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2012 CRC Nash Building pay request 08 0E.0PMENr pCO c0 -um74 e ;F 5 CRC z City of Carmel Indiana CARMEL REDEVELOPMENT COMMISSION Disbursement Number#8 E-Mail the signed Disbursement Direction to: James Brainard Mayor Huntington National bank Corporate Trust Department (INHP22) Commissioners Attn: Kim Wilson kim.wilson(cIhuntington.com (317) 229-4094 William Hammer E1f plJell Ellen (616) 235-5941 President V r ccoA&GiL f ` ,n v∎r)S n-K. David Bowers Vice President Re: Depository Agreement between the City of Carmel and Huntington National Bradley Meyer Bank, dated December 31, 2012-Trust#4087000414 Secretary Jeff Worrell Commissioner Dear Kim: Cowie Meyer On June 2, 2014,you are hereby authorized and directed, as the Depositary under Commissioner 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 Gregory Phillips to: Commissioner Carmel Redevelopment Commission Attention: Mike Lee 30 W Main Street, Suite 220 Carmel, IN 46032 City of Carmel, IN By: AtAt.it) jie ,i A', Diana L. Cordra Clerk-Treasur -- Y, 30 WEST MAIN STREET, SUITE 220, CARMEL, IN 46032 OFFICE 317.571.ARTS (2787) FAX 317.571.2789 CARMEL REDEVELOPMENT COMMISSION Register of Claims 5/29/2014 Payment Request#8 Amount of Wire Vendor Address Invoice Description Instructions 720 3rd Ave SW Carmel,IN Pay app 8,Nash garage Signature Construction Services 46032 $ 9,046.10 construction mgt IF NEEDED 2932 N.Webster Ave. Gibraltar Construction Corp Indianapolis,IN 46219 $ 248,700.00 Pay app 6,Garage&ramp IF NEEDED 2747 N Emerson Ave Robert Haines Company Indianapolis,IN 46218 • $ 5,085.00 Pay app 4,Garage&ramp IF NEEDED Total: $ 262,831.10 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: $ 262,831.10 Director of the CRC Date/ APPLICATION AND CERTIFICATION FOR PAYMENT .41.4 DOCUMENT G702 PAGE ONE OF 2 PAGES 2 TO OWNER CRC at City of Carmel PROJECT: Nash Garage APPLICATION NO:Application u 5 Distribution to: Carmel Indiana 46032 Signature costs OWNER L ARCHITECT PERIOD TO: 05/22/2014 X CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services LLC 720 3rd Avenue S.W. PROJECT NOS: Cannel,Indiana 46032 CONTRACT FOR: CONTRACT DATE: 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 S 156,776.00 2. Net change by Change Orders S 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE(Line I±2) S 156,776.00 4. TOTAL COMPLETED&STORED TO S 149,022,20 ' f B B . �' i Date: z' iY 5. RETAINAGE: Thomas "oatz,President a 10%of Completed Work 5 0 ubscribed and•corn to before me this ,,: day of rriGY r 10, „• (Column D+Eon G703) / "=o`• :; -,, i€"JDA G.BUCHANIAl t b. %of Stored Material $ _ -"oT^ie'•. . Hancock Cully (Column F on 0703) ' __ -.SEAL .'-., "ply Commission Extires " ;5";; August 20,2019 Total Retainage(Lines Sa+Sb or 9 Total in Column lofG703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE S 149,022.20 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) $ 139,976.10 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE 5 9,046.10 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 7,753 80 (Line 3 less Line 6) AMOUNT CERTIFIED S CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Total changes approved Application and onthe Continuation Sheet that are changed to conform with the amot it certified.) in previous months by Owner laiti,ITECT: F / Total approved this Month B *f d d al Date: Zv ! TOTALS $0.00 $0.00 This lertificate is not negotiable. e AMOUNT CERTIFIED is payable nl to he pY Y con ctor named herein.Issuance,payment and acceptance o1 payment are without NET CHANGES by Change Order 50.00 prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION•AIA•01992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE..N.W.,WASH VNGTON,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. SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Application # 8 5/23/14 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 47,815.10 9,046.10 56,861.20 88% 7,753.80 0.00 156,776.00 0.00 156,776.00 139,976.10 9,046.10 149,022.20 95% 7,753.80 0.00 ,.../..