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Legacy TIF draw 13 012615
I' FALCON NEST II , LLC 1 January 13,2015 Diana L. Cordray Carmel Clerk Treasurer (317)571-2414 Via E-mail: DCordravCa.carmel.in.gov; csheeks(a)carmel.in.gov; iohn,alexander@a.regions.coni; fake.taylorCa starfinancial.corn Re: Legacy T1F—Draw#13 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 Zu of Member of SALT, LLC • 1356 BEVERLY RD SUITE 250 • MCLEAN, VA •22103 PHONE: (703) 893-7233 • FAX: (703) 893-5267 STATEMENT NO. 2 REQUESTING DISBURSEMENT OF FUNDS FROM PROJECT FUND PURSUANT TO SECTION 4.3 OF THE TRUST INDENTURE BETWEEN THE CITY OF CARMEL, INDIANA AND REGIONS BANK, AS TRUSTEE Pursuant to Section 4.3 of the Trust Indenture (the "Indenture") dated as of December 1., 2013,. between the City of Carmel, Indiana (the "Issuer") and Regions Bank (the "Trustee"), the undersigned, as the Authorized Representative (as defined in the Indenture) of the Company, hereby requests and authorizes the Trustee, 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 $254,752.17 to pay such person(s) or to reimburse the Company in full, as indicated in the Disbursement Schedule, for 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 or incurred 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 be paid, as set forth in this written request, is reasonable and 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 for its actions taken pursuant hereto; and This statement constitutes the approval of the Company of each disbursement hereby requested and authorized. • IN WI'T'NESS. WHEREOF, the authorized represetntative of the .Company has set his hand as.of the ,dt y Of 20I5:. Pursuant to Section 4.3 of the Indenture the foregoing dishursmmcnt request is hereby FALCON NEST II LLC, an Indiana limited liability company By: SALT, LLC,Member r B 6-� " Rajai Zun ot,Meyttber of SALT, LLC- approved: CITY 'C'ARMI J` , ►DANA .I r) I.. C:ordr�ty', !AMC,ClerI rr rGr if • .. 2 Legacy TIF Dray . .. -.._' Application No 13 1 Application Date: I 13-Jan-15 Prepared By: Kathy Tekulve Telephone No: (317)863-2052 i _ i.. Amount F-2-54,752.17 - I I Reference or Total 1 Retainage Invoice Work This Invoice Code Contractor!Payee Number Completed Period Amount 2 Nelson &Frankenberger 44250 I $ 2,975.50 $ - $ 2,975.50 !Regions Bank Tit annual fee 1 $ 2,000.00 ! $ - $ 2,000.00 .-. $ 4,975.50 $ - $ 4,975.50 3 Crossroads Engineers, PC I 14955 1 $ 4,600 00 $ - ! $ 4,600.00 ..... - 1 $ 4,600.00 $ - $ 4,600.00 4 !Weihe Construction, Inc. 4046 1 $ 12,090.67 $ (1,209.0 $ 10,881.60 Globe Asphalt Paving Co Inc, 0142592 $ - i $ 7 323 60 I $ ....-_7,3323.60 'Globe Asphalt Paving Co., Inc. C-142591 $ 73,236.00 1 $ (7.323 60)1 $ 65,912.40 ..__ — h$ 85,326.67 j $ (1,209.07)1 $ 84,117.60 6 (Globe Asphalt Paving Co., Inc C142592 . $ $ 902.80 I $ 902.80 Paving 9.. .. (902.80)1 $ j-- -. � Asphalt.._ .--_ E $ 9,028,00 $ $ 8,125.20 Globe Pavan Co., Inc. C-142591 $ 9,028 00 i $ $ 9,028.00 8 Weihe Construction Inc 4046 ! $ 11,658.00 $ (1,165.80) $ 10,492.20 $ 11,658.00 ! $ (1,165.80) $ 10,492.20 9 .Globe Asphalt Paving Co., Inc_ C142592 $ $ 10,831.10 S 10 831.10 _ Globe Asphalt Paving Co., Inc. C-142591 $ 108,311.00 ! $ (10,831.1021 $ 97,479.90 $ 108,311.00 ! $__. - $ 108,311.00 10 Manley Finish Grading 5942 $ 2,850.00 I _.— 00_. 1 $ - $ 2,850.00 $ - i $ 2,850.00 11 'County Line Construction, Inc. 3187 f..$ 14,160.00 $ (1,416.00) $ 12,744.00 $ 14,160.00 ; $ (1,416.00); $ 12,744.00 1 1 ;Management Fees }_ _..............._1 076 $ 17,918.19 $ (284.32) $ 17,633.87 5 17,918.19 . $ (284.32) $ 17,633.87 1 Total.