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Draw 2 FALCON NEST II LLC 4 • February 14, 2014 Diana L. Cordray Carmel Clerk Treasurer (317)571-2414 Via E-mail: DCordr;:i&caimel in.cov; :nke t:.-lylorcd,,fVarfinzinciaLcorn Re: Legacy TIF—Draw#2 Dear Diana: Attached please find the Legacy TIF draw for the current month. If everything is in order, please sign the Request for Disbursement Form and forward this draw to the Trustee. Also attached is a budget sheet that will track all costs to date. Please let me know if you have any questions. Sincerely, Rajai Zuniot Member of SALT. LLC 1336 BEVERLY RD SLITE 250 • ;`,.,1 -1._,F,AN, VA •22101 PEJONF: (703) 893-7233 • FAX: (7°3) 893-3267 STATEMENT N(.). 2 REQUESTING DISBL1RSEMENT OF FUNDS FROM PROJECT FtIN1.: Pt.. R.SUAN-F TO SECTION'4.3 OF THE 'I"1:US'I INL)L.ti'IVRI_. BETWEEN EN °1 H CITY OF C".=ARME €.., INDIANA AND REGIONS BANK, AS TRUSTEE Pursuant to Section 4.3 of the [rust indenture (the "Indenture") dated as of December I. 2013. between the City of-Carmel. Indiana (the "Issuer-) and Regsions Bank (the "Trustee"). the undersigned, as the Authorized Representative (as defined in the Indenture) of the Company, hereby requests and authorizes the 'I.rustee, as depository of the Project Fund created by and as defined in the Indenture to pay to the Company or to the person(s) listed on the Disbursement Schedule attached hereto out of the moneys on deposit in the Project Fund, the aggregate sum of S 40,948.74 to pay such person(s) or to reimburse the Company m full. as indicated in the Disbursement Schedule, i'or advances, payments and expenditures made by it in connection with the items listed in the Disbursement Schedule. In connection with the foregoing request and authorization, the undersigned hereby certifies that: (a) the costs of an aggregate amount set forth in this written request have been made or incurred and were necessary for the construction of the Project and were made err incurTed in accordance with the construction contracts, plans and specifications,or purchase contracts therefor then in effect or that the amounts set forth in such written request are for allowable Costs of Construction of the Project; (b) the amount paid or to he paid, as set forth in this written request, is reasonable a.nd represents a part of the amount payable for the Costs of Construction of the Project all in accordance with the cost budget; and that such payment was not paid in advance of the time. if any, fixed. for payment and was made in accordance with the terms of any contracts applicable thereto and in accordance with usual and customary practice under existing conditions; (c.) no part of said costs was included in any written request previously filed with the Trustee under the provisions hereof: and (d) such costs are appropriate for the expenditure of proceeds of the Bonds under the Act. This statement and all exhibits hereto, including the Disbursement Schedule. shall be conclusive evidence of the facts and statements