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2014 2010 Coit Bond Huntington Successor Trustee pay request 3 011415 .IUI1U 000 U + UI. m ® m QnQo CITY O CARMEL _JAMES BRAINARD, MAYOR CITY OF CARMEL,INDIANA LEASE RENTAL REVENUE BONDS OF 2010 CONSTRUCTION FUND DRAW REQUISITION Disbursement Direction No. 3 The Huntington National Bank Corporate Trust Department Attn: Maranda LujaJohnson 45 N.Pennsylvania St. INHP22 Indianapolis,IN 46207 312-229-4039 via email: Maranda.LujaJohnson@huntington.com Date: 12th of January ,2015 RE: City of Carmel (Indiana)Lease Rental Revenue Bonds of 2010—Depository Account Account#4087001459 Dear Maranda: 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 to overnight the checks to the individual as set forth on the attached register. The undersigned certifies that: (a) The undersigned is an officer of the City of Carmel, Indiana; (b) The amounts set forth on Schedule A are requested to be paid from the City of Carmel (Indiana) Lease Rental Revenue Bonds of 2010—Depository Account(#4087001459) (c) Each obligation as reflected by the amounts set forth on Schedule A has been properly incurred,is a proper charge against the City of Carmel (Indiana)Lease Rental Revenue Bonds of 2010—Depository Account and has not been the basis of any previous withdrawal from the Depository Account;and (d) Supporting information with respect to each payee designated on Schedule A as to the amount owing is attached hereto. CITY OF CARMEL, INDIANA QJ BY: r' Diana L.Cordray,Clerk-Treasurer Authorized Officer DEPARTNI iNr or ENGINE:I{HI:NG ONF Civic SQUARE, CAI lEi., TN 46032 Orrice 317.5712441 PAZ 317.571.2439 EMAII. cngineering@c:imichn.gov REGISTER OF CLAIMS CITY OF CARMEL, INDIANA LEASE RENTAL REVENUE BONDS OF 2010 CONSTRUCTION FUND PAYMENT REQUISITION DISBURSEMENT DIRECTION NO.3 12-Jan-I5 AMOUNTS PAYEE'S NAME&MAILING ADDRESS REQUISITIONED COST ITEMIZATION American Structurepoint, Inc. $53,513.74 Main St. from Illinois St to Old Meridian St 7260 Shadeland Station Construction Inspection Indianapolis,IN 46256 Proj. 14-06 P.O.#31847 Inv.#74585 &Inv.#74883 Anthony Properties, L.P. $29,075.00 Main Street Reconstruction-R/W Acquisition Attn:Tony Schelonka Parcel 14 1919 E. 191st Street Parcel Tax I.D. 29-09-26-203-023.000-018 Westfield, IN 46074 Total $82,588.74 ALL CHECKS LISTED HEREON TO BE MAILED TO: CrossRoad Engineers,PC Attn:Jill Newport 3417 Sherman Drive Beech Grove,IN 46107 A-1 Remit to: 0 ii 7260 Shadeland Station El Indianapolis, IN 46256-3957 0 . , AMERICAN TEL 317.547.5580 FAX 317.543.0270 STRUCTUREPOINTwww.structurepoint.com I— INC. O N,� 2324 �6�� Federal Tax ID: 35-1127317 �N ''�c0 December 19,2014 P. -9,c,-\�O�Q �p\ invoice No: 74585 N. c 20 w Mr. Jeremy Kashman S Q GNC-���E� j Ci City of Carmel � , 0 One Civic Square ORIGINAL (nee. 't-�� =v Carmel, IN 46032 t,_1101. o .1.27.,9r' Total Due This Invoice (see breakdown below): $10,913.75 Project 0002014.00444.0002 Main Street from Illinois Street to Old Meridian Street-Cl-Project No. 14-06, PO #31847 Services from November 01,2014 through November 30,2014 Phase 00100 Construction Inspection Professional Services Hours Rate Amount Project Engineer Parks,Natalie 2.75 105.00 288.75 Slocum, Michael .50 105.00 52.50 Resident Project Representative Lengladc,Jon 12.00 95.00 1,140.00 Reeves,Jeffery 3.00 95.00 285.00 Construction Inspector Clayhon,Nikki 106.00 80.00 8,480.00 Grimstad,Heather 5.50 80.00 440.00 Walker,Melissa 1.50 80.00 120.00 Totals 131.25 10,806.25 Professional Services Total 10,806.25 Billing Limits Current Previous Total Total Billings 10.806.25 36.226.25 47.032.50 Maximum 366,980.00 Under Maximum 319,947.50 TOTAL THIS PHASE $10,806.25 Phase 00200 Engineering Support Professional Services Hours