-.... .. -- f$ 258,827.36 $ (4,075.19) $ 254,752.17 1 . $ (0.002_ tof] Invoice#: 36956 CORPORATE TRUST OPERATIONS • 291 MILAN PARKWAY, 2ND FLOOR REGIONS BIRMINGRAM,AL 15211 FALCON NEST II LLC 10/29/2014 ATTN: RAJAI ZJMOT :1356 BEVERLY RD $UITE 250 MCLEAN VA 22101 RE: CITY OF CARMEI, INDIANA TAXABLE ECONOMIC DEVELOPMENT REVENUE BONDS SERIES 2013A (LEGACY PROTECT) BI 4 5916 Please remit the following for Trustee, Paying Agent, Registrar, Custodial or Escrow Agent Fees. Payment due by 12/15/2014. Invoices past due after 60 'days will incur a 1.5k late fee. Annual lee $ 2,000,00 Total Fees Due: $ 2,000.00 Please mail payment with a copy of this Invoice to the address above. If paying by wire, please remit to the following: Regions Bank ABA# 062005690 For Credit to Account: 0304995937 OBI: 9990001235 Reference Invoice # 36956 Please contact John Alexander at 317-221-6275 with questions or concerns. Thank you for choosing Regions Bank. We appreciate your business. NELSON & FRANKENBERGER A PROFESSIONAL CORPORATION 3105 EAST 98TH STREET, SUITE 170 INDIANAPOLIS, INDIANA 46280 PHONE: 317-844-0106 FACSIMILE: 317-846-8782 December 08, 2014 Falcon Nest II, LLC c/o Platinum Properties,Attn: Kathy Tekulve 9757 Westpoint Drive, #600 Indianapolis, IN 46256 t414i - INVOICE Matter ID: FALCON-0028 ROW Dedication 'k...,Je L Invoice#44250 Federal ID# 35-1442210 For Professional Services Rendered: 11/03/2014 cdf Review title work 0.70hr $206.50 11/03/2014 cdf Email-D. Haney 0.20hr $59.00 11/03/2014 cdf Email- P. Rioux 0.20 hr $59.00 11/11/2014 jcd Follow up on right of way dedication D.20hr $39.00 11/12/2014 jcd Work on ROW dedication 0.20 hr $39.00 11/13/2014 jcd Work on dedication forms 0.30hr $58.50 11/14/2014 cdf Work on deeds and schedule 1.10 hr $324.50 11/14/2014 cdf Email- P. Rioux, S. Edwards and T. Walker and telephone conference P. Rioux 0.50 hr $147.50 11/14/2014 cdf Email-title company 0.30hr $88.50 11/14/2014 Ijk Office conference-C. Frankenberger(No Charge) 0.40 hr $0.00 11/14/2014 Ijk Prepare right of way dedication deeds 1.30 hr $325.00 1 111 7/201 4 Gxif or;Ty c:dsda,.. , c f[tight o'; 3.51i hr $147.50 ... .,%ilC:� v� u�o:Way cdf Review and revise Tyner deed with multiple grantors 1.20 hr $354.00 11/20/2014 cdf Review email and substitute legals on Tyner deed 0.50 hr $147.50 11/20/2014 cdf Review and revise Conner Prairie's deed 0.50 hr $147.50 11/20/2014 cdf Review and reply to emails from S. Edwards and T.Walter 0.50 hr $147.50 11/20/2014 cdf Redline legal descriptions and email title company 0.40 hr $118.00 11/23/2014 jcd Work on ROW dedication 0.30hr $58.50 11/24/2014 jcd Work on ROW revised exhibits 0.40 hr $78.00 11/24/2014 cdf Telephone conference-B.Tyner 0.30'hr $88.50 11/25/2014 cdf Research deeds and counterpart signatures and telephone conference- B. Olsen 0.50hr $147.50 at Hamilton title 11/26/2014 cdf Revise Tyner deed to add counterparts and to address V. Hihshaws death 0.50hr $147.50 Total Professional Services: $2,928.50 For Disbursements Incurred: Page 1 December 08, 2014 Matter ID: FALCON-0028 Invoice#44250 Federal ID# 35-1442210 For Disbursements Incurred: 11/25/2014 Check# 112369 Hamilton County Recorder: Disbursement for Recording-Release $22.00 I FALCON-0033 11/25/2014 Check#112370 Hamilton County Recorder; Disbursement for Release Recording $25.00 I FALCON-0033 Total Disbursements Incurred: $47.00 INVOICE SUMMARY Producer Role Rate Hours Amount Lawrence Kemper PARTNER $0.00 0.40 $0.00 Lawrence Kemper PARTNER $250.00 1.30 $325.00 Charlie Frankenberge PARTNER $295.00 7.90 $2,330.50 Jon Dobosiewicz Land Use Professional $195.00 1.40 $273.00 For Professional Services: 11.06 Hours $2,928.50 For Disbursements incurred: $47.00 Total Due: $2,975.50 Balance in Trust; $0.00 Balance in Retainer: $0.00 G .5 [y 1 '1 • Page 2 CrossRoad Engineers, PC 3417 Sherman Drive Beech Grove,IN 46107 317-780-1555 Platinum Properties Management Co., LLC