set forth herein and shall constitute full warrant, protection and authority to the Trustee fin- its actions taken pursuant hereto; and This statement constitutes the approval of the Company of each disbursement hereby requested and authorized. IN 1 `l_f_N1= S \\ HEREOF. the nuthorized re re r mkt'. of the Co npariv has sel. his hand 2S of the rtefFdav of. 2 &.3 20 FALCON NEST II [LC. an Indiana limited liability company By: SALT. LLC. ; lerilbtr•--. —W_ B : Rajai Zumot. Mem er()IS.'1 LT, I_I.0 • 2 Pursuant to Section 4.3 or the indenture the torewuoing disbursement request is hereby • approved: C'I'TY 02 CARME[... N •IA NA I l.)iriiia l._.Cordray, 1.AN1C.Clerk-T,,,,..?urer 1 Legacy TIF Drow 1 Application No.; 2 Application Date. 14-Feb-14 Prepared By: Kathy Tekutve Telephone No: (317)863-2052 Amount , FT- 40,948,741 Reference or Total Retainage Invoice Work This Invoice Code Contractor/Payee Number Completed Period Amount 3 Stoepperlwerlh 8,Assocs., Inc. 186721 „_$ 495,00 $ 495.00 $----- 495.00 $ - $ 495.00 4 Weihe Constriction 3518 5 41.774.28 $ (4,177.43) $ 37,596.85 S 41,774.28 $ (4,177.43) $ 37.596.85 Management Fees 1036 5 3,170.20 $ (313.31) S 2,856.89 $ 3,170.20 $ (313.31) 5 2,856.89 Total $ 45,439,48 . $ (4,490.74) S 40,94814 _.., _._ :--- - $ 0.00 i of i 1 PLATINUM PROPERTIES MANAGEMENT COMPANY, LLC INVOICE 1037 February 14, 2014 Zumot Real Estate Management, Inc. rzumot @zumot.net Falcon Nest II, LLC 1356 Beverly Road Suite 300 McLean, VA 22101 Re: Development Service Fees - The Legacy TIF Draw Summary of February 2014 Construction Costs: Stoeppelwerth & Assocs., Inc. $ 495.00 Weihe Construction $ 37,596.85 Total Monthly Costs $ 38,091.85 Development Fee @ 7.5% $ 2,856.89 Please remit payment to: Platinum Properties Management Company, LLC 9757 Westpoint Drive,Ste 600 Indianapolis, IN 46256 9757 Westpoint Drive,Suite 600, Indianapolis, IN 46256 (317) 818-2900 d w . S T O E P P E L W E R T H ofc: 317.849.5935 ;'965 E ast 1.06.th ST.rQe: r- • _A fax: 317 S4+9.5902 t'oher , rd$ana,i1.6033. t , ti'ikYi ph' `t3tp;-.✓1''e'Chccr FALCON NEST II, LLC invoice.number 186721 0/0 PLATINUM PROPERTIES,LLC Date 02107/2014 9757 WEST POINT DRIVE SUITE 600 Project 55115PLA-HP LEGACY-HOPEWELL INDIANAPO1..IS, IN 45256 PARKWAY Professional Serves fo the Period:January 2014 ) \• Contract Percent Total Poor Cuareril Description Amount Complete Billed Billed Billed Overall Design Outside Consultant Reveiw-Williams Creek 750.00 0.00 0.00 0.00 0.00 Subtotal 750,00 0.00 0.00 0.00 0.00 Final Design Design&Construction Document Preparation 10,550.00 100.00 10,550 00 10,550.00 0.00 Design&Const.Docs for Drainage Linear Ditch 825.00 100.00 825.00 825.00 0 00 Subtotal 11.37;00 100.00 11,375 00 11,375 00 0.00 Construction Services Construction Staking 3,450.00 65 00 2,242.50 1.897.50 345.00 Subtotal 3,450.00 65 00 2,242.50 1,897.50 345.00 Completion Certifications Watermain(Hydrant&Valve Locations only) 400.00 100.00 400.00 0.00 400.00 Storm Sewers 1,280.00 0.00 0.00 0.00 0.00 Sanitary Sewer