2012 CRC Nash Building Pay request 07 Disbursement Number#7
E-Mail the signed Disbursement Direction to:
Huntington National bank Corporate Trust Department (INHP22)
Attn: Kim Wilson kim.wilson @huntington.com (317) 229-4094
Ellen Campbell Ellen.campbell @huntington.com (616) 235-5941
Re: Depository Agreement between the City of Carmel and Huntington National
Bank, dated December 31, 2012-Trust#4087000414
Dear Kim:
On May 7, 2014,you are hereby authorized and directed, as the Depositary under
the above referenced Agreement,to pay the amounts set forth on the attached
Register of Claims from the above-referenced Trust account and overnight checks
to:
Carmel Redevelopment Commission
Attention: Mike Lee
30 W Main Street, Suite 220
Carmel, IN 46032
City of Carmel, IN //{{
r / F
By: A /
Diana L. Cordray, Clerk-Treasurer
CARMEL REDEVELOPMENT COMMISSION
Register of Claims
5/1/2014
Payment Request #7
Amount of Wire
Vendor Address Invoice Description Instructions
720 3rd Ave SW Carmel,IN Pay app 7,Nash garage
Signature Construction Services 46032 $ 1,292.30 construction mgt IF NEEDED
2602 N Arlington Ave
Maxwell Electric Indianapolis,IN 46218 $ 4,332.38 Pay app 4,Garage&ramp IF NEEDED
2603 N Arlington Ave
Maxwell Electric Indianapolis,IN 46218 $ 61,469.28 Pay app 5,Garage&ramp IF NEEDED
Total: $ 67,093.96
ALLOWANCE OF CLAIMS
We have examined the claims listed on the above Register of Claims,consisting of 1 page(s),and except for claims not allowed as
shown on the register such claims are hereby allowed in the total amount of: $ 67,093.96
51j /;oI
Director of the CRC Date
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 2
TO OWNER CRC at City of Carmel PROJECT: Nash Garage APPLICATION NO Application a 7 Distribution to
Carmel Indiana 46032 Signature costs OWNER
'ARCHITECT
PERIOD TO 04/25/2014 X CONTRACTOR.
FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design
Signature Construction Services LLC
720 3rd Avenue S . PROJECT NOS:
Carmel,Indiana 46032
CONTRACT FOR CONTRACT DATE:
CONTRACTOR'S APPLICATION FOR PAYMENT I'he 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 0703,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 $ 156,776.00
2. Net change by Change Orders $ 0.00 CONTRACTOR:
3. CONTRACT SUM TO DATE(Line 1.�.2) $ 156,776.00
4. TOTAL COMPLETED&STORED TO $ 139,976 10 /
/By' ,5 / Date
5. RETAINAGE: Thoma ontz,President f( J!
a. 10%of Completed Work $ 0 Subscribed and I vom to before me this a 1 day of ! t/
(Column D+Eon G703)
.-r-•�. ¢,; LINDA G. k BUCHANAN
Hancock County
b %of Stored Material ,, .f-•- +_ r
(Column F on G703) .�.SEAr,,_,= My Commission Expires
Total Retainage(Lines 5a+Sb or 1'-.&∎!?a,`' August 20,2019
Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMEN
6. TOTAL EARNED LESS RETAINAGE $ 139,976.10 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 Architect's knowledge,information and belief the Work has progressed as indicated,
PAYMENT(Line 6 from prior Certificate) $ 138,683.80 the quality of the Work is in accordance with the Contract Documents,and the Contractor
8. CURRENT PAYMENT DUE $ 1,292.30 is entitled to payment of the AMOUNT CERTIFIED.
9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 16,799.90
(Line 3 less Line 6) AMOUNT CERTIFIED $ 2.
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified• fers from the amount applied Initial all figures on this
Total changes approved Application and o.t e 'ontin • to .h that are changed to conform with the amount certified.)
in previous months by Owner ARCHITEC
Total approved this Month By: illike! i 1 ` Date: V
TOTALS $0.00 $0.00 This Ceni I• to is not neg.tiable. The AM b. T CER IFIED is payable only to the
Contractor na-•ed tie in Issuance,payment and acceptance of payment are without
NET CHANGES by Change Order $0.00 prejudice to any r • s of the Owner or Contractor under this Contract.
AIA DOCUMENT 0702-APPLICATION AND CERTIFICATION FOR PAYMENT-1992 EDITION-AIA-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 0401-Certification of Document's Authenticity from the Licensee.
SIGNATURE CONSTRUCTION LLC
720 3rd Avenue, S. W.