Invoice number 14955 Timothy Walter, P.E. Date 12/31/2014 9757 Westpoint Drive,Suite 600 Indianapolis,IN 46256 Project RIVER ROAD RECONSTRUCTION-TALL TIMBER RUN TO 146TH ST. For services performed November 29,2014 through December 26,2014. PROMPT PAYMENT OF INVOICE IS APPRECIATED!! The services were provided in accordance with our proposal dated February 14,2014,and our Professional Services Agreement dated March 20,2014. Amount 1.Topographic Survey Contract Amount 16,500.00 Percent Complete 100.00 Total Billed 16,500.00 Current Billed 0.00 2.Preliminary Design Contract Amount 8,100.00 Percent Complete 100.00 Total Billed 8,100.00 Current Billed 0.00 4.Phase I Final Design Contract Amount 37,500.00 Percent Complete 100.00 Total Billed 37,500.00 Current Billed 3,75D.00 5.Phase I Drainage Permitting Contract Amount 2,000.00 Percent Complete 90.00 Total Billed 1,800.00 Current Billed 0.00 7.Phase i Rule 5 Permit Application Contract Amount 1,000.00 Percent Complete 90.00 Total Billed 900.00 Current Billed 0.00 Platinum Properties Management Co.,LLC Invoice number 14955 Invoice date 12/31/2014 Page 1 of 3 Platinum Properties Management Co„LLC Invoice number 14955 Project RIVER ROAD RECONSTRUCTION-TALL TIMBER RUN TO 146TH ST. Date 12/31/2014 Amount 8.Roadway Legal Descriptions Contract Amount 3.00 5,400.00 Percent Complete 66.67 -Total Billed 2.00 3,600.00 Current Billed 0.00 0.00 9.Phase I Monumentation Contract Amount 1,500.00 Percent Complete 0.00 Total Billed 0.00 Current Billed 0.00 10.Preliminary Design for RAB @ Cherry Creek Blvd. Contract Amount 9,500.00 Percent Complete 100.00 Total Billed • 9,500.00 Current Billed 0.00 13.Maintenance of Traffic to close traffic during Construction Contract Amount 3,000,00 Percent Complete 100.00 Total Billed 3,000.00 Current Billed 300.00 14. Meetings Contract Amount 3.00 1,200.00 Percent Complete 100.00 Total Billed 3.00 1,200.00 Current Billed 0.00 0.00 16.Wetland Permitting Contract Amount 2,000.00 Percent Complete 0.00 Total Billed 0.00 Current Billed 0.00 16a.Williams Creek-Natural Resource Assessment Contract Amount 3,100.00 Percent Complete 100.00 Total Billed 3,100.00 Current Billed 0.00 16b,Williams Creek•Stormwater Consultation Contract Amount 5,700.00 Percent Complete 100.00 Total Billed 5,700.00 Current Billed 0.00 17. Construction Cost Estimate-Preliminary Design Area Contract Amount 1,500.00 Percent Complete 100.00 Total Billed 1,500.00 Current Billed 0.00 Platinum Properties Management Co.,LLC Invoice number 14955 Invoice date 12/31/2014 Page 2o13 Platinum Properlies Management Co,LLC Invoice number 14955 Proles( RIVER ROAD RECONSTRUCTION-TALL TIMBER RUN TO 146TH ST. Date 12/31/2014 Amount 18. Construction Cost Estimate-Final CD Area Contract Amount 3,000,00 Percent Complete 100.00 Total Billed 3,000.00 Current Billed 300.00 19.Project Manual Contract Amount 2,500.00 Percent Complete 100.00 Total Billed 2,500.00 Current Billed 250.00 21.Topographical Information-Final CD Area .� +,<, Contract Amount 800.00 Percent Complete 100.00 Total Billed 800.00 Current Billed 0.00 23. 12"Water Main Relocation Design-new Eliz.Warner culvert to Community Dr. Contract Amount 4,900.00 Percent Complete 0.00 Total Billed 0.00 Current Billed 0.00 Total 4,600.00 Invoice total 1 4,600 00 1 Aging Summary ,_ , 1t Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120'. t. . 