Manholes 360.00 100.00 360.00 0.00 360.00 Drainage Swale from Linear Ditch to D010 200.00 0.00 0.00 0.00 0.00 Subtotal 2,24000 33.93 760.00 0.00 760.00 Monumentation Street Centerline Monuments 525.00 0.00 0 00 0 00 0.00 Subtotal 525.00 0.00 0,00 0 00 0.00 Additional Services 0.00 0 00 2,245 00 1.400.00 345.00 'STORM ORDERED TOO FAR iN ADVANCE. REQUIRED CREWS TO GO BACK AND RECHECK STORM S TAKES- $350 'STAKE OFFSITE YES BASIN AND ASSOCIATED SWALE FROM 006-$.495(AREA NOT INCL L.JDE.-D WHEN CONTRACT WAS PREPARED) Total '18.340.00 90 64 16,622.50 14,672 50 1.950 00 ;t: .I- .. i.;E ,t :f{ 1 a,4-t .. `.:_ .t`t...: . Inv:Dice'total ,950,001.... Aging Summary .- , :',., . 1 i 1 r _ f tT InVOICe�'t:rnbcr invoice Date Outstanding C frrent Over 30 _,0'ec 613 Over 30 Over 126-1 '.136721 02/07/2014 1,950 00 1,950 00 "I ota i __. 5550.00 1,950 00 0 00 0.00 000 0.00 FALCON t4rsI i! Li('; !nvc c£nurr t.,ur 186721 551•SPL..A-HP LEGACY-HOPEWELL PARKWAY Dale 02'"'72CI If any portion of this invoice is in dispute, it is the clients responsibility to notify Sloepociviertll&Associates. Inc.in wi iinp within thirty (30)calendar days from the dale of the invoice. The Ghent rerr'1ai'is responsible for paying the undisputed oortion of the invoice by the due date. Any invoices unpaid after 30 days shall incur a finance charge of one-arid-one-half j? .,)percent of the invoiced amount per month, excepting any disputed portion of/hO i,i'VOICC(l amount. Payment thereafter shall be applied first to accrued interest and then to the unpaid principal amount. • APPL!CATION FOR PAYMENT pRo.,-:1 N.fmof Litvacy Towns A.f ill,Ph II Off.vie co,e,1,-;:ki,.-rit4 mt.,,i■VT.-1 Plat.-■..,n,PI opt,lie8 LLC (7,:.,tilf.,,AC. 0,... .,..v., -...:,,..t ,,.nn r, ,1•.0.1:).:".,Nr., 3`,"..,■,•k 2.=' ;ON!"...,:- 0.1.,4.7%,,,,; ,r)1-.,TA,:". 1,1 waiter ,-NI Ac, t,,,-s, AFrt ir.e.nt".N DAIL ..( 11 S...te V: Aznio.:ss p,t t wastoo,nt cm,.fic,,,...3,:Y: ,,.0;5a4F.:is 1 S.,1'f>,,,,r.,,,....,...., a.,F•ii.04Aa, ,i,,,,,,...,.<„,,,,,...,.,:-,•,; ,-.i„,,,,,r.... .,, ,t.:46;....,6 ,,,,.......,.,.., .a.■ ,,,.: t‘Pr'R.'5,1•Li,,, ? ,• ," n,,,,. ••• .,,.,•,, 5 •F9'.' 1i , .,, -- -,,,,,-.716C - ,/,...".:',0!-•,:,, ..... ,...,, ,_., ''''..Li. ...1 if.'T C C.' ,..„. r., , .. _r_ .. , _ v .,..., , __ ,i-F..i•G, _ _ ........._ • — i.,,.rwt : C.,`,.,I ,,,,.r›,...,,,,CS, 1 PrAf Com,,,Pil r+.,...,1.,j i ROtd,,,,,,, i ,WA' , .. _ 4 • . 4 7 va,,,,c, 11 1-.1. Sk.",,,,1 Ar0 th-,,,,Tli 3,,, ;..,0,,o, f--,,,,,-,.2■- .1`j,.■7,2=_I P,,,,,,, Legacy Towns&FInts Ph I,-Offsle . Earl hwora, i ! : L.,*.;y • •4 Demoi•t5o1 14t:.:Iti Fo RAN i NA $19 715 t%4 i 1 i t { y 1 AO F.,;(,,m1,,s,nEl i.."',.ont,,•,3 ',IA $5,22.Si.24 fi.::',.2',8 r", S!,2M 24 , . ?1 I V.■23.E? ■ i5,;,,,.;:,' 1 S'( ',IA SS 57:'..1!.i I:,..1,)0n?'. V.•;.',":00:43 ••,•i 1..")...._., i $63U OA ; 1... v • 49 Se&Fr,...,C.rathr.1 Stree, !,,f A CA.058 1 i'l SS,641 lt; V,.61 1 15 ",P.,1 : 1 $2981 ''•1 I i Sc51 tai:pi,:eat.on NA S-539.277.;% 1 $4.7,7,,°•,...; • € Sate titnitie.s ' I a 1 I gy I St, Santa-y Sc.,,e.,MI;-,,,^, NA • 16.574 DC 116 5:,4 00 ';•'•I 6,.57,1 Go '9'."