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HomeMy WebLinkAboutSIMPLEXGRINNELL LP- 001218- 9/20/2010 tAIA Document G702/CMa1M - 1992 Application and Certificate for Payment Construction Manager-Adviser Edition TO OWNER: PROJECT: APPLICATION Distribution to Carmel Redevelopment Comm Parcel 7A Regional One Civic - Square Performing Arts Center PERI TO' 9 16-20 OWNER ❑ Carmel, IN 46032 tl�% 1. CONSTRUCTION MANAGER i FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: qq�, TRACT DAT"445,28 0 • ! ARCHITECT D 11.820 Pen.Teton Pi Shiel Sexton 0 ROJECT OS: 0 / CONTRACTOR ❑ Indianapolis ,Pendleton Pike VIA ARCHITECT: FIELD El Indianapolis , IN 46236 CSO Archit�c0 f . CONTRACT FOR: Auto Fire Protection ��.. r� /�. LI r Y e tin Ier�io r certifies that to the Contractor's knowledge, information and CONTRACTOR'S APPLICATION FOR PA �� r s=ned �r� t best of eomraotot _ Application is made for payment,as shown below,in connection w•ii t le'.1 tract. belief the Work h -r;p : pplicntian for Payment has been completed in accordance with the 2.Net ORIGINAL CONTRACT by Sheet, Al Se Orders S6f4� 3 9 . 00 Certift a . her 'o, r issued have been pent by the Contractor for Work ,for and that current Continuation Sheet. AIA Document 0703_Is attache [scared smd payments received from the Owner, anti that current Pt Y e 3.CONTRACT SUM TO DATE(Line. I +,2)" ..,. ..i..,. F el , 910-00 By tt•rn - 1 ._j//�J ,/ Date: Sept 21, 2010 4.TOTAL COMPLETED&STORED.TOOATE(Coeur G on .�S�q i e l: ndiana �7�cYtael M. '1eIacDOnald ` 5.RETAINAGE YY�r11I1,�FF''unty of:Marion PAULA K.LEWIS a 5 ;1.4 Completed Work Subscribed and sworn to before f Notary Public-Seal (Columm D +bon 0703) / S 30 , 746 . 5Q me this 21st day of Se temyier 2010 State of Indiana b. %of Stored Material '.11��` __ Notary Public_ c,,. -e oty My Commission Expires Aug 12,2017 (Column E en 0703) $ 0 DO My Commission expires: 8-12-2017 _ _ _ . . _ _ Total Retainage{Lines 5a+5bor Total in Column IofG703)- $ 30,746 . 50 CERTIFICATE FOR PAYMENT In accordance with the Contract Documents. based on on-site observations and the data comprising 6.TOTAL EARNED LESS RETAINAGE S607 , 039 . 41 this application.the Construction Manager and Architect certify to the Owner that to the best of their (Line 4 Less Line 5 Total) knowledge, information and belief the Work has progressed as indicated,the quality of the Work is in 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 557 , 039 . 41 accordance with the Contract Documents.and the Contractor is entitled to payment of the AMOUNT (I.ine 6 tram prior Certificate) 550 , 000. 00 AMOUNT CERTIFIED. pp���/�7{�� 8.CURRENT PAYMENT DUE...................._......,....,......,.... ..... T CERTIFIED $5"F b'0 9.BALANCE TO FINISH, INCLUDING RETAINAGE- • (Attach nrplanntion rf antnr0U cent(Mel differs fir n the moo ett ap lied. Cursed all figirrns on Ibis A> lien'ion and o e Conti rr tint[ Ire_thang !1n conform with the amount certified.) !P tilt Sec°� (Line 3lass Line 6) $_5_7_,.890 . 59 CON' UCTIO• G•: Ey. �t it a. �A as Ls:� Date: 9 a D CHANGE ORDER SUMMARY. ADDITIONS DEDUCTIONS ARCH! CT: — Total changes approved'in previous months by Owner $24 , 721 . G 15 (25, 150 . 00)By: At' A./A Date. 0 ' {,Y Total approved this Month �$ �_r0 ]O • C. � () • d G This Certificate not• cganiablc. The AMOUNT CBI{'fIE[ED is payable only to the .iontrncror TOTALS S74 , 721 . ( m (25 , 150 . 