Carmel, Indiana 46032
Application # 7
4/25/14
Nash Garage
Carmel, Indiana
Revised WORK COMPLETED TOTAL BALANCE TO
DESCRIPTION OF SCHEDULED Change SCHEDULED FROM PREVIOUS THIS COMPLETED AND FINISH
WORK VALUE Orders VALUE APPLICATIONS PERIOD STORED TO DATE % LESS RETAINAGE RETAINAGE
General Conditions 92,161.00 92,161.00 92,161.00 0.00 92,161.00 100% 0.00 0.00
Construction Management Fee 64,615.00 64,615.00 46,522.80 1,292.30 47,815.10 74% 16,799.90 0.00
156,776.00 0.00 156,776.00 138,683.80 1,292.30 139,976.10 89% 16,799.90 0.00
•
AIA Type Doc,...,ent '
Application and Certification for Payment
Page 1 of 2
TO(OWNER):City of Carmel PROJECT:CITY CENTER GARAGE
Redevelopment Commission ONE PEDCOR SO APPLICATION NO: 3314-4 DISTRIBUTION
9-54 Parking Garage&Ramp 720 3RD AVE. S.W. PERIOD 70:3/20/2014 TO:
IN 46032 CARMEL, IN 46032 _OWNER
_ARCHITECT
FROM(CONTRACTOR): MAXWELL ELECTRIC VIA(ARCHITECT): ARCHITECTS _CONTRACTOR
2601 N ARLINGTON AVE PROJECT NO:
INDIANAPOLIS, IN 46218
RFrEIVF1) t,, 7 ' 2014
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 $_ 157,244.00
2.Net Change by Change Orders $ 0.00 CONTRACTOR: MAXWELL ELECTRIC
1 N RLINGTON E I IANAPOLIS, IN 46218
3.CONTRACT SUM TO DATE (Line 1 +2) $ 157,244.00
4.TOTAL COMPLETED AND STORED TO DATE $ 71,473.60 By: Jfc Date: V �`t
5.RETAINAGE: Paul Hood / Project Manager
a. 10.00%of Completed Work $ 7,147.36 State of: IN
County of: Marion
b. 0-00%of Stored Material $ 0.00 Subscribed and Sworn to before me this T
Z 0 Day of Ala, � zo l
Total retainage(Line 5a+5b) '
g ( ) $ 7,147.36 Notary Public: - * .
My Commission Expires: ZIZ.212 i) ,
6.TOTAL EARNED LESS RETAINAGE $ 64,326.24 ,'Viii, -ac
(Line 4 less Line 5 Total) ARCHITECT'S CERTIFICATE FOR PA f NT
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,based on on-site"observations and the data corn-
(Line 6 from prior Certificate) $ 59,993.86 prising the above application, the Architect certifies to gwner that to the best of the Architect's
knowledge,information and belief the Work has'rtf ressed as indicated,the quality of the work
8.CURRENT PAYMENT DUE $ 4,332.38 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) $ 92,917.76
?"-/-1.361
AMOUNT CERTIFIED $ 4
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied. Initial all figures on this
Application and on he ontinuation Sheet that am changed to conform to the amount certified,)
Total changes approved in ARCHITEC
previous months by Owner 0.00 0.00
By: : ��� Date: 7,
1 !L 'j'
Total approved this Month 0.00 0.00 This Certifi .te is not r egotiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS named herein. su••ce, Payment and acceptance of payment are without prejudice to any
0.00 0.00 rights of the Owner or Contractor under this Contract.