^1 S;.65,.10 1 S1,6.57 4 0 i S 1.6 5 I 4 G ■ I 7;,,I ha Stor,Sewers NA S37.49A OC, 5:?13•194 00 4,-.3.4 00 ' ^ 1 52 ii 49 10 50 Sub uCc Dra n NA S15,450 01..• ! S,10 f;1' r0 ::.i15 00 ,,', li ',8• "..: I , 1 c l Y r i 75 V1-,1,■,....al 71; NA $64-707,:r.1 ic.1,7u:00 $5",1.701 00 'Y..,. so 4:',.:Ff.) i S 6 -/O D) 1 1'41,47c:1,7o , 1 . 5b M.3,1,,fric.11!.. San SIQrri&WateI; NA 'I V:0•00 i 1 ! -s ,-,c,Go • I 1 Legacy Master Stormwater Park 1 , • Earthwork • 1 . : i i . 1 i t gy.1;.. 4 ."347.00 SFr;;;;;,:n.,, NA 53',14 00 $3 1,4 09 S;).11:.;00 ,-.–.1 53,i C 53,i nO 53''AC' f Lgy SP 4e Mass E‘cavalwr Storm BNIP NA S.:14,41 iti 124,451,7; S24.451 75 vs!:.'•1 $3445 le 5.2,445'''5 $2.145'A $2200560 1 i I gy.SP 1 =to . 1 ' ',:ttr.;A lin sh GrAti,nr.,-S'..c,-^BMP NA .".:L.019 80 i , I 1..7,0 10,50 1 i 1 COzi-Site Conctuto i € I I i Lcv t .9,1 5 Chairtark Curl, i cry€ ,) I1S t0-:0'` 51'.3 8'i0 C) 31:1.86l 60 513 6410 ,... .3551 00 S P)4 or, S'85 wooer Chni,Ra–cs 'i f ,,: r0e21 S 00 0 i I $1,2,10 00 i„gy 1 80 5M".P.o€Char R.arro;i CA WA'‘ I$325,ua 3975.00 1 I I 3137500 i Lqi I An ".:..cmtalor)Area F.:vie...A/3:k I 53}i',.'..' 1.:"i01 3,,1 1 $7.20'7 30 . . Lc/i, ''''' B'C..1.1art>.30 CS.,It IS 13 E"-:.'W f S.`.;965 00 I . S5 iitir,4) 4 1 i gy 1 8C Tra,:sd■on Curt'a''',SiZ,b NA 31'7,'1,0,00 I • I . 1 Sl.iP...! 0 I • 1.9.v; i.ic Mc,1,,y 0=4(.7,-r,-,s 01,0,c S'Sir.' $?.71._<.0(1 1 ' . 1 1.,.-.1fTriP1 MOTII,..,^3,, ,,Bo,e1 NA 5300,00 3300 0') 1 , E 85 C0:2 -Thern,31b1-Ikeis S'120L',1 31 320 00 51.320 00 S':120.00 : ''.,ii'22,,.1: I Si-,,.:.N:. 5 51:12 30 31,1-.,`.;:i OC Loy SP 4e CO53-I.Joae,cui 5 insmIlnor to F3MP NA 517 322 00 ) $17.322.50 Si 322.50 II 732 75 31732.25 i Si 732.25 315.590 25 . I 1---- ' _ ..• TOTAL L $2713.,63.8..) 1 '1 if,i ,711,:'•16 $4..i.o....94 28 -12'11,4-h-..1 rf5 r '''':–I S"6:1 j'i-S°f.'s::$4.:31'0.1" s2n,446 3, i._ .,05 1._ - A. P , _ i . ._ _ Document G702. - 1992 ‘ ('''''-, ( .ri - • - -" pr)iication atld ,,i,q.,Qs:(tc- tot Payt)icrit _ ........... _....._ 10 f.)v,,ri:F. ' U J C C1 r ro-rt I<1,,,,r,I'',, Arp ICATION.Ki.T-' ' r", tt'ibuit_Irrit PER,OD TO; „r,o't,:t( , 3-3,35'!:',/,:,±13 3, ''■3, . 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Cr I it.r-,. __ ________ CONTRACTORS Al'PLICATION FOR PAYMENT 11.,tird ,,, c.ti,trli.,Lor c aiLfief tam V:3i•,7 t,....1 04 ihe',2ecit,,,,a1',kr.s,_,,,init",e,47.1,,nt nt-.,,,t nd'br tie lb-'de it;toy...frt.:I by f..-ft,c A.i.,,,,,,c.,,-tc,t-f ei;','F.vrat-to ,....pi, ,F1:,,,,p,j,i'afkil`1,,n",,,,,,-,nr nt,,r,:1,,,,,brt.,:o,,,,ra z.4)nr.i,+:or,v,-..il.'„,,,r f..:rtiac. ..7,11'z",..ht Ccutt.r 12,),QmcaTt ant 111 R.R..1'irtn,s'tt.g.ve',eft paid ,,r tilt Cont---,,,zer-fir Woer fix: AIA'',,,:-,,,--1,C'71.7'3'" re,tr,tnItrc.r, "...erert, rut 1 t,rttvintlt,It.',11.11,,t,,S fc33 ia30131,7,.wtrr,;..3.1.;,,31‘ !payitte:rds rt,er-nort:d-I.:-.,,,,t OK Own,.tul, 1 1,:\RC,1,44L.C07.11kAel SIJLI 7•..",'1 C•45,10 I.IK n....m..1:t imyMnit 013-3,:c1 ,3.,V,.oncIrce,tv, I r: 7, tit■Gii,ANC,'Fi BY Cu!NC', 1)70'Ll F.. .. . .. I. .7.;2!.,, r,ihrRAC... 