14922 12/0312014 9,150.00 9,150.00 14955 12/31/2014 4,600.00 4,600.00 Total 13,750.00 13,750.00 0.00 0.00 0.00 0.00 r� • i Platinum Properties Management Co.,LLC Invoice number 14955 Invoice date 12/31/2014 Page 3 of 3 APPLICATION FOR PAYMENT AND FINAL RELEASE OF LIEN Subcontractor or Supplier Name Weihe Construction,Inc. Subcontractor or Supplier Address Noblesville,IN 46060 Phone £317)776.2966 Type of Service Furnished Construction Construction Cost Division Number Project(Building Number) Meadows ii Legacy Sec 3 _ Owner _— Platinum Properties Application Number 4046 Date 12/1/2014 Period From 12/1/2014 To 12/30/2014 Original Contract Sum $ 575,940.17 Net Change by Approved Change Orders $ 25,063.17 Contract Sum to Date $ 551,003.34 Total In-Place Work Completed $ 529,890.04 Value of Material Stored on Site $ - Total Earned to Date $ 529,890.04 • Retained Percentage $ 52,989.01 _ Total Earned Less Retalnage $ 476,901.03 Less Previous Certificates for Payment.. $ 452,883.93 Current Payment Due $ 24,017,10 • The undersigned hereby certifies that the amount Earned and Due the Undersigned for at materials,supplies furnished,and labor and services of every nature performed by the Undersigned for the use on or in connection with the above named Project. 1) Has been paid In full as per shown(except Amount Due as listed below)through the above-mentioned pay period;and 2) The Undersigned hereby warrants that the premises of the above-named Job cannot be made subject to any valid lien or claim by anyone who furnished materials,supplies, labor or services to the Undersigned for use in the above-named Project;and 3) The Undersigned hereby waives any and all claims of whatsoever kind or nature against the General Contract,and the Owner,and against the building(s),improvements or Project,and the land on which same is located for any labor,materials,or supplies furnished or services performed through the above-mentioned pay period. ' This release is given in order to induce payment in the Amount Due of$ $ 24,017.10 and on receipt of Amount Due by the Undersigned,this release as to the Amount Due becomes valid,enforceable and of full effect. Upon attachment of the legal description of the Project,the release my be recorded by the Owner or Mortgagee of the Project. Notwithstanding the foregoing,the Undersigned does hereby unconditionally waive and release any and all liens or rights to liens upon the premises,improvements thereto,or monies due in connection therewith, with respect to monies due the Undersigned for previous payment requests in the total sum of $ 24,017.10 ,the receipt and sufficiency of which Is hereby acknowledge. Dated this 29 day of Dec 2014 Weihe Construction,Inc. S r u lerName) State of Indiana ) BY: SS: (uneerstgn County of Hamilton ) Title: HR/Safety Direct() Before me,a Notary Public In and for said County and State,this 29 day of Dec 2019, personally appeared Brian Nifong known to me to be Nit/Safety Director of the Undersigned who acknowledge the execution of the foregoing for and on behalf of the Undersigned. WITNESS my hand and Notarial Seal. Dated this 29 day of Dec 2014 My commission expires: Oct 2015 U5 My county of residence is: Hamilton ia Public Michelle Garcia (Printed) • a4.I. x Document 702TM — 1992 /w b' �3 - Application and Certificate for Payment TO OWNERplatinum Properties PROJECT: Meadows(aZ Lceacv Section 3 APPUCATION NO4046 Distribution to: 9757 Westpoint Drive PERIOD TO: OWNER )C7 Suite 600 CONTRACT FOR: ARCHITECT ❑ FROM CO ,s„ IN 46256 VIA ARCHITECT: Weihe Construction,Inc. CONTRACT DATE: CONTRACTOR p 15215 Stony Creek Way PROJECT 3405 201422-01 / / Noblesville,IN 46060 FIELD CI • _ OTHER 1:1 • CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,information Application is made for payment,as shown below,in connection with the Contract, and belief the Work covered by this Application for Payment has been completed in accordance AIA Document Application is made G703 ,Continuation Sheet,is attached. 