NET CHANGES by Change Order 0.00
\,
AIA Type Document
Application and Certification for Payment
Page 2 of 2
TO(OWNER):City of Carmel PROJECT: CITY CENTER GARAGE
Redevelopment Commission ONE PEDCOR SQ APPLICATION NO: 3314-4 DISTRIBUTION
9-54 Parking Garage&Ramp 720 3RD AVE. S.W. PERIOD TO:3/20/2014 TO:
IN 46032 CARMEL, IN 46032 OWNER
ARCHITECT
_
FROM(CONTRACTOR): MAXWELL ELECTRIC CONTRACTOR
VIA(ARCHITECT): ARCHITECTS
2601 N ARLINGTON AVE PROJECT NO:
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 17,200.00 11,180.00 0.00 0.00 11,180.00 65.00 6,020.00 1,118.00
2 Lighting Installation 16,440.00 0.00 0.00 0.00
0.00 0.00 16,440.00 0.00
3 Gear/Panels 37,900.00 33,352.00 0.00 0.00 33,352.00 88.00 4,548.00 3,335.20
4 Gear/Panel Installation 21,364.00 4,486.44 1,922.76 0.00 6,409.20 30.00 14,954.80
640.92
5 General Material 41,300.00 12,803.00 2,891.00 0.00 15,694.00 38.00 25,606.00 1,569.40
6 General Material Installation 23,040.00 4,838.40 0.00 0.00 4,838.40 21.00 18,201.60 483.84
REPORT TOTALS $157,244.00 $66,659.84 $4,813.76 $0.00 $71,473.60 45.45 $85,770.40
$7,147.36
SUBCONTRACTOR'S AND SUPPLIER'S AFFIDAVIT,
WAIVER OF LIEN
AND AGREEMENT FOR INDEMNIFICATION
FINAL XX PARTIAL
Paul Hood being duly sworn stated the following:
Name of Subcontractor or Supplier: Carmel City Center
Name of General Contractor: Maxwell Electric
Project Location: City Center Garage
PARTIAL WAIVER: that the balance due from the General Contractor is the sum of
Dollars ( g 4,332.38 )
receipt of which is hereby acknowledged;or
XX the payment of which has been promised as the sole consideration for this Affidavit and
Partial Waiver of Lien which is given,effective upon receipt of such payment;
FINAL WAIVER: That the final balance due from the General Contractor is the sum of
Dollars( $ )
receipt of which is hereby acknowledged;or
the payment of which has been promised as the sole consideration for this Affidavit and
Final Waiver of Lien which is given, effective upon receipt of such payment;
THEREFORE,the undersigned waives and releases the Owner of said premises,any and all lien or claim
whatsoever on the above-described property and Improvements thereon on account of labor or material or i
both,furnished by the undersigned,and further certifies that no other party has nay claim or right to a lien
on account of any work performed or material furnished to the undersigned for said project,and within the
scope of this affidavit and waiver.
Unconditional Agreement to Indemnify. Upon the condition that Subcontractor receives payment of the
above listed amount,and in consideration of that payment,Subcontractor/Supplier agrees to indemnify and
hold Owner and Contractor harmless against all claims and mechanic's liens on or against the Premises for
any labor,materials,equipment,tools or services performed or provided by or through
Subcontractor/Supplier relating to the Project.
CONTRACT . i 7
irD CI
By:
Printed: aut Hood
Title: Project Manger/Agent
STATE OF Indiana )
)SS:
COUNTY OF Marion )
Subscribed and sworn to before me,a Notary Public in and for, ai4Vjy and State,this
20th clay of March ,2014. __ ..:,'^;a .T 4t ,
c�.' /°� •7.1 ' d ;---,•
My commission expires: 2/22/20 `tai `
.fin
Residing in Hancock County,IN Signature 4'°, -:; a
Printed: cki'Ei¢uugh
TARY PUBLIC
AIA Type Document
Application and Certification for Payment
Page 1 of 2
TO(OWNER):City of Carmel PROJECT:CITY CENTER-GARAGE _
APPLICATION NO: 3314-5 DISTRIBUTION
Redevelopment Commission ONE PEDCOR SO- —
9-54 Parking Garage&Ramp 720 3RD AVE. S.W. PERIOD 70:4/1512014 TO:
IN 46032 CARMEL, IN 46032 OWNER
_ARCHITECT
FROM(CONTRACTOR):MAXWELL ELECTRIC VIA(ARCHITECT): _CONTRACTOR
ARCHITECT'
2601 N ARLINGTON AVE S
INDIANAPOLIS, IN 46218 PROJECT NO:
RECEIVED APR 1 8 MU
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 $ 157,244.00
2.Net Change by Change Orders $ 0.00 CONTRACTOR: MAXWELL ELECTRIC
3601 N ARLINGTON AVE INDIANAPOLIS, IN 46218
3.CONTRACT SUM TO DATE (Line 1 +2) $ 157,244.00
4.TOTAL COMPLETED AND STORED TO DATE $ 139,772.80 �/ / /
By: l <.tv1 Date: `7 -/(x')`-1
5.RETAINAGE: Paul Hood / Project Manager
a. 10.00%of Completed Work $ 13,977.28 State of:IN
County of Marion
b 0.00%of Stored Material 1(i"4--- / .
$ 0.00 Subscribed and Sworn to before me this Day of • .` i
g (Line 5b) Notary Public: "'
Total retainage Line 5a+5b $ 13,977.28 ,,4 T le
My Commission Expires: � ,(
7„) ✓`z ,/4-
6.TOTAL EARNED LESS RETAINAGE $ 125,795.52
(Line 4 less Line 5 Total) ARCHITECT'S CE RTI FICA E FJR PAYM T. ..:.:�
7.LESS PREVIOUS CERTIFICATES FOR PAYMENT In Accordance with the Contract Documents,bas on-site observations and the data corn-
(Line 6 from prior Certificate) $ 64,326.24 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 $ 61,469.28 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) $ 31,448.48
AMOUNT CERTIFIED $ 41,
-
CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation i . ••:. . c.rtified differs from the amount applied. Initial all figures on this
Application and on 'I- Conlin Iii•,n Sheet that are changed to conform to the amount certified.)