Rate Amount Senior Engineer Lau, Wing .50 125.00 62.50 Staff Engineer Murillo,Jose .50 90.00 45.00 Full payment of this invoice is due within 30 days from invoice date. Interest at the rate of 1.5%per month(525.00/month minimum)plus anyfall collection costs/attorney costs maybe charged if payment is not received within 60 days from the invoice date. Project 0002014.00444.0002 Invoice 74585 Totals 1.00 107.50 Professional Services Total 107.50 Billing Limits Current Previous Total Total Billings 107.50 4,563.39 4,670.89 Maximum 7,500.00 Under Maximum 2,829.1 I TOTAL THIS PHASE $107.50 TOTAL DUE THIS INVOICE $10,913.75 Very truly yours, Todd Rutledge Full payment of this invoice is clue within 30 clays From invoice date Interest at the rate of 1.5%per month($25.00/month minimum)plus any/all collection costs/attorney costs maybe charged if payment is not received within 60 clays from the invoice date- • Page 2 TimeSheet for the Period Ending 11/15/2014 Wednesday,December 03,2014 2:53:19 PM American Structurepoint, Inc. Employee NPARKS Parks, Natalie Signed Parks,Natalie „11�Dsto(L�J�JI n Approved Kicinski,Gregory Project Phase Task Labor Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Code Hr 1111 11/2 11/3 11/4 11/5 1116 1117. 11/8 11/9 11/10 11/11 11/12 11/13 11/14 11/15 0002012.02044.0001 00800 IN060 00 Reg 1.00 1.00 Labor Category Project.Engineer OVT 0.00 0002012.02337.0001 00302 IN030 00 Reg 0.25 0.25 Labor Category:Project Engineer OVT 0.00 0002013 00889.0001 00300 00300 00 Reg 0.2 ' 0.25 Labor Category: Project Engineer OVT 0.01 0002013.01257.0001 00300 OUTIL 00 Reg 2.50 0.50 0.50 0.25 1.00 0.25 Labor Category: Project Engineer OVT 0.00 0002013.01679.0001 00600 00100 00 Reg 1.00 1.00 Labor Category: Project Engineer OVT 0.00 0002013.01778.0001 00370 00300 00 Reg 1.51 0.50 1.00 Labor Category.Project Engineer OVT 0.01 0002014.00444.0002 00100 IN090 00 Reg 2.25 0.25 0.50 0.50 0.50 0.50 Labor Category:Project Engineer OVT 0.00 0002014.00608.0001 01500 01510 00 Reg 2.00 ' 0.50 0.50 1.00 Labor Category:Project Engineer OVT 0.00 1 01N2005.01137.0001 06140 IN030 00 Reg 1.00 0.50 0.50 Labor Category: Project Engineer OVT 0.00 Daily Totals Reg 38.75 2.25 8.00 3.00 3.50 1.50 8.50 8.50 0.75 0.50 2.25 OVT 0.00 TimeSheet for the Period Ending 11/30/2014 Wednesday,December 03 2014 2:56:50 PM American Structurepoint, Inc. Employee NPARKS Parks, Natalie Signed Parks,Natalie Approved ?O SII2 v" Kicinski,Gregory Project Phase Task Labor Total Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Code Hr 11116 11/17 11/18 11/19 11/20 11/21 11122 11/23 11/24 11/25 11/26 11/27 11128 11/29 11/30 0002013.00696.0001 00200 00001 00 Reg 0.50 0.25 0.25 Labor Category: Project Engineer OVT 0.00 0002013.00889.0001 00300 00300 00 Reg 0.25 0.25 Labor Category:Project Engineer OVT 0.00 0002013.01679.0001 00600 00100 00 Reg 2.00 1.00 0.50 0.50 Labor Category: Project Engineer OVT 0.00 0002013.01778.0001 00370 00300 00 Reg 0.5d 0.50 Labor Category:Project Engineer OVT 0.00 0002014.00444.0002 00100 IN090 00 Reg 0.50 0.50 Labor Category: Project Engineer OVT 0.00 0002014.00608.0001 01500 01510 00 Reg 0.50 0.25 0.25 Labor Category: Project Engineer OVT 0.00 01N2004.00304.0001 00340 00001 00 Reg 1 5C 0.50 1.00 Labor Category:Project Engineer OVT 0.00 01N2005.01137.0001 06140 IN030 00 Reg 3.00 0.50 0.50 0.50 1.50 Labor Category. Project Engineer OVT 0.00 Daily Totals Reg 26.75 6.00 6.00 6.50 1.00 1.25 6.00 OVT 0.00 TimeSheet for the Period Ending 11/15/2014 Wednesday,December 03,2014 2:53:19 PM American Structurepoint, Inc. Employee MSLOCUM Slocum, Michael Signed Slocum, Michael Approved POStGdl Grinstead,Joseph Project Phase Task Labor Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Code Hr _11/1 11/2 