 14:44:20 on 01/17/2011 under Order No.2064228033_1 which expires on 04/14/2011,and is not for resale. User Notes: (1196187981) PRIME CONTRACTOR'S UNCONDITIONAL PROGRESSIVE WAIVER OF LIEN Paul Hood Being duly sworn upon his/her oath disposes and says that: 1. He/she is V i c e President (inserting sole proprietor, partner or corporate office held, as the case maybe), of Maxwell Electric , 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 Electrical Prime Contractor for the construction of the Village on the Green — Parcel 7C1 — Theater Building development, located Carmel (City), Indiana (state), hereafter referred to as the "Development", pursuant to the contract between the Prime Contractor and Carmel Theater Development Corporation,LLC,the Owner. 3. Prime Contractor hereby waives and releases any and all liens and rights to claim a lien to which Prime Contractor is or may be entitled for services, labor, and/or materials furnished for the Development for work covered by and through the date of the Prime Contractor's Application and Certification for Payment number (p dated 1-17-I/ 4. There are no bills, charges, costs or expenses for services, labor, and/or material which could now or hereafter result in lien being filed, or a right to claim a lien, against the Development or a claim being asserted against the Owner for this work. 5. Prime Contractor has been paid in full, exclusive of retainage, for all services, labor, and materials furnished to, provided for, or u ed,J' connection with, the Development through the period noted above and acknowledges the receipt of$/� ' (p�.4'Z' to date. IN WITNE ' WHERE OF,affiant has signed this doe/ ent on behalf of the Prime Contractor this /7 day of C` 20 11_7‘d V ii aalidsA (Authorized Representative of Prime Contractor, Title) County of Marion State of Indiana i / / / L Subscribed and s, orn to before me,a Notary Public in and for said County and State,This / Day of / ' LL i `' _ , 20 iJ • ,;', ota Puo � 1:4I Mill 1 My Commission Expires: . o1 l'/�. (Printed Name) NOTARY SEAL MUST APPEAR ON THIS FORM. 1