0 J)rned herein. Issuance, payment and acceptance of payment are without prejudice to any tights of NET CHANGES by Change Order S 4 9, 5 71 . 0 0 the Owner or Contractor under this Contract. CAUTION:You should sign an original NA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document 0702ICMa^^—1992.Copyright m 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 wilt 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 MA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. AIA Document G702/CM1 - 1992 Instructions Application and Certificate for Payment Construction Manager-Adviser Edition A.General Information AIA Document G702!CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition,is to be used in conjunction with AIA Document G703, Continuation Sheet.These documents are designed to be used on a Project where a Construction Manager is employed as an adviser to the Owner,but not as a constructor,and where multiple Contractors have direct Agreements with the Owner.Procedures for their use are covered in MA Document A201iCMa,General • Conditions of the Contract for Construction,Construction Manager-Adviser Edition, 1992 Edition. B.Reproductions . This document is a copyrighted work and may not be reproduced or excerpted from withoutthe 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 mazenum of ten copies of a completed 37021CMa�,but only for use in connection with a particular project.The AIA will not permit reproduction outside of the limited license forIeproductiion 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.�Liccehsed AIA software users should consult the End User License Agreement(EL LA). To report copyright violations of AlA Contract Documentspe-mail Ttia.itnelcan Institute of Architects'legal counsel,copyright®aia.org. C.Completing the G7021CMa Form F , •, After the Contractor has completed AIA Document G703,OontineAtion Sheet,summaryInformation should be transferred to AIA Document G7021CMa,Application and Certificate for Payment,Construction Manager-Adviser Edition. s `w'' l- The Contractor should sign 0702/CMa,have it notarjied and submit it togeTKeT with G703,to the Construction Manager and Architect. The Construction Manager and Architect should re viewG7021CMa'ancfiG703 and, if they are.e&ceptable,complete the Certificate for Payment on G7021CMa.The Construction Manager and Architect may certify4a-diifarenl amotylfjlian mat applied for pufsuIhl to Sections 9.5 and 9.6 of A201/CMa.They should then initial all figures on G7021CMe and G703 that have been chaftged to conforrlto the amount certified and°attaSalrexplanation.The completed G702/CMa and 6703 should be forwarded to the Owner s'7 " D.Completing the G703 Form etm a!`+ 'o 4%. Heading:This information should becorn3 ted lobe consistent with similar Informs ton on AIA Document 0702,CMa,Application and Certificate for Payment, Construction Manager-Adviser Edition' "r • it Columns A,B&C:These columns should be completed by identifying the various Indians of the Project and their scheduled value consistent with the schedule of values submitted to the Architect at the cog3mencement of the Pltiject-orras subsequently adjusted.The breakdown may be by sections of the Work or by Subcontractors and should remain consistent throughout the Piojeot. Multiple e&:ttioukl be used when required. Column C should be subtotaled at the bOtlom when more thart b paoe'aged and totaled