11/3 11/4 11/5 11/6 11/7 11/8 11/9 11/10 11111 11/12 11/13 11/14 11/15 0002014.00444.0002 00100 IN090 00 Reg 0.50 0.50 Labor Category:Project Engineer OVT 0.00 0002014.01640.0001 00001 00001 00 Reg 1.00 I 0.50 0.50 Labor Category: Project Engineer OVT 0.00 01N2008.00507.0001 00100 IN081 00 Reg 1.0 1 o Labor Category Project Engineer OVT 0.00 Daily Totals Reg 80.0 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 OVT 12.01 2.00 2.50 1.00 1.00 1.50 1.50 1.5 1.00 TimeSheet for the Period Ending 11/15/2014 Wednesday, December 03,2014 2:53:19 PM American Structurepoint, Inc. Employee JLENGLADE Lenglade,Jon Signed Lenglade,Jon P ostGd Approved Cross,Ryan Project Phase Task Labor Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Code Hr 1111 11/2 11/3 11/4 11/5 11/6 11/7 11/8 11/9 11/10 11/11 11/12 11/13 11/14 11/15 0000000.00000.0040 00304 00 Reg 2.00 2 00 Labor Category: OVT 0.00 0002010.00179.0001 00401 00401 00 Reg 0.00 Labor Category: Resident Proj. Rep.(Overtime) OVT 1.00 1,00 0002013.02348.0001 00100 IN090 00 Reg 14.00 8.00 6.00 Labor Category:Resident Project Representative OVT 0.00 0002014 00444 0002 00100 IN090 00 Reg 12.01 12 Dal Labor Category' Resident Project Representative OVT 0.0 +I 0002014.01625.0001 00100 IN090 00 Reg 44.00 6.00 7.00 8.00 7.00 6.00 8 01 2.00 Labor Category: Resident Project Representative OVT 0.00 0002014.01625.0001 00500 IN090 00 Reg 8.00 2.00 1.0 1.00 2.00 2.00 Labor Category: Resident Project Representative OVT 4.00 1.0 2.00 1.00 Daily Totals Reg 80.00 8.00 8.00 8.00 8.00 8.00 12.00 2.00 10.00 8.00 8.00 OVT 5.00 1.00 1.00 2.00 1.00 TimeSheet for the Period Ending 11/30/2014 Wednesday, December 03,2014 2:56:50 PM American Structurepoint, Inc. Employee JREEVES Reeves,Jeffery Signed Reeves,Jeffery P0SiG lr��Jl n Approved Snyder,Charles Project Phase Task Labor Total Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Code Hr 11/16 11/17 11/18 11/19 11/20 11/21 11122 11/23 11/24 11/25 11/26 11/27 11/28 11/29 11/30 0000000.00000.0010 00300 00 Reg 34.00 3.00 4.00 8.00 2.00 8.00 2.00 4.00 3.00 Labor Category: OVT 2.00 2.00 0000000.00000.0020 00300 00 Reg 8.0L 8.00 Labor Category: OVT 0.00 0000000.00000.0030 00300 00 Reg 8.0 8.00 - Labor Category: OVT 0.00 0002011.01169.0003 00300 1N090 00 Reg 3.00 1.00 2.00 Labor Category: Resident Project Representative OVT 0.00 0002013.00211.0002 51000 00590 00 Reg 6.0 2.00 3.00 1.00 Labor Category:Resident Project Representative OVT 0.0 I 0002013.00802.0001 00100 IN090 00 Reg 11.00 5.00 3.001 3.00 Labor Category:Resident Project Representative OVT 6.50 3.50 3.00 0002013.01287.0001 00100 1N090 00 Reg 4.00 4.00 Labor Category: Resident Project Representative OVT 4,00 4.00 0002014.00263.0001 00200 00210 00 Reg 2.00 2.00 • Labor Category: Resident Project Representative OVT " 0.00 • 0002014.00444.0002 00100 IN090 00 Reg 3.00 1.00 2.00 • Labor Category: Resident Project Representative OVT 0.00 01N2008.00200.0009 00100 IN090 00 Reg 1.00 100 Labor Category:Resident Project Representative OVT 0.00 Summarized Timesheet for the Period Ending 11 /15/2014 Monday,December l5,2014 11:11:17 AM American Structurepoint,Inc. Employee NCLAYBON Claybon, Nikki G. Signed Claybon,Nikki G. POStGd Approved Reeves,Jeffery R. Organization Al:A1:A4:AC:AM Project Phase Task Labor Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Category Hr 11/1 11/2 11/3 11/4 11/5 11/6 11/7 11/8 11/9 11/10 11/11 11/12 11/13 11/14 11/15 0002014.00444.0002 100 IN090 Construction 34.00 2.00 8.00 8.00 8.00 8.00 0002013.01873.0001 30000 30900 Construction 34.50 I 1 10.001 6.00110.501 8.001 I I I I I I I I Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Hr 11/1 11/2 11/3 11/4 11/5 11/6 11/7 11/8 11/9 11/10 11/11 11/12 11/13 11/14 11/15 DAILY TOTALS 68.50 10.00 6.00 10.50 10.00 8.00 8.00 8.00- 8.00 v6.2.503(QBUCHANAN)- Page 1 of 1 Summarized Timesheet for the Period Ending 11 /30/2014 Monday,December15,2014 11:13:50 AM American Structurepoint, Inc. Employee NCLAYBON Claybon, Nikki G. Signed Claybon,Nikki G. Posted Approved Reeves,Jeffery R. Organization Al:Al:A4:AC:AM Project Phase Task Labor Total Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Category Hr 11/16 11/17 11/18 11/19 11/20 11/21 11/22 11/23 11/24 11/25 11/26 11/27 11/28 11/29 11/30 0002014.00444.0002 100 IN090 Construction 72.