HomeMy WebLinkAboutLITTLE CONSTRUCTION CO., INC.- 333- 8/11/2011 Little Construction Co., Inc. Check: 333
104 South Harrison Street Date: 8/11/2011
Greenfield, IN 46140 Vendor: LITTLE1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
2-8 4,344.86 4,344.86 0.00 0.00 4,344.86
App 8 on Theater
4,344.86 4,344.86 0.00 0.00 4,344.86
333
8/11/2011 ***********4,344.86
THE SUM OF FOUR THOUSAND THREE HUNDRED FORTY FOUR DOLLARS AND 86 CENTS *******
Little Construction Co., Inc.
104 South Harrison Street
Greenfield, IN 46140
Little Construction Co., Inc. Check: 333
104 South Harrison Street Date: 8/11/2011
Greenfield, IN 46140 Vendor: LITTLE1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
2-8 4,344.86 4,344.86 0.00 0.00 4,344.86
App 8 on Theater
4,344.86 4,344.86 0.00 0.00 4,344.86
'K
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE OF PAGE
TO CONTRACTOR: PROJECT: Village on the Green APPLICATION NO: 8 Distribution to:
Carmel Theater Development Co. Theater OWNER
1016 3rd Ave.SW,Ste.200 ARCHITECT
Carmel,IN 46032 PERIOD TO: 05/30/2011 X CONTRACTOR
FROM SUBCONTRACTOR: VIA ARCHITECT: Pedcor Design Group,LLC
Little Construction Inc. 355 City Center Dr.
104 South Harrison PROJECT NOS:
Greenfield,IN 46140
CONTRACT FOR: CONTRACT DATE: 07/09/10
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 (11) $ 195,000.00
2. NET CHANGE BY CHANGE ORDERS 1 $ (3,249.00) CONTRACTOR: Little Construction Inc.
3. CONTRACT SUM TO DATE(Line 1±2) � $ 191,751.00
4. TOTAL COMPLETED&STORED TO DATE s-a $ 171,672.20 •- .1' ) = ,
(Column G on G703) �/ By:
I �cJf /�,�c
5. RETAINAGE: C ^ e C � ( Date: �� % J
a. 10 %of Completed Work /77 $ 17 167.22 State of:Indiana
`�> County of:Hancock
(Column e +Eon G703) 0 C Subscribed and sworn to before me this I ) day of Y `t T I
b. 10 %of Stored Material A+•-�� $ 0.00 Notary Public: <'- O
(Column F on G703) My Commission exp s: 7/8/15
TOTAL RETAINAGE $ 17,167.22
Lines 5a+5b or Total in Column I of G703) ARCHITECT'S CERTIFICATE FOR PAYMENT
6. TOTAL EARNED LESS RETAINAGE $ 154,504.98 In accordance with the Contract Documents,based on on-site observations and the data
(Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 150,160.12 Architect's knowledge,information and belief the Work has progressed as indicated,
(Line 6 from prior Certificate) the quality of the Work is in accordance with the Contract Documents,and the Contractor
8. CURRENT PAYMENT DUE $ 4,344,86 is entitled to payment of the AMOUNT CERTIFIED. x\\
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 37,246.02 41-3L-1 Fi<
(Line 3 less Line 6) AMOUNT CERTIFIED $
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied.Init'al all figures on this
Total changes approved Application and onthe Continuation Sheet th are changed to confo. w' the amount certified.)
in previous months by Owner ($3,249.00) — nrurrcri '1,.....4.1.--tr.
Total approved this Month $0.00 By: ._�� L Date: 00//A/
TOTALS 0.00 (3,249.00) This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the
3,249.00 Contractor named herein.Issuance,payment and acceptance of payment are without
NET CHANGES by Change Order prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT G702•APPLICATION AND CERTIFICATION FOR PAYMENT•1992 EDITION'NA'01992 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.