on the last page. Initially,this total should equal the original Contract Sum. The total of column C may beefacely Change Ordersiduring the!Praject. shy•Column 0: Enter in this column the amount of completedwork cod by the previous application(columns D&E from the previous application).Values from column F (Materials Presently Stored)from4he previous gsplicatjon sY7ptilddj, t be entered in this column. Column E:Enter here the value of Work compleJed:Ot the F nYf this application, including the value of materials incorporated into the project which were listed on the previous epplicetiorttnder Materials Presenit stored(column F). Column F: Enter'here the value of Ivfaterials Prese y Stored for which payment is sought.The total of the column must be recalculated at the end of each pay period. This value covers both materials newly stgfed for w�chrpayment is sought and materials previously stored which are not yet incorporated into the Project.Mere payment by the Owner for stored materiadjdoes-rot resufflbta deduction from this column.Only as materials are incorporated into the Project is their value deducted from this column and incorporated into cotumff E(Wor cJ.arnpleted-This Period). Column G:Enter here theTiotat "1,15,....fcolumns1D"E and F.Calculate the percentage completed by dividing column G by column C. Column H:Enter here the difterencebetween column C(Scheduled Value)and column 0 (Total Completed and Stored to Date). • Column 1:This column is nornjiilly i-SBd only for contracts where variable retainage is permitted one line-item basis.It need not be completed on projects where a constant retainage is withheld Rocfrihre overall contract amount. 1 r' Change Orders:Although Change Orders could be incorporated by changing the„schedule of values each time a Change Order is added to the Project,this is not normally done.Usually,Change Orders are listed separately,either on their own 6703 form or at the end of the basic schedule.The amount of the original contract adjusted by Change Orders is to be entered in the appropriate location on the 0702/CMa farm. Construction Change Directives:Amounts not in dispute that have been included infConst&uctionChange Directives should be incorporated into one or more Change Orders.Amounts remaining in dispute should be dealt with according to Section 7.3 in A2011CMe. r' • E.Making Payment i -E. The Owner should make payment directly to the Contractor based on the amount cenified.by the:Construction Manager and Architect on AIA Document G7021CMa, Application and Certificate for Payment,Construction Manager-Adviser Edition.The completed form7contains the name and address of the Contractor. Payment should not be made to any other party unless specifically indicated on G7021CMa. AIA Document G7021CMaTU—1992.Copyright © 1992 by The American Institute of Architects.All righhts reserved.WARNING:This AlA® Document Is protected by U.B. Copyright Law and International Treaties.Unauthorized reproduction or distributvon of this`AIA"e"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 SinsplexGrinnell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, Sinlplex.Grinnell LP APPLICATION NO,, 22 containing Contractor's signed Certification,is attached. CARMEL PERFORMING ARTS APPLICATION DATE. pa/1612010 In tabulations below, amounts are stated to the nearest dollar PERIOD TO, 09/16/2010 Use Column [ on Contracts where variable retainage for line items may apply. PROJECT NO.: 2695-4280 A B C D E F C H I WORK CO.b1 P LET D MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESEN'T'LY COMPLETED BALANCE RETAINAGE NO, VALUE APPLICATION -illIS ' STORED AND STORED .