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AiirI :Trr i Pizc!!:{-1"•.,.e . • • . , i . . . p. :, 1, i .. . • I ,, 1 ,, • ■ , f. -t • I ,.o.yr,,,..,-)....,1 I 1,,, c.A Li,AI;I: i ..... n...3-1,..: , ' I...A k.,:c ' II RI:SF,,I1., ', 'C"',':',;r,:' : , ' , .III,1),,1 Fp :,,,,,m,,k1;,,,.;.;;;;,; ,Z...;.III1V1::Os:\y'•",:., ',7, I . .' . I '1) I 'A:''' ' M.I.I•1‹..A.,110:, . ''.1.1c:I'FI,,,:f, , ,■;0:,.•,:-,, , IC, i ,' m . •..., r‘ _ ._.,f:r: I (II•r.•ri. 1 ■.., ..' ..: • 1- I , ' i I . I i • 9 6 . i 1 ' 715(4 0i;cn it,'ernol4;;FT1 : 7,5 4 I 9 Si CO el .. I;'riry Erosenc.'„unt,o1 : 5138 24 S2...15 I 5.238 24 i . ! , . 24 I 100 r:o I , • .• f::3 52 o t',1ass Fvcrivati on,S!,pp,t : 8.572.38 1 5,C00 38 i 1 6,00C 38 ! 70 03 '2.572 on 1.A....0 DA , Oil••IO '..ii!e& ,j.,..,;,,ee! 8.058'5 I .•?.641 !IS I : ; .1,641 11: ; ,C1.t.;• ! 2 4 17.0r) 554'2 "1 1" $00 S:Abiiii.,1;;o•'. I 12,750()c ! 5 9)5 00 i 5.925 00 1 70 '',I-) ; 3.825,0c, 5;92 50 '!i,-r'x'; i4Ini"zi.re Sewer 1,1..,-,!,:•, I 1(1 574 CAI 1;')574 00 ! 'in..-4,)0 11.10.,../., , 1.657 4') 01"•00 '4•4;..gf-,St3,,,,,x's 1 37 4H4 01. 2[14114 00 i i 26,40:4 00 , '70,6E1 11 0(0 r,K) riE,on <1,lbswfatle f1,1,-,; i 113.45.0 00 , ''.2.8,51,1t: • : ;;;1815 0i) 70 00 41•35 r;('' I 10E • (4).CO ticlierrn.a,:s : 64,707 on ! .:::4 ,'01(10, ' I 34 107 00 1100.00 ' 4/ %...1 . C 73 (' 717 ror,15, .550,00 i .• ! ,! 21,451 75 ' : • 1 3;14 00 100 00 , 311 AI) r;'XI ri3S0.1...;:tdcpar,' , - -„r I • . : 2 114 00 I ,'14 C1O '.. ,...xcavrttton•So c.,,,,:.' j 24.451 78 ! 24.451 78 '100.00 ' , , •44 :o ; it.,00 tr!le F,,,Si,(1,r11,..•-,StOfm BM> i 7,019 1.1.!0 i I i . . • : . ' 7 019 BC i • CI t,iPtitr.,.;ift C( 1" ' 1 ti 590 00 : 1 A 5.90 Or. ; '8.590 00 I 100 00 i '8:,•,:;:'?0 i1•(12, betiii,.•,-;rt C(). I ; 1.257 50 ' I •1.207 5 C' i .1267 50 I 130 CO 1 I I . ;25,5 : I • ; . . • , ! : • • . , . , I .• .•• . I .• I . : 1 .••• . I • I ! I i ! .• . : . , . . I I I I I . . . • 1 ! 1 I . ; . 1 1 . , .• • .• , ! . .• ; . , . . ! . .• I • I • I I ; • • I I .• : '. I .• • I : I I•1.41-.. _..... ___.: ',1'-1 Ii•rs0 1.47 1,1.18J 1i... ' 41 774 28_ i i :8,-;•••, 1 ty3_ ! 1 44 i 02,034.4,1 i 1$;,928 31 • t.",,,,,,, A.IA COCIFIYIENFI F:77)1•.••:1,1,4i,.•11014'.i.i I.-. fit!:,.',.:2•,',.::1,•1-1,,,,,•‘1,I..: •I•,'I:II:.'-1 io,/....ticr.ir,I.,ii oir i,, .i.,Hi,rtis.,,,,,Ny,yu.,,,z ..1.k._V...t AI.F:;;;F 1.4,'•',...c.,t,I•J•,•'•,L•i.,...,...,,..,,,,•kr,•,,I,WIC, ..4 phntoon,Ing..froint.4 US comrkett taw,.1,3■•••ti sulv,Mr Nolo,x):to 40..94 p.o.,KAAIon, G703-1992 CAU1I04 Yc,,,,.:hould wAr im,,rig■or31 MA dccu mcrtt which hag It,15 cni;tior•printed in Fr Ø.An origin/0 P.SSIII,II th..11Ch,nges wilt nol to nt,scured as tr■Ay°00m c4;111,ds,U.,C;Ilt 5.arc reorotionod • APPLICATION FOR PAYMENT AND PARTIAL RELEASE OF LIEN 'Subcontractor Or SUP;Aier fvirne. Weihe Construction,Inc. Sultcnntratior or Stiopiier Address Noblesville,IN 46060 pnore 1317)776-2965 Type 01 Service