-.:,:-..,-ATA Document G732TM 2009 Application and Certificate for Payment, Construction M ana.er as Adviser Edition TO OWNER:one elute square PROJECT: " - - ' ' ' - '•- ' ' • APPLICATION NO: DISTRIBUTION TO _ Carmel;IN 46032 5x20/13 OWNER — PERIOD TO' CONSTRUCTION MANAGER FROM Gibraltar Construction Corp VIA CONSTRUCTION CONTRACT DATE: 512113 — CONTRACTOR: 2932 N.Webster Ave. MANAGER: ARCHITECT — Indianapolis, IN 46219 PROJECT NOS: I CONTRACTOR Nash Parking Garage FIELD — CONTRACT FOR: VIA ARCHITECT: OTHER — CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contrai,tni's know ledge.information and belief the Work covered by this Applir.tion for Payment has been completed in accordance with the Application is made for payment,as shoes n bi Iou,in connection with the Contract Contract Documents,that all amounts ti ve been paid by the Conti actor for Work for which previous -11A Document 0703TM,Continuation'sheet,is attached Certificates tot Payment were i sued a payments received from the Owner,and that current payment 'I.ORIGINAL CONTRACT SUM $1,476,000.00 shown herein is now due. 2.NET CHANGES IN THE WORK $ 0.00 CONTRACTOR: Gibraltar slucti•n Corp 3.CONTRACT SUM TO DATE(Line I t 2) . . . . $1,476,000 00 Bs j Date ji/t' 4.TOTAL COMPLETED AND STORED TO DATE(C.'olwnn G on ir'03/ ..$1,391,800.00 State of j.,1,r• t 5.RETAINAGE: County of: ��� ��? ply. _ '1 `e;;I• gBBRIA N R. MCBRIDE a. %of Completed V,'orl. Subscribed and Sworn s1 :efe'e� gg ryGL of Hancock County (Column D+E on C'"0.3) 5 73.800 00 me this 2.--7 :''of w — G ,/r My Comm, Exp, 11.29-2017 b. %of Stored Material (slotao. Public; r , .�.A�1; COmmIssfon #611862 (Column I-on(O3) $ M} Commission expires M/f -°......15,rJ'7 — Total Rctainagc(Lines 5a+5h, at To.'a!in Column Ion G703) ...$ CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE • $1,318,000.00 In accordance with the Contract Documents,based on evaluations of the Work and the data comprising (Line 4 minus Line 5 Total) this application,the Construction Manager and Aichiteet mini!, to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT 1.069,300.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in (Erne 6 from prior Cert f care) accordance with the Contract Documents and the Contractor is entitled to payment of the AMOUNT 8.CURRENT PAYMENT DUE 1 CERTIFIED 1$ 248,700.00 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED . $ (Attach explanation if amount certified diffcets POP',me amaun'applied.Initial all f2ures on this (Line 3 minus Lim 6) $ 158,000.00 1pplication and on the Contrm,atron Sheet tout are changed to conform with the amnnn:cm'tilt el I CONSTRUCTION MANAGER: B` Date: SUMMARY OF CHANGES IN THE WORK ADDITIONS DEDUCTIONS ARCHITECT'.(NOTE IJ, u hole Prime Contractor,-are respon'ible for perforn'7g portions of the Total changes approved in pies ions months by Owner $ $ 'roe,c! I/;41.ehi i s '.