Total changes approved in ARCHITE •previous months by Owner 0.00 0.00 J
By. ��. ��► Date:
Total approved this Month 0.00 0.00 This Certifi - - is not egotiable. The AMOUNT CERTIFIED is payable only to the Contractor
TOTALS named herein. Is '- ce,Payment and acceptance of payment are without prejudice to any
0.00 0.00 rights of the Owner or Contractor under this Contract.
NET CHANGES by Change Order 0.00
.. 1 ; fl 7711,4
•
AIA Type Document :
Application and Certification for Payment
Page 2 of 2
TO(OWNER):City of Carmel
Redevelopment Commission PROJECT: CITY CENTER GARAGE APPLICATION NO: 3314-5 DISTRIBUTION
9-54 Parking Garage&Ramp ONE PEDCOR SQ
720 3RD AVE.S.W. PERIOD TO:4/15/2014 TO:
IN 46032 CARMEL, IN 46032 _OWNER
_ARCHITECT
FROM(CONTRACTOR): MAXWELL ELECTRIC _CONTRACTOR
VIA(ARCHITECT): ARCHITECT'S
2601 N ARLINGTON AVE PROJECT NO:
INDIANAPOLIS, IN 46218
CONTRACT FOR:
CONTRACT DATE:
SCHEDULE PREVIOUS COMPLETED STORED COMPLETED
ITEM DESCRIPTION VALUE APPLICATIONS THIS PERIOD MATERIAL STORED
BALANCE RETAENAGE
1 Light Fixtures 17,200.00 11,180.00 4,128.00
0.00 15,308.00 89.00 1,892.00 1,530.80
2 Lighting Installation 16,440.00 0.00 10,686.00 0.00 10,686.00 65.00 5,754.00 1,068.60
3 Gear/Panels 37,900.00 33,352.00 3,790.00 0.00 37,142.00 98.00 758.00 3,714.20
4 Gear/Panel Installation 21,364.00 6,409.20 13,886.60 0.00 20,295.80 95.00 1,068.20 2,029.58
5 General Material 41,300.00 15,694.00 21,063.00 0.00 36,757.00 89.00 4,543.00
3,675.70
6 General Material Installation 23,040.00 4,838.40 14,745.60 0.00 19,584.00 85.00 3,456.00 1,958.40
REPORT TOTALS $157,244.00 $71,473.60 $68,299.20 $0.00 $139,772.80 88.89 $17,471.20
$13,977.28
SUBCONTRACTOR'S AND SUPPLIER'S AFFIDAVIT,
WAIVER OF LIEN
AND AGREEMENT FOR INDEMNIFICATION
FINAL XX PARTIAL
Paul Hood being duly sworn stated the following:
Name of Subcontractor or Supplier: Signature Construction
Name of General Contractor: Maxwell Electric
Project Location: City Center Garage
PARTIAL WAIVER: that the balance due from the General Contractor is the sum of
Dollars ( $13,227.86 )
receipt of which is hereby acknowledged;or
XX the payment of which has been promised as the sole consideration for this Affidavit and
Partial Waiver of Lien which is given,effective upon receipt of such payment;
FINAL WAIVER: That the final balance due from the General Contractor is the sum of
Dollars($ )
receipt of which is hereby acknowledged;or
the payment of which has been promised as the sole consideration for this Affidavit and
Final Waiver of Lien which is given,effective upon receipt of such payment;
THEREFORE,the undersigned waives and releases the Owner of said premises,any and all lien or claim
whatsoever on the above-described property and Improvements thereon on account of labor or material or
both,furnished by the undersigned,and further certifies that no other party has nay claim or right to a lien
on account of any work performed or material furnished to the undersigned for said project,and within the
scope of this affidavit and waiver.
Unconditional Agreement to Indemn . Upon the condition that Subcontractor receives payment of the
above listed amount,and in consideration of that payment,Subcontractor/Supplier agrees to indemnify and
hold Owner and Contractor harmless against all claims and mechanic's liens on or against the Premises for
any labor,materials,equipment,tools or services performed or provided by or through
Subcontractor/Supplier relating to the Project.
CONTRACT
By: %461_,P i v(Y(
Printed:Paul Hood
Title: Project Management
STATE OF Indiana
)SS:
COUNTY OF Marion )
Subscribed and sworn to before me,a Notary Public in and for said County and State,this
17st day of April ,2014.
My commission expires: 2/22/20 :
r�
Residing in Hancock County,TN Signa ,e
Printed Jacki Hough ' �e...�
NO 'ARY PUBLIC*