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 Inspector Total Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Hr 11/16 11/17 11/18 11/19 11/20 11/21 11/22 11/23 11124 11/25 11/26 11/27 11/28 11/29 11/30 DAILY TOTALS 72.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 v6.2,503(QBUCHANAN)- Page 1 of 1 TimeSheet for the Period Ending 11115/2014 Wednesday,December 03,2014 2:53.19 PM American Structurepoint, Inc. Employee HGRIMSTAD Grimstad, Heather Signed Grimstad, Heather POStG �lll n Approved Lr� Reeves,Jeffery Project Phase Task Labor Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Code Hr 1111 1112 11/3 11/4 11/5 1116 1117 11/8 1119 11/10 11/11 11/12 11/13 11114 11/15 0000000.00000.0010 00300 00 Reg 5.50 4.00 1.50 Labor Category OVT 0.00 0002014.00263.0001 00200 00210 00 Reg 22.00 8.00 8.00 6.00 Labor Category:Construction Inspector OVT 0.00 0002014.00444.0002 00100 1N090 00 Reg 3.0 3.00 • Labor Category:Construction Inspector OVT 0.0C Daily Totals Reg 30.51 4.00 4.50 8.001 8.001 6.00 OVT 0.0 TimeSheet for the Period Ending 11/30/2014 Wednesday,December 03,2014 2:56:50 PM American Structurepoint, Inc. Employee HGRIMSTAD Grimstad, Heather Signed Grimstad,Heather P0s� (l��J�� n Approved Reeves,Jeffery Project Phase Task Labor Total Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Code Hr 11/16 11/17 11/18 11/19 11/20 11/21 11122 11/23 11124 11/25 11/26 11/27 11/28 11/29 11/30 0000000.00000.0010 00300 00 Reg 2.00 2.00 Labor Category: OVT 0.00 0002013.00802.0001 00100 IN090 00 Reg 3.5 3.50 Labor Category.Construction Inspector OVT 0.00 0002014.00263.0001 00200 00210 00 Reg 15.00 6.001 0.50 8.50 Labor Category:Construction Inspector OVT 0.00 0002014.00444.0002 00100 IN090 00 Reg 2.50 2.50 Labor Category:Construction Inspector OVT 0.00 Daily Totals Reg 23.00 3.50 6.00 3.00! 2.0C 8.50 OVT 0.00 TimeSheet for the Period Ending 11/1512014 Wednesday,December 03,2014 2 53:20 PM American Structurepoint, Inc. Employee MWALKER Walker, Melissa Signed Walker,Melissa LLII�OStad Approved Jasinski,Kevin Project Phase Task Labor Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Code Mr 11/1 11/2 11/3 11/4 11/5 1116 11/7 1118 11/9 11/10 11/11 11112 11/13 11/14 11/15 0002011.00567.0001 00303 00001 00 Reg 2.00 2.00 Labor Category:Staff Engineer OVT 0.00 0002011.00886.0002 CPS30 8100R 00 Reg 1.25 0.25 0.25 0.25 0.50 Labor Category:Staff Engineer OVT 0.00 0002011.00886.0002 CPS30 8100R 00 Reg 0.00 • Labor Category:Staff Engineer(Overtime) OVT 1.00 1.00 0002011 00886.0002 CPS50 8100B 00 Reg 0.25' 0.25 Labor Category:Staff Engineer OVT 0.00 0002011.00886.0005 CPS60 8100B 00 Reg 0.75 0.25 0.50 Labor Category:Staff Engineer OVT 0.00 0002011.00886.0005 CPS60 8100R 00 Reg 0.25 0.25 Labor Category:Staff Engineer OVT 0.00 0002013.01287.0001 00100 IN096 00 Reg 0.00 Labor Category:Construction Inspector(Ovt) OVT 27.00 3.00 2.00 3.00 2.00 8.00 2.0C 3.00 1.00 2.50 0.50 0002013.01287.0001 00100 IN090 00 Reg 69.50 8.00 5.75 2.50 7.50 8.00 8.00 8.00 7.00 7.25 7.50 Labor Category:Construction Inspector OVT 0.00 0002014.00444.0002 00100 IN090 00 Reg 1.0C 1.00 Labor Category:Construction Inspector OVT 0.00 01N2008.00807.0002 00350 00300 00 Reg 5.0 5.00 Labor