° TO HE VARIABLE) (DTE) PERIOD (NOT IN TO DATE (O=C) FINISH RATE D OR E) (DrE-F) IC-C) 10000 ADMINISTRATION 10010 Bonds & Insurance $4.500.00 54,500.00 $0.00 $0.00 54,509.00 100°/ 50.00 50.00 10020 Permits& Fees $500.00 5500.00 50.00 50.00 5500.00 100% 50.00 50.00 10030 Submittals $20.307.00 520,307.00 $0,00 $0.00 $20,307.00 100% 50 A0 50,00 10040 Drarwing& Drafting Srvices $33,638-00 $33,638.00 $0-00 $0.00 533,638.00 100% 50.00 $0.00 10050 As Built Drawing Conversion to CAD $5,000.00 50.00 50.00 50.00 50.00 0% 55,000.00 $0.00 10060 Mobilization $17,910.00 517,910.00 $0.00 $0.00 517,910.00 100% 50.00 $0.00 20000 MATERIAL 20010 Underground $2,229.00 $2,229.00 5000 $0.00 $2,229.00 100% $0.00 $0.00 20020 Fire Pump 535,920.00 $35,92000 $0.00 $0.00 $35,920.00 100% $0.00 50.00 20030 Standpipe 513,218.00 $13,218.00 $0.00 $0.00 $13,218.00 100% $0.00 50.00 20040 Basement $32,772.00 $32,772.00 50.00 50.00 $32,772.00 100% $0.00 $0.00 20050 Plenum Level $13.310.00 513,310.00 50.00 $0.00 513,310-00 100% $0-00 $0.00 20060 Orchestra Low Level 515,977.00 $18,977.00 $0.00 $0.00 $18,977.00 100% $0.00 50.00 20070 Orchestra High Level $12,010.00 $12,010-00 50.00 $0.00 512,010.00 100% 50.00 50.00 20080 Box Tier Level $21,950.00 $21.950.00 50.00 $0.00 521,950.00 100% $0.09 50.00 20090 Balcony Low Level $12,800.00 $12,800.00 50.00 $0.00 $12,800.00 100% 50.00 50.00 20100 Balcony High Level 523,900.00 $23,900.00 50.00 $0.00 523,90000 100% 50.00 5090 20110 Attic 50 ft. Level 55,500.00 $5.60,00 50.00 $0.00 $5,500 00 100% 50.00 50.00 20120 Attic 66 It Level 58,805.00 $8.805.00 10,00 $0.00 $8.805.00 100% 50.00 50.00 20130 Attic 80 It Level $12,335.00 512.335.00 50,00 $0.00 512,335.00 100% $0.00 50.00 20140 Pre-action 515,984,00 $15,904.00 50.00 50 00 515,984.00 100% 50.00 50.00 30000 INSTALLATION 30010 Underground $3,714.00 $3,714.00 $0.00 50.00 $3,714.00 100°! $0.00 5000 30020 Fire Pump $12,381.00 $12,257.19 $0.00 $0.00 512,257.19 99% $123.81 $0.00 30030 Standpipe 517,024.00 $17.024.00 $0.00 $0.00 $17,024.00 100% $0.00 $0.00 30040 Basement $49,602.00 $49,105.98 $0.00 $0.00 $49,105.98 99% $496.02 $0.00 SimpierGrinnell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO.: 22 containing Contractor's signed Certification, is attached. C.ARMEI. PERFORMING ARTS APPLICATION DATE: 09/16/2010 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: 09/16/2010 Use Column ion Contracts where variable retainage for line items may apply. PROJECT NO,: 2695-4280 A - B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED BALANCE RETAINAGE NO. VALUE APPLICATION THIS STORED AND STORED Si; TO CE VARIABLE) (Di-E) PERIOD (NOT IN TO DATE (G+C) FINISH RATE 0 ORE) (DH-E=P) tC-G) 30050 Plenum Level 517.179.00 $17,00721 50.00 50.00 517.007.21 99% $171.79 $0.00 30050 Orchestra Low Level $25,620.00 $25,353.80 $0.00 $0.00 $26,352.80 99% 526620 $0.00 30070 Orchestra High Level $15.012-00 $14,861-88 $0-00 $0.00 514,861.88 99% 5150.12 $0.00 30080 Box Tier Level $31.572.00 529,046.00 50.00 50.00 529.0 4.6.00 92% $2,525,00 $0.00 30090 Balcony Low Level $16,328-00 $14,695 00 $0.00 $0.00 514,695.00 90% 51,633300 $0-00 30100 Balcony High Level 534.822 00 531339,85 