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 1,ORIGINAL CONTRACT SUM $ 575,940 17 that current payment shown herein is now due. 2.NET CHANGE BY CHANGE ORDERS S • 5p6z 17 CONTRAC R: We' a Construction,Inc. 3.CONTRACT SUM TO DATE(Line I±2) $ ' 1,00..1.3..L-- By. Date: 1 z:1y)14 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 5 4,845 04 State c :Indiana 5.RETAINAGE: County of4amilton , a10,0 of Completed Work Subscribed and sworn to before - - - —%0 - (ColumnsD-1'E on G703) $ 2,989.01 me this 30 day of Dec, - b. ht of Stored Material t' (Column F on G703) $ Notary Public• k UPI 'LAQ�) My commission expires: 0 . . . : Total Retainage(Lines 5a+5b,or Total in Column I of G703) $ 5 989M1 i I 6.TOTAL EARNED LESS RETAINAGE $ 476,9.01 03 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 minus Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 452.883.93 this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, (Line 6from prior Certificate) information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE IS 24517 10 1 AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAIN.AGE; AMOUNT CERTIFIED $ -1-10 IT.. 10 (Line 3 minus Line 6) $ 7 a Ifl)31 (Attach explanation if amount certified differs from the amount applied Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUi MAtrY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved if{{iievious months by Owner $ S By: Date: 2. 3 i i Total ap retec [ltisi<rionth $ $ This Certificate is not xtegotiable.The AMOUNT CERTIFIED is payable only to the ontractor TOTAL $ $ named herein.Issuance,payment and acceptance of payment are without prejudice to any rights of NET CHANGES by Cltarte Order $ the Owner or Contractor under this Contract. CAUTION:You should sign an original AIA Contract Document,on which this text appears In RED,An original assures that changes will not be obscured, AIA Document G762"'..-1992.Copyright 0 1953,1863.1865,1871,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA‘Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of It,may result in severe ctvii and criminal penalties,and will be prosecuted to the ma,dmum extent possible under the lava.As,J..baser.are permitted to reproduco ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American institute of Architects'legal counsel,capyrlght@ala.org. APPLICATION FOR PAYMENT PROJECT NAME The Meadows at The Legacy Section 3 OWNER: Falcon Nest II,LLC CONSTRUCTION MANAGER:Platinum Properties Mgmt Co.,LLC CONTRACTOR:Wens Constructor.,Inc. INVOICE NO 4346 CONTACT: CONTACT:Tim Walter CONTACT:Alar,Smarr APPLICATION DATE: 12,30i2014 ADDRESS 1356 Beverly Road,Suite 300 ADDRESS:9757 Westpoint Drive,Suite 600 ADDRESS:15215 Stony Creek Way REIAINAGE 10%.; McLean.VA 22101 Indienapole.IN 46256 Noblesville,IN 46060 APPROVED BY- r i+ , ■ Phone: Phone: 317)816-2000,550.8817114 Phone:317-776-2966(o3,776-3050 it) 3'L} A 8 ' Cr Cu, 0 E t F G N=E+F+G I=HID J K L�J+K 1 M=D-H'L N 1 ' Project Cost Work Description Unit Scheduled Work Comoleted Materials Total Completed % PrevIOuti Reta in age Total 8AL.TO Net Pay Code Code Price Value Previous This Stored And Stored To Date COmnl. Retainage This Period Retained PAY This Month The Meadows at The Legacy Section 3 On-site construction Lgy 03 4c Stripping Topsoil NA $5,179.00 $5,179.00 $5,179.00 100/ $517.90 $517.90 $517.90 Lgy 03 4d Prelim Erosion Control NA $9,181.00 $9,181.00 $9,181.00 100% 5918.10 $918.10 $918.10 Lgy 03 4e Mass Excvation and Mounding NA $41,544.27 $41,544.27 $41,544.27 100% $4,154.43 $4,154.43 $4,154.43 Lgy03 4h Soil Stabilization NA $19,442.50 $19442.50 $19,442.50 100% $1,944.25 $1,944.25 $1,944.25 Lgy 03 4g Site&Finish Grading NA $10,841.00 $8,841.00 $8,841 00 82% $884.10 $884.10 $2,884.10 Lgy 03 5b Sanitary Sewer Mains NA $75,730.20 $75,730.20 $75,730.20 100% $7,573.02 $7,57302 $7,573.02 Lgy 03 5c Sanitary Sewer Laterals NA $32,895.00 $32,895.00 $32,895.00 100% 53,289.50 $3,289.50 $3,289.50 Lgy 03 6a Storm Sewers NA $36,051.80 $36,051.80 $36,051.80 l00% $3,605.18 $3,605.18 $3,605.18 Lgy 03 6b Subsurface Drains NA $50,532.00 $50,532.00 $50,532.00 100% $5,053.20 $5,053.20 $5,053.20 Lgy 03 7b Water Mains NA $108,516.40 $108,516.40 $108,516.40 10o% 510,851.64 510,851.64 $10,851.64 Lgy 03 7e Water Service Laterals NA $26,837.60 $26,837.60 526,837.60 100% $2,683.76 $2,683.76 $2,683.76 Lgy 03 8a Roil Curb and Gutter 57.00111 $22,344.00 $22,344.00 $22,344.00 1o0% 52,234.40 52,234.40 $2,234.40 Lgy 03 8b 5'Wheel Chair ramps $600/ea $1,200.00 $1.200.00 Lgy 03 8b Common Area Sidewalk $3.50/sf $2,625.00 $2,625.00 --11;1r-; Cherry Creek Blvd Constructic Lgy TIF 4c Stripping Topsoil NA $3,184.00 $3,184.00 $3,184.00 1oa% $318.40 $318.40 $318.40 Lgy TIF 4e Mass Excvation and Mounding NA 58,641.00 $8,641.00 $8,641.00 100% $864.10 $864.10 5864.10 Lgy TIF 4h Soil Stabilization NA $12,428.50 $12,428.50 $12,426.50 100% 51,242.85 $1,242.85 $1,242.85 Lgy TIF 4g Site&Finish Grading NA $11253.00 $2,253.00 $7,000.00 $9,253.00 70% $225.30 $700.00 $925.30 54,925.30 56,300 00 Lgy TIF 6a Storm Sewers NA $24,225.60 $24,225.60 $24,225.60 100% $2,422.56 $2,422.56 $2,422.56 Lgy TIF 8a Chair Back Curb and Gutter 57.60111 $12,600.80 $10,000.00 $10,000.00 79% $1,000.00 $1,000.00 $3,600.80 $9.000.00 Lgy TIF 8b Multi Use Path Wheel Chair Ran$1,10O1e2 54.400.00 $4,400.00 i3 Lgy TIF' 8b Common Area Sidewalk $3.501sf 54,287.50 54,287.$0 CO#1•Cherry Creek Blvd °, , Lgy TIF 4h Multi-use Path Stabilization NA $4,360.00 $4,360.00 $4,360.00 100% $436.00 $436.00 $436.00 - I CO#2-Conduit Crossings Lgy03 6e Utility Conduits NA $11,017.50 $11,017.50 $11,017.50 ton% $1,101.75 $1,101.75 $1,101.75 CO#3-CC Blvd Spec Cond Lgy TIF 4i Subgrade Special Conditions NA $5,090.67 $5,090.67 $5,090.67 1oc% $509.07 $509.07 $509.07 $4,581 60 CO#4-Winter Protection Lgy TIF 8a CC Blvd-Curb concrete blanket $1.00/I1 51,658.00 $1,658.00 $1,658.00 100% $165.80 $165.80 $165.80 $1,492.20 Lgy 03 8a Onstte-Curb Concrete Blankets$1.00/If $2,937.00 52,937.00 _ $2,937.00 100% $293.70 $293.70 $293.70 $2.64/ 0- A. TOTAL $551,003.34 $503,204.37 $26,685.67 $529,890.04 96% $50,320.44 $2,668.57 $52,989.00' $74,102.30 , 524, 1.10 l ,0 CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side) PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: containing Contractor's signed Certification, is attached- APPLICATION DATE:4°46 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 12130/2014 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: n11,121-61 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED PRESENTLY COMPLETED BALANCE NO. DESCRIPTION OF WORK FROM PREVIOUS AND STORED % TO E VARIABLE) VALUE APPLICATION THIS PERIOD (NOT STORED TO DATE (G ' C) FINISH (FE VARIABLE) (D + E) D OR E) (D+E+F) (C-G) RATE) 01-00 On-Site 02-00 Stripping Topsoil 5,179.00 5,179-00 5,179.00 100.00 517.90 03-00 P elim Erosion Control 9,181.00 9,181.00 9,181.00 100.00 918.10 04-00 Mass Exc.&Mounding 41,544.27 41,544.27 41,544.27 100.00 4,154.43 05-00 Soil Stabilization 19,442.50 19,442.50 19,44250 100.00 1,944.25 06-00 Ste&Finish Grading 10,841.00 8,841.00 8,841.00 81.55 2,000.00 884.10 0 90 Sanitary Sewer Mains 75,730.20 75,730.20 75,730.20 100.00 7,573.02 08-00 S-nitary Sewer Laterals 32,895.00 32,895.00 32,895.00 100.00 3,289.50 0 00 S orm Sewers 36,051.80 38,051,80 36,051.80 100.00 3,605.18 1 00 S.rbsurface Drains 50,532.00 50,532.00 50,532.00 100.00 5,05320 1100 Watermain 108,516.40 108,516.40 108,516.40 100.00 10,851.64 1 00 Water Service Lateral 26,837.60 26,837.60 26,837.60 100.00 2,683.76 1 0 Roll Curb and Gutter 22,344.00 22,344.00 22,344.00 100.00 2,234.40 1 00 51 Wheel Chair ramps 1,200.00 1,200.00 1 0 Common