Category:Staff Engineer OVT 0.0c TimeSheet for the Period Ending 11/30/2014 Wednesday,December 03,2014 2:56:50 PM American Structurepoint, Inc. Employee MWALKER Walker, Melissa Signed Walker, Melissa Posed Approved Jasinski,Kevin Project Phase Task Labor Total Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Code Hr _11116 11/17 11/18 11/19 11/20 11/21 11122.11/23 11/24 11125 11/26 11/27 11/28 11129 11130 0000000.00000.0020 00407 00 Reg 8.00 8.00 Labor Category: OVT 0.00 0002011.00886 0002 CPS30 8100B 00 Reg 1.00 0.50 0.50 • Labor Category:Staff Engineer OVT 0.00 0002011.00886 0002 CPS30 8100R 00 Reg 0 O - Labor Category:Staff Engineer(Overtime) OVT 2.00 1.00 1.00 0002011.00886.0002 CPS30 8100R 00 Reg 1.00 0.75 0.25 Labor Category:Staff Engineer OVT 0.00 0002011.00886.0002 CPS50 8100R 00 Reg 1.25 1.00 0.25 Labor Category:Staff Engineer OVT 0.00 0002011.00886.0005 CPS60 8100R 00 Reg 0.75 0.25 0.25 0.25 Labor Category:Staff Engineer OVT 0.00 0002013.01287.0001 00100 IN090 00 Reg 0.00 Labor Category:Construction Inspector(Ovt) OVT 11.00 0.50 2.00 0.50 2.00 3.00 3.00 0002013.01287 0001 00100 1N090 00 Reg 67.50 7.25 7.75 7.7 ' 8.00 5.75 7.75 8.0 I 7.25 8.00 Labor Category:Construction inspector OVT 0.00 0002014.00444 0002 00100 IN090 00 Reg 0.50 0.50 Labor Category:Construction Inspector OVT 0.00 TimeSheet for the Period Ending 11/30/2014 Wednesday,December 03 2014 2:56:50 PM American Structurepoint, Inc. Employee WLAU Lau,Wing Signed Lau,Wing Approved poste` Jasinski,Kevin Project Phase Task Labor Total Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Code Hr 11/16 11/17 11/18 11/19 11/20 11/21 11/22 11123.11124 11125 11126 11/27 11/28 11/29 11/30 0002011.00886.0005 CPS40 8100R 00 Reg 1.25 0.75 0.50 Labor Category:Senior Engineer OVT 0.00 0002011.00886.0005 CPS60 8100R 00 Reg 5.50 1.25 1.50 1.50 1.25 Labor Category:Senior Engineer OVT 0.00 0002013.01679.0001 00300 00100 00 ' Reg 3.001 3.00 Labor Category:Senior Engineer OVT 0.0011 0002014.00444.0002 00200 IN030 00 Reg 0.50 0.50 Labor Category:Senior Engineer OVT 0.00 0002014.02345.0001 00101 00001 00 Reg 0.50 0.50 Labor Category: Senior Engineer OVT 0.00 01N2004.00304.0001 00340 00001 00 Reg 15.00 2.75 0.75 2.00 1.75 2.00 0.75 3.25 1.75 Labor Category:Senior Engineer OVT 0.00 PR02014.02562.0000 00100 00001 00 Reg 1.0 1.00 Labor Category Senior Engineer OVT 0.0C Daily Totals Reg 80.50 1.50 8.50 8.00 6.50 8.00 8.00 8.00 8.00 8.00 8.00 8.00 OVT 0.00 TimeSheet for the Period Ending 11/15/2014 Wednesday,December 03,2014 2:53:19 PM American Structurepoint, Inc. Employee JMURILLO Murillo,Jose Signed Murillo,Jose P O S tG d Approved Payne,Sharon Project Phase Task Labor Total Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Code Hr 11/1 11/2 11/3 11/4 11/5 11/6 11/7 11/8 11/9 11/10 11/11 11/12 11113.11/14 11/15 0000000.00000.0010 00408 00 Reg 11.00 2.00 0.50 0.50 8.00 Labor Category: OVT 0.00 0002014.00444 0002 00200 IN030 00 Reg 0.50 • 0.50 Labor Category:Staff Engineer OVT 0.00 0002014.00523.0001 00200 00010 00 Reg 66.0 5.50 6.00 8.0 8.00 7.50 7.00. 8.001 8 OC • Labor Category:Staff Engineer OVT 7.75 1.00 0.50 1.7 0.25 1.25 0.50 1.50 0.50 0.50 0002014.02345.0001 00101 00001 00 Reg 0.01 Labor Category:Staff Engineer OVT 2.0 2.00 - 01N2004.00304.0001 00340 00001 00 Reg 2.50 2.50 Labor Category:Staff Engineer OVT 3.50 3.50 Daily Totals Reg 80.0 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 8.00 OVT 13.25 3.50 1.00 0.50 1.75 0.25 1,25 0.50 1.50 0.50 0.50 2.00 Remit to: 7260 Shadeland Station tIndianapolis, IN 46256-3957 Q AMERICAN TEL 317.547.5580 FAX 317.543.0270 goPM STRUCTUREPOINT www.structurepoint.com INC. Federal Tax ID: 35-1127317 ■ December 31,2014 Invoice No: 74883 Mr.Jeremy Kashman City of Carmel ORIGINAL One Civic