CONTINUATION SHEET AlADOCU11MEN G703 PAGE 2 OF 2 PAGE
AIA Document G702, Owner: Carrnel Theater SUBCONTRATOR: Little Construction Inc. APPLICATION] 8
APPLICATION AND CERTIFICATION FOR PAYMENT,containing Develop.Corp.LLC JOB NAME: Village on the Green-Theater APPLICATION DATE:5/17/11
Contractor's signed certification is attached 1016 3rd Ave SW,Ste.200 PERIOD TO: 5/30/11
In tabulations below,amounts are stated to the nearest dollar. Cannel,IN 46032 LOCATION: ARCHITECT'S PROJECT NO: 12012
Use Column I on Contracts where variable retainage for line items may apply. Carmel,IN 46032 +,
p 13 C D I E F 0 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 (IF VARIABLE
APPLICATION STORED AND STORED (C-G) RATE)
(0+0) (NOT IN TO DATE
D OR E) (D'0-`F) _
107-1000 Air/Moisture Barrier Material 29,108.00 29,108.00 29,108.00 100% 2.910,80
107-1001 Air/Moisture Barrier Labor 67,921,00 67,921.00 67;921,00 100% 6,792.10
107-1002 EILS Material 25;995.00 25;995.00 25.995.00 100% 2,599.50
107-1003 EIFS Labor 48,276.00 41,034.60 4.827.60 45,862.20 95% 2.413,80 4,586.22
107-1004 Misc.Material 3,550.00 1,065.00 1,065.00 30% 2,485.00 106.50
107-1005 Misc.Labor 8,300,00 2,490.00 2.490,00 30% 5.810.00 249.00
107-1006 P R P Bond 1.850,00 1,850.00 1;850.00 100% 185.00
107-1007 Allowance 10,000.00 630,00 630.00 6% 9,370.00 63.00
107-1008 C0.47-Tax Exemption (3.249,00) (3,249.00) (3,249,00) 100% (324.90)
GRAND TOTALS $191,751.00 $166,844.60 $4;827.60 $0.00 $171,672.20 90% $20,078.80 $17,167.22
Users may obtain validation of this document by requesting of the license a completed AIA Document D401-Certification of Document's Authenticity
AIA DOCUMENT G703•CONTINUATION SHEET FOR G702•1992 EDITION•AIA-019132 G703-1992
THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N.W.WASHINGTON,D.C.20006.5232
CONTINUATION SHEET .=1.4 DOCUMENT G703 PAGE OF PAGE
AlA Document 6702, SUBCONTRATUR Little Construction,Inc. APPLICATION I' 8
APPLICATION AND CERTIFICATION FOR PAYMENT,containing JOB NAME Village on the Green Theater APPLICATION DATE'S/16/I I
Contractor's signed certification is attached STORE B PERIOD TO 05/30/2011
In tabulations below,amounts aie stated to the nearest dolls LOCATION ARCHITECT'S PROJECT NO
Use Column I on Conti acts where vat!able damage for line items may apple.
A _ B _ C _ D J E F G H
ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL °' BALANCE RETAINAGE
NO VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G—C) TO FINISH (IF VARIABLE
APPLICATION STORED AND STORED IC-G) RATE)
(D+E) (NOT IN TO DATE
D OR L) (D+E+F)
Allowance$I 0,000.00
Change Order 456-PR.1 d 630.00 630.00 630.00 I00% 63.00
GRAND TOTALS $10,000.00 $630.00 $0.00 $0.00 $630.00 6% $9,370.00 $63.00
Users may obtain validation of this document by requesting of the license a completed AIA Document D401 -Certification of Document's Authenticity
AlA DOCUMENT G703 CONTINUATION SHEET FOR 0702 1992 EDITION AIA 01992
THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,N W WASHINGTON,D C 20006-5232 G703-1992
PRIME CONTRACTOR'S SWORN STATEMENT OF
INDEBTNESS &WAIVER OF LIEN
STATE OF Indiana
COUNTY OF Hamilton
Pc ^∎C`c, c_.4-k (`-to Being duly sworn upon his/her oath disposes and
says that 1 _
1. He/she is 1 N5icL' -1-- (inserting sole proprietor, partner or corporate office held, as the case maybe),
of L i-14 e he uc-t-i ort 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 5 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(state), 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
y 1. Amount Owed _. 2 3
o
#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.
ciel L IN WITNESS WHERE OF, affiant has signed this document on behalf of the Prime Contractor this /
day of "72..7 , 20 f1
(Authorized Representative of Prime Contractor, Title)
County of_kg,,yt__ )
State of -e(1 6_iscv\c,\ )
Subscribed and sworn to before me, a Notary Public in and for said County and State,
This 17 Day of ( 0-y , 20 c—k-/ -/\
0. •
(Notary Public)
416 cr\nq L- 4(1.4c-k.Q.r
-7q(c (Printed Name)
My Commission Expires:
NOTARY SEAL MUST APPEAR ON THIS FORM.