Area Sidewalk 2,625.00 2,625.00 1 Cherry Tree Blvd Construction 1 -00 Stripping Topsoil 3,184.00 3,184.00 3,184.00 100.00 318.40 1 -00 Nass Exc&Mounding 8,641.00 8,641.00 8,641.00 100.00 864.10 1 00 S3i1 Stabilization 12,428.50 12,428.50 12,428.50 100.00 1,242.85 2 -00 Ste&Finish Grading 13,253.00 2,253.00 7,000.00 9,253.00 69.82 4,000.00 925.30 2 -00 Storm Sewer 24,225.60 24,225.60 24,225.60 100.00 2,422.56 2'-00 Chair Back Curb&Gutter 12,800.80 10,000.00 10,000.00 79.36 2,600.80 1,000.00 22-00 Nulti Use Path Wheel Ramps 4,400.00 4,400.00 24-00 Oommon Area Sidewalk 4,287.50 _ 4,287.50 CC-01 L me Path 4,360.00 4,360.00 4,360.00 100.00 436.150 ARA DOCUMENT G703 •CONTINUATION SHEET-FOR 0702 • 1992 EDITION• AIA • 01992•THE AMERICAN INSTLTt17E OF ARCHITE r Litil,?: AVENUE,NW,WASHINGTON,D.C.20006.5292•WARNING:Unlicensed photocopying violates U.S.copyright l+�and will su*Jest me violator to legal rosecution. • V o;r G703-1992 Y�Y� �w CAUTION:You should use an original AIA document which has this caution printed in red.An original assures that changes will not be obscured as may occur when documents are reproduced. CONTINUATION SHEET AIA DOCUMENT G703 (Instructions on reverse side)•„ PAGE OF PAGES ASA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: containing Contract• r's signed Certification, is attached. APPLICATION DATE: In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 12!3012014 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO.: ~A g C 0 E F C H 1 WORK COMPLETED MATERIALS TOTAL SCHEDULED PRESENTLY COMPLETED BALANCE 1NO. DESCRIPTION OF WORK FROM PREVIOUS % TO RETAINAGE TE ,ELUE STORED AND STORED APPLICATION THIS PERIOD (NOT IN TO DATE (G _ C) FINISH (IF VARIABLE) • • (D + E) D OR E) (D+E+F) (C_G) RATE} C 02 Conduit Crossings 11,017.50 11,017.50 11,017.50 100.00 1,101.75 C 03 Gerry Creek-Subgrade Prep 5,090.57 5,090.67 5,090.67 100.00 509.07 CC O4 Concrete Blankets 4,595.00 4,595.00 4,595.00 100.00 459.50 4 AIA DOCUMENT 070.9•CONTINUATION SHEET FOR 0702 • 1992 EDITION•AIA • ©1992•THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE,N.W.,WASHINGTON.D.C.20006.5292•WARNING:Unlicensed photocopying violates U.S.copyright laws end will subject the violator to legal prosecution. Gras-y9sz CAUTION;You should use an original AIA document which has this caution printed in red.An original assures that changes will not be obscured as may occur when documents are reproduced. APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES Project Name: Legacy TIF-Cherry Creek Blvd and Cherry Tree Road Improvements OWNER: Falcon Nest II,LLC Construction Mngr- Platinum Properties Mgmt CONTRACTOR: Globe asphalt Paving Co.,Inc. Invoice No: C-142592RET CONTACT: Raja!Zumol Contact: Tim Walter CONTACT Bill Shumaker Application Date: 12/17/2014 ADDRESS: 1356 Beverly Rd-Suite 300 Address 9757 Westpoint Dr.,Ste.600 ADDRESS 6445 E.30th St. Retainage: McLean.VA 22101 Indianapolis,IN 46256 Indianapolis,IN 46219 Approved By: Phone: Phone 317-818-2900,590-6617(m) Phone: 317-568-4344,568-4277(f) Date: CONTRACT FOR:Asphalt Paving&Related Work CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,infor- Application is made for Payment,as shown below,in connection with the Contract. nation and belief the Work covered by this Application for Payment has been completed Continuation Sheet,AIA Document G703,is attached. in accordance with the Contract Document,that all amounts have been paid by the 1, ORIGINAL CONTRACT SUM $ 190,575.00 Contractor for Work which previous Certificates for Payment were issued and pay- ments received from the Owner,and that current payment shown herein is now due. 2. Net change by Change Orders 5 CONTRAC R: Globe asphalt Paving Co.,Inc. 3. CONTRACT SUM TO DATE(Line 1 +2) $ 