-a t •lien is■-ot r e used) Total approved this month,including Construction . . , 4 III; eall G Date: 2. /� Change Directi■ea S 5 Fh ..ertificate is not egoti ice The AMOUNT CERTIFIED is pays le onI to the Contractor named TOTALS $ $ herein.Issuance,payment and acceptance of payment are without prejudice to am; rights of the Owner NET CIIANGES IN THE WORK $ or Contractor under this Contract CAUTION: You should sign an original AIA Contract Document,on which this text appeals in RED.An original assures that changes will not he obscured. AlA Document G7321"-2009(formerly G702",CMa-1992).Copyright©1992 and 2009 by The American Institute of Architects All rights received,WARNING:This AIA"'Document is protected by U , Copy'rghi Law and Internahonai Treaties.Unautharized n prodeci,on or distribution of'his A:A' Document or any portion at it may result in severe civil and criminal penalties and will be proseruled to tine maomum extent possible under the law Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of NA Contract Documents e-mail The Amencar Institute of Aid-elects'legal counsel,copyright @aia.org. - CONTINUATION SHEET Page 2 of APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION NO. 6 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts APPLICATION DATE: 5/20/2014 where variable retainage for line items may apply. PERIOD TO 5/31/2014 ARCHITECT'S PROJECT NO. A B C D E F G H 1 WORK COMPLETED MATERIALS TOTAL ITEM FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO DESCRIPTION OF WORK SCHEDULED VALUE FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (0/C) (D+E) DORE) (D+E+F) (C G) RATE) 1 1 Mobilization 25,000 $20,000 $5,000.00 $25,000 100% - 2,500 2 General Conditions 42,000 $38,500 $1,500.00 $40,000 95% 2,000.00 4,000 3 Engineering and Layout y 8,100 $8,100 $8,100 100% - 810 4 Mass Excavation 135,000 $135,000 $135,000 100%V - 13,500 5 Mass Backfill 86,000 $28,000 $10,900.00 $38,900 45%r 47,100.00 _ 3,890 6 Foundations -Material 52,000 $52,000 $52,000_ 100%_ - 5,200 7 Foundations - Labor 42,000 42,000 $42,000 100% - 4,200 8 Cast in Place Walls - Material 76,000 76,000 $76,000 100% - 7,600 9 Cast in Place Walls- Labor 124,000 124,000 $124,000 100%- - 12,400 10 Elevator Pit-Material 2,000 2,000 _ $2,000 100% - 200 11 Elevator Pit-labor 3,000 3,000 $3,000 100% - 300 12 Slab on Grade-Material 41,000 16,000 21,000_ $37,000 90% 4,000 3,700 13 Slab on Grade-Labor 31,000 5,500 23,000_ $28,500 92% 2,500 2,850 14 Topping Slab-Material 55,000 50,000 $50,000 91% 5,000 5,000 15 Topping Slab- Labor 22,000 20,000 $20,000 91% 2,000 2,000 16 Metal Pan Stairs- Material 2,400 1,800 $1,800 75% 600 180 17 Metal Pan Stairs- Labor 6,500 5,500 $5,500 85% 1,000 550 18 Precast Hollow Core Planks _ 161,000 161,000 $161,000 100% - 4,920 19 Masonry 142,000_ 77,000 _ 60,000 $137,000 96% 5,000 20 Structural Steel Material 195,000 195,000 $195,000 100% - 21 Structural Steel Labor 34,000 _ 34,000 $34,000 100% - 22 Earthwork and Site Utilities 85,000 20,000 50,000 $70,000 82% 15,000 23 Rebar Material 52,000 52,000 $52,000 100% _ 24 Rebar Install 29,000 29,000 $29,000 100% - 25 Allowances 25,000 25,000 $25,000 100% - $1,476,000 $1,143,100 $248,700 $0 $1,391,800 94% $84,200 $73,800 ISA Form # 1-402 AFFIDAVIT AND WAIVER OF LIEN U FINAL Fi PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Parcel 9-54 Garage & Ramp and owned by City of Carmel— Redevelopment Commission and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER) that there is due from the Owner the sum of Two Hundred Forty Eight Thousand Seven Hundred and -- No/100 Dollars ($248,700.00) n receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due from the Owner is the sum of Dollars ($ .00) U receipt of which is hereby acknowledged; or {1 the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon aiccount of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions ex,,ressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work pe •rmec or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver_ Gibraltar Construction Corp l p By �. / Title President i WITNESS MY HAND AND NOTORIAL SEAL, this 2 o i f Vey, 2014. (Notary Public) ocrs'PC/4G BRIAN (�R..t MCBRIDE 4 :1J� ..r. ANA '. H1 :....'PA"Y."A: 24:, .: A' .:ti Nr.".gP..AA•F: 2 .