FurniStted Construction Ilrenstrtglion Cost Division fetimbei Project(Budding Ivrernher) Legacte'Town a.Rats Ph Owner Plat;ntirn Properties Appction Nurnbcr 3518 • Dale 1/19/29.14 Pericri From 1/1/2011 To 1/30/2014 Original Contract Sum S 2;s.3,995.00 Nee!Change by Approved Change Orders Contract Stern to Datf, $ 241,317.50 Toraf;:n.Platte.Wk Completed 89.73.C6 value Of Matenal Stored on Sge Total Earned to Date $ 199,283.0G Retained Percentage • •• • • • $ 18,928.31 Total Earned Less Retainage . $ 1.?0,3.51.75 ----- Less Previous Certificates for Payment. 132,757.90 Current Payment Due $ 37,596.85 Ttie undersicoed hereby certifies that the ornr)or-rt Exr,ed ariO Dos oisiende,,,,grif or al:mate ,ar‘t,siepolees furnished,and L'31.-,or and services of every nature cerfcrmed iw Jr cord the use on(y connection with the abcrie named Project. ",as been paid in full as per shown(except Amount Due cc r5tthd below)through dip ohnve-mentioned pay perirxi;and 2) The.Undersigned hereby warrants mat tire XeMISCS of t'T above'named jot,cdnnot he madbr s:rbject to any valid lice or claim by anyone who hrnisried materials,suuni,e.s, laWr Cr services to the Unders-gned for use abu'a-riamed Priii(K:t:arid 3) Tin,e Undersigned hereby wolves any and an clams f whatsoever kind or nature against the General Contract,and the Owner,and against the building(s),imoroveme.nts nr Proect,and the and on which came is located for any iabor,materials.or 5upcities furnished or services performed through the above-menrioned pay period.. This release is given in order to induce payment in die Amount Due of$ $ 37,596.85 and on receipt of Amount Due by the Undersigned,this release as to the Amount Due becomes vaild,enforceaore and of full effect. Upon attachment of the legal description of the Project,the rc.iet.--se my be recorded by the Owner or:4ortgagee of the Project. Notwithstanding the forE.,00ing,the Undersigned noes hereby unconditionoliy waive and release any and all liens or rights to liens uPon tne premises,improvements there;o,Or morves due in cdrnection therew-Ith, with respect to monies due the Undersigned for previous payment reQuests in the total sue'of $ 37,595.85 ,the receipt and suffidency of which is hereby ai:kn,owiedge. Dated this 30 day of Jan :014 Weihe Construction,Inc. State cf.Indiana tiNlersicirVi / CO,nt','of Hamilton ) HR/Safety...Direct Softy nc,a hct5r PuOliC sa:o County enr!5!ate,urns day or Jan 2014, oerson;Oy appeared Brian Nifong known to me to tie tiFit/Sifety Director ;;1 fITJJ.i:3iTr5igned ackrov4e.dge the eyecor1ori of the foregoing fa;and on be"ali of the Underskrnc-d. veTTNESST,..rind anti warm!Setd. laa.toir rts,s Jan 201,1 Oct,2015 count'i:rf resioence ..,,torjjj.q.a.. Michelle Garcia • •, ',.2 11 r'o,,. , rir'i‘ 1•''' •. ' 4' t / ocLimetiL r702 — 992 At)plicatior7 i.-itici Cei:.tificate for Pavn7ent i ) ....,_ -------— --- ------- --- ,---.--..c;J I,-,,it' ',.t"A I lo , i ',,,r 't: A 73,ICA7 ION',.0 l'r,)p-,r L, c- I P PERIOD TC;; 0"',...; V, ,'''. i',1 ),,,, C..),',1 RAC< -OR - '', - +,..,„.