Square Carmel, IN 46032 Total Due This Invoice (see breakdown below): $42,599.99 Project 0002014.00444.0003 Main Street Reconstruction-Amd#1 PO 31847 Services from November 01,2014 through November 30,2014 Fee Percent Fee Prior Current Phase Fee Complete Earned Billing Fee Road Design Serivces 20,000.00 100.00 20,000.00 0.00 20,000.00 (Amd I) •ii'. Rigt-of-Way 14,600.00 95.8904 14,000.00 0.00 14,000.00. Engineering Right-ofWay 25,063.00 34.3135 8,599.99 0.00 8,599.99 Acquisition Total Fee 59,663.00 42,599.99 0.00 42,599.99 Total Fee 42,599.99 TOTAL DUE THIS INVOICE $42,599.99 Very truly yours, Wing Lau 952930317 C CCCI C/23,C1//141118 144:°°1 & el419191 1' Full payment of this invoice is clue within 30 days from invoice date. Interest at the rate of]:5%.per month($25.00/month minimum)plus any/all collection costs/attorney costs may be charged if payment is not received within 60 clays from the invoice date. aes AMERICAN • STRUCTUREPOINT INC. L December 29, 2014 Jeremy Kashman City of Cannel Carmel Engineering Department One Civic Square Carmel IN 46032 ORIGINAL Re: Project Name: Main Street DES Number: 1400673 Parcel Number: 14 Dear Jeremy: The subject parcel has been secured. Number of Accounts Payable Vouchers enclosed: 1. 1. Please process payment. Backup documentation is attached. 2. After the check is processed, please forward to me at 8314 Wicklow Way, Brownsburg, IN 46112 for distribution. 3. Special Notes/Instructions: None 4. Documents To Be Recorded: American Structurepoint will record documents upon receipt of check. © None The parcel packet should be retained by your office for five(5) years after completion of construction. Also, 1099S should be provided to property owner in January of the year following land acquisition payment. If you have any questions or need additional information, please let me know. Best regards, , g303�-Sylvia "Skip" Tennancour ��'128 Torrey Pine Drive RECEIVEp Brownsburg 1N 46112 DEC 2014 317-456-4610 phone CAR 317-858-8082 fax C�NENG VEER r� stennancour@structurepoint.com structurepoint.com O 4> el a 91,.SV64, Il a o Shadeland Indianapolis,[IN 46256-3957 MIL.30275580 FaK831Y.54g.02170 www.structurepoint.eom O Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL , INDIANA An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Anthony Properties, L.P. Purchase Order No. Attn.; Tony Schelonka Terms 1919 E. 191st Street Date Due Westfield, IN 46074 Invoice Invoice Description Date number (or note attached invoice(s) or bill(s)) Amount DES. NO.: 1400673 PROJECT: Main Street Reconstruction PARCEL: 14 COUNTY: Hamilton Compensation for Permanent(Fee Simple) Right-of-Way Total $29,075.00 I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except .4)/ AuL'ktc �" 2014. By: Signatu\-. Title By: Signature: Title I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5-11-10-1.6. , 2014 Clerk-Treasurer • Form W-9 Request for Taxpayer Give Form to the (Rev.August 2013) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service Name(as shown on your income tax return) Anthony Properties, L.P. Business name/disregarded entity name,if different from above N N O) °- Check appropriate box for federal tax classification: Exemptions(see instructions): c c ❑Individual/sole proprietor is C Corporation ❑ S Corporation 111 Partnership ❑ Trust/estate a Exempt payee code(if any) ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► Exemption from FATCA reporting o w code(if any) c E O. o ❑ Other(see instructions)I. E' Address(number,street,and apt.or suite no.) Requester's name and address(optional) 0 a 1919 E. 191st Street rn � City,state,and ZIP code a) Westfield, IN 46074 List account number(s)here(optional) Part I Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line Social security number to avoid backup withholding.For individuals,this is your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other - - entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN on page 3. Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identification number number to enter. - ) Part II Certification 41/� Under penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and 2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding,and 3. I am a U.S.citizen or other U.S.person(defined below),and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 3. Sign Signature of Here !( � Date■ fre O'{ f&' U.S.. 11/ General Instructi ns withholding tax on foreign partners'share of effectively connected income,and 4.Certify that FATCA code(s)entered on this form(if any)indicating that you are Section references are to the Internal Revenue Code unless otherwise noted. exempt from the FATCA reporting,is correct. Future developments.The IRS has created a page on IRS.gov for information Note.If you are a U.S.person and a requester gives you a form other than Form about Form W-9,at www.irs.gov/w9.Information about any future developments W-9 to request your TIN,you must use the requester's form if it is substantially affecting Form W-9(such as legislation enacted after we release it)will be posted similar to this Form W-9. on that page. Definition of a U.S.person.For federal tax purposes,you are considered a U.S. Purpose of Form person if you are: A person who is required to file an information return with the IRS must obtain your •An individual who is a U.S.citizen or U.S.resident alien, correct taxpayer identification number(TIN)to report,for example,income paid to •A partnership,corporation,company,or association created or organized in the you,payments made to you in settlement of payment card and third party network United States or under the laws of the United States, transactions,real estate transactions,mortgage interest you paid,acquisition or •An estate(other than a foreign estate),or abandonment of secured property,cancellation of debt,or contributions you made to an IRA. •A domestic trust(as defined in Regulations section 301.7701-7). Use Form W-9 only if you are a U.S.person(including a resident alien),to Special rules for partnerships.Partnerships that conduct a trade or business in provide your correct TIN to the person requesting it(the requester)and,when the United States are generally required to pay a withholding tax under section applicable,to: 1446 on any foreign partners'share of effectively connected taxable income from such business.Further,in certain cases where a Form W-9 has not been received, 1.Certify that the TIN you are giving is correct(or you are waiting for a number the rules under section 1446 require a partnership to presume that a partner is a to be issued), foreign person,and pay the section 1446 withholding tax.Therefore,if you are a 2.Certify that you are not subject to backup withholding,or U.S.person that is a partner in a partnership conducting a trade or business in the 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If United States,provide Form W-9 to the partnership to establish your U.S.status applicable,you are also certifying that as a U.S.person,your allocable share of and avoid section 1446 withholding on your share of partnership income. any partnership income from a U.S.trade or business is not subject to the Cat.No.10231X Form W-9(Rev.8-2013) Page 4 DES. NO. / PROJECT 1400673; Main Street Reconstruction PARCEL 14 it you decide to accept the offer of$29,075.00 made by the City of Carmel, Indiana, sign your name(s) below and mail this form to the address indicated above. An additional copy of this offer