50.00 $0.00 531,339.85 90% 53,482.15 50.00 30110 Attic 50 It Level S=.333.00 54,333.00 $0.00 $0.00 $4.333-00 100% $0.00 $0.00 30120 Attic 66 ft. Level $9,673.00 $9,67300 50-00 $0 00 $9.573 00 100% 50,00 $0.00 30130 Attic 80 ft, level $15.554.00 $15,554.00 50.00 50.00 515.554.00 100% '50,00 SC 00 ALLOWANCE 50.00 50.00 50.00 50.00 $0.00 0% 50.00 50.00 4280A-001 51.940.00 51,940.00 50.00 $0.00 $1,940.00 100% 5000 50.00 4280A-002 5911.00 $911.00 50.00 50.00 5911.00 100% 50.00 $0.00 4250A-003 Reduction $25,000.00 $0.00 $0.00 $0.00 $0.00 0% 525,000.00 50.00 4280A-004 5531.00 5531.00 $0.00 $0.00 5531.00 100% 50.00 50.00 4280A-005 $5.064.00 $5,064.00 $0.00 $0.00 $5,064.00 100% $0.00 $0-00 4280A-006 $614-00 $614.00 $0.00 $0.00 3614.00 100% $0.00 $0.00 4280A-007 514.235.00 514,236.00 $0.00 S0,00 $14,236,00 100% 50.00 50.00 2695-4280-04 Addticn 513.44 45.00 50.00 $0.00 $0.00 S0,00 0°/ $13.445.00 $0.00 4280A-009 $2,755.00 52,765.00 $0.00 50 A0 $2,765.00 100% $0.00 $0.00 4280A-010 $1,656.00 51,655.00 $0.00 50.00 51,556.00 100% 50.00 50.00 4280A-012 $1,351.00 51181 00 $0.00 $0.00 $1.361.00 100% $0.00 $0.00 42804-013 $501.00 $501.00 $0.00 50.00 $501.00 100% 50.00 $0.00 4260A-014 $1,976.00 $1.976.00 $0.00 5000 $1,976.00 100% $0.00 $0.00 CHANGE ORDERS $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 Change Order I RFO 006 $4,601.00 $4,601.00 $0.00 $0.00 54,601.00 100% $0.00 $0.00 Change Order I ($25,150.00) $0.00 $0.00 $0.00 0% ($25,150.00) $0.00 Change Order 2 $20,120.00 $0-00 $0.00 $0.1.00 0% $20,120.00 $0.00 Simplex-Grinnell DETAIL AND CONTINUATION SHEET APPLICATION AND CERTIFICATE FOR PAYMENT, SimplexGrinnell LP APPLICATION NO,: 22 containing Contractor's signed Certification, is attached CARIvlEL PERFORMING ARTS APPLICATION DATE: 09/16/2010 In tabulations below, amounts are staled to the nearest dollar. PERIOD TO: 09116/2010 Use Column I on Contracts where variable retainage for line items may apply, PROJECT NO.: 2695-4280 A R C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM DESCRIPTION OF WORE SCHEDULED FROM PRE VIOL'S PRESENT],Y COMPLETED BALANCE RETAINAGE NO, VALUE APPLICATION THIS STORED AND STORED 81 TO (IF VARIABLE) (D+E) PERIOD (NOT IN '1'O DATE (0-C) F]NISH RATE D OR E) (DTE+F) (C-CB Steet Issue 550,000.00 50.00 550,000.00 50.00 550.000.00 100% 50.00 50.00 TOTALS 5664.930.00 5587.785.91 $50,000.00 50.00 5637,785.91 96% 527,14409 50.00 • SimplexGrinnel! 11820 Pendleton Pike,Indianapolis,IN 46236 S6ffiliplene innell BE SAFE. A Tyco International Company UNCONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT The undersigned has been paid and has received a progress payment in the sum of $50,000 for labor, services, equipment or material furnished to City of Carmel for the job of Carmel Performing Arts Center located at 777 3rd Ave, Carmel IN 46032 and does hereby waive any mechanic's lien, stop notice or bond right that the undersigned has on the above referenced job to the following extent. This release covers a progress payment for labor, services, equipment or material furnished to City of Carmel through 9/21/10 . DATED: 9/21/2010 SimplexxGGjriinneell LP .) BY: -�/ ITS: 0ii54r tJ Bust.\cSS 01An cr State of: Indiana County of: Marion S rn to and subscribed before me this 21st day of September, 2010. • ecv 7 Notary Public My Commission Expires: PAULA K. LEWIS Notary Public- Seal State of Indiana 1 My Commission Expires Aug 12, 2917