-,. , 15)2 - ---;C:.' f7 C.;'..,i 5-.'S•' CI,;' V,' -,s,C-h I _-CT' :0',`TRI,CT -,- ,- '',,,,t1),L)(,onc•rk.s.` cm ;-1( /,) ,: ,, c '' c . ( )ce., `‘ -, --':.c.ii.-o,i- NCS '- 'N 0 .1.I t' .\ 4 h()``'' --; CONTRACTORS APPLCATION: FOR PAY; ENT -,he ,,,,,,,,,,,,,,, (...,:,..,-,,(,-, _ 1::,, :m.: '., ::,- .--,-:of f'e (..,,,,tr.,.:);',, ;*;o .,,•, ,..--,, ne,,cf tt-J- -0,';,r',.,,c,vezer, 1,y•1))).. Ap)he it.;);., !,): i' -.1e-.;h;ss :\eL.:1 r. :,-: '•.-- ' .s. 1,_).-. ,,,rraCts f,,. , -.)--..c-: -'c‘c,"'11 i),:i'4,.:1-1..:1('"*.:C:-',,,'; tht-r-r ",':?Lt a•LI- t•,-, Con1rVC: 1.)0,,u:nent•;, s-a: ,,I avy-r,:tr,,.., (:,):,trd,•;.y.- _-) ' ',---,- '- (=`L.;1''' C,-,n),.,,,•,),i S:_e,e,..,‘;L.-A(-...„1. vItn:re,":011, (,..;e):)11(..;Ptc):,for P;"■..1t,t---:we:. GrZ,C=It,'AI, CC:1711/-,C7 SU,',1 -..t.,•c).)-re::4-,))) T,{:=1- c),27:1 1`17.1{• -.7,y• '\,ilic C Lly,111.Ct)(11 in: 2 1:E1 C.:--:A NC,E riY C 1-:.',I,I',3E ORDERS s ' -,- CO'-:T7-',L„Urit"i7 s ) ,•,:: I 7-1„1 t(-t-- .„-- 4---, ., :‘,0;„"ip,:,',7 SI.:;.','M ");--1:. ", -P, ' ;; — 4 .-...)I A (C.:1,r1 F.7ED C.',STC7',E,DTC., '," 'Coh,‘1,2 t,',',7(3,) 1,. ;`) IN, m) r: . --.--4h-t-rir,..) ,2,,,,i,),..-(, \ 0 1", --.-TAINAGF.. :. ,1111-L of ‘, " , ( r-1,., -`s''-.,.7,• 1.)1),ct:1)-(1 and:..',,rn)1,.scf o::-.' 4 ch.--.....,,,.") +-!..',,,-(;7,...',, i c 1 c<Po 1 2 ---- ::•‘• _ : ito „It rA...,..., r rot,-..? r , ,::71:= ' -* Luis-- 1,tril-\\ ' V.,,,cul 11,cic r Lxrrct,;‘, ., l'st-,..11 _;',,','..',;:_ ;..:-' 5),,), -(-.J:P:(:('1, ) 01 G7rr<, _ k C) i -,'et c) __..._____ _____ .TOTAL El.R;:ED LESS:::"I-I,,'',\3:: S ,,,L,t)..1) A.RCHITECT'S CtRTIFICA1E FOR PAYMENT ,,,,,,,V17.5: ,-.r..5 ,-L,-:,, -,c..).-dance-,,,)•!:::Ile Con.',1 act"..,:)c)--,e.-vs,- s;e.on(1-1-yite,.os.,-va.'_to:.,z:•(' _SS PREVIOUS CE'r-N'T'.71C,',T':-S FOR PAN.'1,',E;r7 ,5. ;,.)„," ,. i II-0; __;)_,-:ce,,t-fries;,- :I.);Dv-E.::::„"it%-.)•:-t., -.,.-it..;.,.." •ru-AICLIt.CC'''. _ . !,.)11-.d:011 '17,7 *-)C-It f 'ill:. .A70-i: .1", p:DZ'Criged .IS 1:".e.icatLe, thc c:...a.):, of • .) -1c,-. - - 17•ne 'jr,)•::,...,” o 1_:;','. c t.',' 2.ccoreanct v,11)-). t.:.L C.., ,..:-t ')J(.Irr.e....t.,, arc,' 'ht." C;10::-,LC:0: r 1 _ ,..1xx ,..2 ..--.. -, . . „. LLIRRE-i\T P,e,‘:::ENT DUE i c '\tryl\,'-;(----„,1-F:-.,---) :7) SA' CE TO F-INISH I;','Ci_;,'DI\!`,31.<'ETAIt':-,GE CUNT CEI.',T19:'-_',.: . ', '•,-. !:=2)-r 3..t PL.s 1,t-t,.(.. ‘i__ _.._2 1 1 11._111. -;;;(..tch t t.7,1(v.21z.-;,,.-.;c'n<ru,1!ce1 'it.:(7,4k,:6-orn r;.:^,711runfari.D,7 rr lea: ?',,.,,,,,,,, ?: n:,,c'to))5.:,..-L;:1.--,-T al C rc7.ne :0 ev,.-.1,•;),-:w-t: P.L. -.,,v)•)-.,':',-,,•t;‘,•-' -.;''';.,'‘,NC;L Cr,-;:L.:1''..Z S,21■:iv:2',:..1,'..);', _ -ii,')I,'CI 0:,,,1/4: i'1CHITEC 7.°`/:-c.:::'-:•-F,'-', c ra•::::,.•.':', ,1-.,).;:r.'-),I-■ Ov,)„,- ',, 1- Ily. ) l'o`sa.':Ii•pro,,,t,.,',2',-ot..•„month ,„ .. ;1, _ , I lils C c-t11",c,att..,s17,Qt:lege:1;11)1c T1 c A::0'._,-N-r(:i.,:',271,11-.7-)1F':):V.7-•:-....t.-0,- :-01 AI 1$ ,T, ' tIPtnt-ti I'c.:-:.