• Res. of Hancock County .•A,in.7':0r:PEJ'.u7 1■0 �f .... * MY Comm. EXP. 11-29-2017 n Pt Commission # 611862 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 Page ONE of 2 pages TO(OWNER): Carmel Redevelopment Commission PROJECT: CCC-Parcel 9-54 Garage&Rar APPLICATION NO: 4 Distribution to: 30 W.Main Street,Suite 220 []OWNER Carmel,IN 46032 PERIOD TO: April 30,2014 []ARCHITECT FROM: VIA(ARCHITECT): ARCHITECT'S NO: []CONTRACTOR (Contractor) Robert Haines Company PROJECT NO: Q 2747 N. Emerson Avenue RHC#: 13C275 Q Indianapolis,IN 46218 CONTRACT FOR: CONTRACT DATE: May 23,2013 Application is made for payment,as shown below,in connection with the Contract. CONTRACTOR'S APPLICATION FOR PAYMENT Continuation Sheet,AIA Document G703,is attached. CHANGE ORDER SUMMARY 1,ORIGINAL CONTRACT SUM $210,000 Change orders approved in ADDITIONS r DEDUCTIONS 2.Net change by Change Orders previous months by Owner 3.CONTRACT SUM TO DATE(Line 1+-2) $210,000 TOTAL 4.TOTAL COMPLETED&STORED TO DATE $72,125 Approved this Month (Column G on 0703) Number Date Approved S.RETAINAGE: a. 10 %of Completed Work $7,213 (Column D+E on G703) b. %of Stored Material Column F on G703) Total Retainage(Line 5a+5b or proved this Month TOTALS - _Approved Total in Column I of G703) $7,213 Net change by Change Orders 6.TOTAL EARNED LESS RETAINAGE $64,913 The undersigned Contractor certifies that to the best of the Contractor's knowledge, (Line 4 less Line 5 Total) information and belief the Work covered by this Application for Payment has been 7.LESS PREVIOUS CERTIFICATES FOR completed In accordance with the Contract Documents,that all amounts have been PAYMENT(Line 6 from prior Certificate) $59,828 paid by the Contractor for Work for which previous Certificates for Payment were 8.CURRENT PAYMENT DUE $5,085 issued and payments received from the Owner,and that current payment shown 9.BALANCE TO FINISH,PLUS RETAINAGE $145,088 herein is now due. (Line 3 less Line 6) CONTRACTOR:Robed Haines Co. State of: Indiana County of `` `�`� ri i t f �i,///, , Subscribed an sh n to before me tthhi/g,�day Apr 21,201 ---.. Notary Public:\4_ (1i? . rc�llt-e�L, . ,. By: _.�- Dale: April 21,2014 My Commissio xpires: 9/17/2672N.= No-1-.A �' • AMOUNT CERTIFIED y ARCHITECT'S CERTIFICATE FOR PAYMENT (Attach explanation If amount certified differs from the amount applied for$.q AV -IF In accordance with the Contract Documents,based on on-site observations and the ARCHITECT: / at_IC data comprising the above application, me Arcttitectcertifies to the Owner that to the ��q `� best of the Architect's knowledge,information and belief the Work has progressed as By:•t r i/ i a Dat r,� `'`' indicated,the quality of the Work is in accordanace with the Contract Documents,and This Certificate is ni ••otiab e. The •UNT,,. -TIFIED is payable only to the �'�; L. `• the Contractor is entitled to payment of the AMOUNT CERTIFIED. Contractor named -in. Issuance,payment and acceptance of payment are without ''"I i c t f c c�c prejudice to any rights on the Owner or Contractor under this Contract. Raw/191a4 AIA 130275 CCC Parcel 9-54 Garage&Ramp 4 CONTINUATION SHEET AMA DOCUMENT G703 Page 2 of 2 pages AIA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT,containing