has been provided for your file. ACCEPTANCE OF OFFER Anthony Properties, L.P. owner of the above described property or interest in property, hereby accept the offer of $ 29,075.00 made by the City of Carmel, Indiana, on this day of Ave/4 er , 2014. * Contingent upon the drive, located at STA 64+82.4 Left, being reconstructed as indicated on the attached plan sheet. "Should any field adjustment be needed during construction, the construction inspector will coordinate with the owner. Anthony Properties, L.P. / By: ,q9 By: Signature: Signature: NOTARY'S CERTIFICATE STATE OF Tookiang ) SS: COUNTY OF 14Grn; I+or ) Subscribed and sworn to before me this � day of /VOJerni0e( , 2014. My Commission Expires /as'/?o?O My County of Residence is: Warn; I-D n - IL14-a (Siajiature) I 1 Jenn; r Vyie7 (Printed) NOTARY PUBLIC 10/08 STATEMENT OF THE BASIS FOR JUST COMPENSATION Code N/A REV-29 1. This is a written statement of, and summary of the basis for, the establishment of the amount believed to be, through a valuation process,just compensation for the purchase of this right-of-way for highway purposes. The amount set forth in Item 5 below is not less than the approved estimate of value. In accordance with Public Law 91-646 as amended, the "Uniform Act", and as codified in Indiana at IC 8-23-17-1 through 8-23-17-35, this value disregards any decrease or increase in fair market value of the property prior to the date of valuation caused by the public improvement for which the property is acquired other than physical deterioration within reasonable control of the owner. 2.The legal description of this acquisition is set forth in the instrument of conveyance in the following identified parcel and this acquisition is identified in the Acquiring Agency's records as: Des.# N/A Parcel 14 Road Main Street County Hamilton Owner(s) Anthony Properties, L.P. 3. The area and type of interest being acquired: 0.089 Acres of Fee Simple* The amount in Item 5 below includes payment for the purchase of all interests in the real property and no separately held interest is being acquired separately in whole or part,except as may be explained in Item 8 below. 4.This acquisition is (Check one): a. ❑ A total acquisition of the real property. b. ® A partial acquisition of the real property. 5.The Agency's Offer: Just compensation has been determined to be and the Acquiring Agency's offer for the purchase of this real property is as follows: a.Total Land, Land Improvements and Buildings $24,775.00 b.Severance Damages(i.e.: Setback, Loss in Value to the Residues, etc) $ 0.00 c. Other Damages(Itemize) Cost-To-Cure estimates: Relocate 3 parking spaces $4,300.00 Temporary RAN $ 0.00 Total Damages $ 4,300.00 d. Perpetual Easement $ 0.00 Total amount believed to be Just Compensation offered for this Acquisition is: $29,075.00 6. The amount in Item 5 above may include payment for the purchase of certain buildings and improvements and their ownership shall pass to the Acquiring Agency. These buildings and improvements are identified as follows: None 7.The amount in Item 5 above may include payment for the purchase of certain Land Improvements, Fixtures, Equipment, Machinery, Signs, Etc., and their ownership shall pass to the Acquiring Agency. These items are identified as follows: Lawn, asphalt,concrete curbs, and concrete drive. 8. Items owned by others(i.e.: lessee, tenants, etc.) included in Item 5 above are identified as follows: 9. Remarks: *Includes 0.009 Acs of Presently Existing R/W. A cost-to-cure is included to relocate 3 parking spaces. Acquiring Agency Approval: Reviewer: Signature: A Signature: Name Printed: eo J4&.(C! Name Printed: Julie M.West Title: ( Company: Appraising Indiana Date: /00-7//4 Date: 9/5/2014