=:1-„IsfiLLelt,c,pavalent arc,.-czeptl-wc c:pPyr;:rit .;.'1':,.:0:0 — — t)ic nWEC 2:C•Dritrrr.ter un:ler I:1:s Cr;1::',:c• I<: , _ — _L _ , CAL'TION:you s.,omid I.Icm .-tn onc,inzil J",,A Con*rael Docunlont on which ttnS text dppeats li,RCD.An ol ginal nssur,,s that clianclon wit not no obsct.reci— - _ A‘,4,Document C,702-,' 1992 Copyrierttt C;19.53 1963,;93.5 'gel 1978,1983 rntt 19.2:),,,Tt'ef,-.1.C8-''',011/tr.o`A. '...c.'47..Ad rig,it,resorved Vitk-ZNI' ..z.This AiA' Docilft,n. ...,proti,--teci by U S COQ'',- ,-1,"...a ant'Irl:r_r.i.ltinn,):Tet,at,,s.Umt:or zed repro:att.:ion or Ch.t. o,..non of ttsea AIA floc,'tat,or any po t tp,of tt.,may ri_;Jut':la r.c,...to,3,,,,;n,Grlirlrtni ts,,,It.,^ tin''wtil bo pru-4,`,.....1t ,i to 1111:Inn)fir n t xtt.,1* tin,-.hel,,, ,,,,,,)- r, pe,--,t'r-t• ,ep. ,,,,, (1;3;c,,r-,,of tI,v3 e.),:,,,C9`a or t.f11,11Ltr.e. 10 re,..0,-:c.p.,,r ',1 viC,LA 0,'.01,0A enl.f art 1,,c1.tr,,n1,... e-rri IC T',,,A r,c,,,,:s2.^ '1;:i:ite 0'1..C.'t I,C.....5 ',,r,;• COu .c, CONTINUATION SHEET A A ! !‘ )e I \11:. 1- :17i':; -i ; ; -.)r-:,; ;...);. ::-,-(-N:: •;,',:l ,;,',: .\.iA :),,,,unIt':!.! Ct7,...) ',PP:ICATX,'': AN!) (,E1-Cr1F:CATP 12()1( i!‘,-,-m.:N•i ...i, ! -Th . ! t! :.-0!)!•;thitn!' (:;):11!.!■ :!.!!':, c.iyhxci C.•:!nifictuot.. !s :!;r:h 'it::: .`,;T!...!...-AT!,'..Y. !",1.1. h. '::1!!,..ti.k,w, :)c. !\-.. itnothr.:. ht c1;11,-() I,■ I.:;t' 1.;,,,;:if-,‘,1 d..',:n ...i.P.:,•;:', I'Ll i 2-- 2,-,•.1 i 'h 1:!':` I or,: ( s'H I:1•15. ',..;11i'it' •,-,!rh :4!n; <-' ;,-!! .;:t-it. hrh.- h.,,h., :ti,1,1,' Akt:Ii!TF(7‘"; l' (01.!—! N4, , • 1 . i! 1*,17 i', !---` . ., • 1,, , , - I t, , • \',%R:•,. s„trdi'!-''rc;) ...At '.,*-, ''''0,,A. , _ Piz 1.::,1,,,',..-;y : .,;:•;,..11,,r 1 ri,; , -, 1.-,, -,.,,( :. 1;',.:, : ,,:, t;!:',;■ ;;;)-, ;,, wttl< --") 1',:, rz, ,WIC.,)1, -.,,,•, .1 • 1 : 1) ■-');: F'; i I./•I.•1'. . , • • i , :3- :hay-back Curl) 13 860.00 1388C 00 : ' afie no 1.y. Do 1,386 CC 00 'Iyheal Chad-Ramos te,.Par,...) 1.20 00 hail Ramos,'„C 37 i,,Ynialk) I 9 7•5:.';`• :-)4-a:.' C,C.nmon • 0!..{-00 if Chabar...k.Curb 5865 01) CO P1 ii on Curt)and 31;:3;) ' 1 650 CO , I ; ' '.65C O'D . D1-00 Heavy Duly C.,111;5;,`,!..3:,,,f-, ' , 2 771.)C0 I I 2 . [2.C-01 -',:ermal Blan-cets 1.320 00 • 1.320 CO I I 1,320 00 ;10C OC: ; 1 I : I , . ; I : . I . I ; 1 . . , ; I , . . • . . I I ; I 1 I ; i . I , , 1 . . . , I , , 1 , ; . . . , . . • • . . , . ; , . I i I , I , '.:-., ; ..hic ' "Zsi.(3ttfz'f) : '1 1 Rrir!OC. . ".3'' '''' '-'... '' ";!".:‘, MA DOCUMENT 0703 • CnN1 IN' .:si-F,F-r Fc-k,-,-,-:o., • i,-;.? ; ,:i; :..:• MA" • ::‘11'),12 •THE AMER:0,N:Nr,r.TUT:2 i.,I otliti,11:1 I:CI:, I",' .F.‘,' 4\"ITA 1.:,1E.,NV .%VA,'!PX.C,TC■N ,11,. ..,),):16 s20?•=FINING:Llulieent;eci phorocopyintj vvArites 0 S.ropyriyht lawr.,r•incr will sublet:3 the vioInter In legal pronertitioo. G703-1992 CAUTION:You s.houtd use an oriclinr11 Ali',document which la tz thin cr,ution printed in red An original nsstires thin chrincies wit!ncl be nbscweri;--.:.ITIP,r er.:.ur,..!-,;:n Oocurncntr:et 2