APPLICATION NUMBER: 4 Contractor's signed Certification is attached. APPLICATION DATE: Apr 21,2014 In tabulations below,amounts are stated to the nearest dollar. PERIOD TO: Apr 30,2014 Use Column 1 on Contracts where variable retainage for line items may apply_ ARCHITECTS PROJECT NO: A B C 0 F E F G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM THIS PERIOD PRESENTLY COMPLETED (GIC) TO FINISH PREVIOUS STORED AND STORED (C-G) APPLICATION (NOT IN TO DATE (D+E) - - - IT{0^) G 1 Submittals, Bonding&Insurance 7,500 7,500 ;00 100% 750 2 Firestopping 146,000 10,950 150 8% 135,050 1,095 3 071700 Bentonite Waterproofing 56,500 48,025 5,650 (0 031- S >75 95% 2,825 5,368 210,000 66,475 5,650 72,125 34%_ 137,875, 7,213 Ravi 1118184 AIA 13C275 CCC Parcel 9-54 Garage&Ramp 4 SUBCONTRACTOR'S SWORN STATEMENT OF INDEBTNESS& CONDITIONAL WAIVER OF LIEN -� al TR I P6 CN Being duly sworn upon his/her oath disposes and says that 1. He/she is the TR PE-14 r (inserting sole proprietor, partner or corporate office held, as the case maybe),of ROBERT HAINES CO.INC. (hereafter called the"Subcontractor"). He/she is over the age of twenty-one. He/she is authorized to make this affidavit on behalf of Subcontractor. 2. Subcontractor Is the 1trakt1ip,Nci Subcontractor for the construction of the BUILDING development known as NASH BUILDING, located in CARMEL (City), IN (state), hereafter referred to as the "Development', pursuant to the contract (the "Trade Contract") between the Subcontractor and Signature Construction,LLC,the General Contractor, 3. This affidavit is made for the express purpose of inducing Signature Construction, LLC, to make payment to c,"rrt+r !nr in the amount of $ 07:45- 1 O 0 representing Payment Application # '-� dated /1/AI /-f for labor and materials furnished pursuant to said Trade Contract through this date. Upon receipt of said payment the Subcontractor shall be paid In full, exclusive of retainage, for all services, labor and materials furnished to, provided for or used in connection with the Development through the date noted above and hereby waives any lien rights to which Subcontractor is entitled throe h the above date. Subcontractor further acknowledges that upon receipt of said payment the receipt of$ 5 ,1CA(40Q to date. 4. Listed below are all suppliers or other persons who either has furnished or might furnish the Subcontractor 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 E II . (final) lien release has been signed and delivered to the General Contractor. 3.) If the initial delivery has not been made. 'Supplier List(Add list if necessary) 1.Amount Owed 2 3 M ikT l2 t- T a b or 7 p 1 nt PO T G(� #1 and 2 correspond to the same numbered choices on the waiver format. Signature Construction, LLC is hereby authorized to make payment to each such unpaid creditor either directly or by check jointly payable to Subcontractor and such creditor,as Signature Construction,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 General Contractor except the persons or businesses named In Paragraph 4 above. IN WITNESS WHERE OF,affant has signed this document on behalf of the Subcontractor thisA'?ay of k P,P t .— ,20 (Authorized ant- •=otary County of Ai A-2.1 D PJ ) State of i 1,4 iD /Pr A/ a ) Sub cr ed and sworn to b ore me,a Notary Public in and for said County and State,this 5 tday of ff 121L - ,201' a/ 97 Yid/14X/ ����tiu.�iHirl�� r�LV �i? � ,.�`� 111• N,c� '''�., (Notary Public) ��`gyp`,. (Printed Name) SEAL My Commission Expires: 4-17-024 =51. PUBLIC •'�; NOTARY SEAL MUST APPEAR ON THIS FORM.