190,575.00 By ..._— Date:12/J 7/2V/ Y 4. TOTAL COMPLETED&STORED TO DATE 190,575.00 William A.Shumaker,President 5. RETAINAGE:%of Completed Work State of' Indiana \,7 /\\,N:0`i I11%- iF'/i p $ - County of Marion •S (Columns 0 +Eon G703) , s"1 ; t ,,, �-•. eStov CO, ,0� Subscribed and sworn to before this day of t. •' ' a `Q 5r b. %of Stored Material y:u, (Column F on G703) Notary Public: Jii` — t r tlorQry pUDlic Total Retainage(Line 5a- 55 or ,Alma D--Wiggins - Total in Column I on G703 My Commission expires: September 30,2017 -:--- s ,p 1piftES- i �-9/.'Rd0-20!!. 'y �� 6. TOTAL EARNED LESS RETAINAGE 190,575.00 ARCHITECT'S CERTIFICATE FOR PAYM 1OF IN0 ' \- (Line 4 less Line 5 Total) In accordance with the Contract Documents,based on on-site observations and thei�Mt, I�r,\ comprising this application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT` Architect's knowledge,information and belief the Work has progressed as indicated,the (Line 6 from prior Certificate) 5 171,517.50 quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 8. CURRENT PAYMENT DUE S 19,057.50 AMOUNT CERTIFIED $ J qc�-7,5v 9. BALANCE TO FINISH,INCLUDING RETAINAGE (Line 3 less Line 6) (Attach explanation if amount certified differs from the amount applied for.Initial all figures on this Application and on the Continuation Sheet that are changed to CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS conform to the amount certified.) Total changes approved in ARCHITECT: 1, previous months by Owner _ By: .' w Date: 12/ Total approved this Month This Certificate is not negotiable.The AMOUNT C T IE is payable only to the Contractor TOTALS - - named herein.Issuance,payment and anceptance of payment are without prejudice to NET CHANGES by Change Order $ - any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702*APPLICATION AND CERTIFICATE FOR PAYMENT*1992 EDITION 'AIA"1992•THE AMERICAN INSTITUTE OF ARCHITECTS 1735 NEW YORK AVENUE,N.W.,WASHINGTON.D.C.20006-5292 G702- 1992 APPLICATION FOR PAYMENT PROJECT NAM Legacy TIP-Cherry Creek Blvd and Cherry Tree Road Improvements OWNER: Falcon Nest II,LLC CONSTRUCTION MANAGER: Platinum Properties Mgmt CO.,tilSIDJTRACTOR.Globe Asphalt Paving Co.,Inc. INVOICE NO:C-142592ret CONTACT: Rajai Zumot CONTACT:Tim Walter CONTACT: Bill Shumaker APPLICATION DATE: 12/17/2014 ADDRESS: 1356 Beverly Road,Suite 300 ADDRESS:9757 Westpoint Drive,Suite 600 ADDRESS:6445 E.30th Street RETAINAGE_ 10% McLean,VA 22101 Indianapolis,IN 46256 Indianapolis,IN 46219 APPROVED BY v td Phone: Phone: 317)818-2900,590-8817(M) Phone: 3117)564-4344(o)568-4277 I) DATE: 'It.`I'7 A B Ci Cz 0 E I F G H=E+F+G I=HID J K L=J+K. M=D-H+L N Project Cost Work Description Unit Scheduled Work Completed Materials Total Completed % Previous Retainage Total BAL,TO Net Pay Code Code Price Value Previous This Stored And stored To Date Compl. Retainage _ This Period Retained PAY This Month Legacy TIF-Cherry Creek Blvd and Cherry Tree Road lmprovemen _gy TIF 4a Demo(Asphalt&Curb Removal) NA $11,330.00 $11,330.00 $11,330.00 100% $1,133.00 ($1,133.00) $1,133.00 _gy Tlf 4e Earthwork NA $57,555.00 $57,555.00 $57,555.00 100% $5,755.50 ($5,755.50) $5,755.50 _gy TIF 6a Storm Sewer NA $6,103.00 $6,103.00 $6,103.00 100% $610.30 ($810.30) $610.30 _gy TIF 6b Subsurface Drain NA $2,925.00 $2,925.00 $2,925.00 100% $292.50 ($292-50) $292.50 _gy TIF 9a Paving(Stone,base&binder) NA $83,006.00 $83,006.00 $83,006.00 100% $8,300.60 ($8,300.60) $8,300.60 _gy TIF 9b Paving(Surface Coat) NA $23,483.00 $23,483.00 523,483.00 100% $2,348.30 ($2,348.30) $2,348.30 CO#1 •Undercut and milling _gy TIF 4h Subgrade Undercut NA $4,351.00 $4,351.00 $4,351.00 100% $435.10 ($435.10) $435.10 _gy TV 9h Add'I milling to adjust grade NA $1,822.00 $1,822.00 $1,822.00 100% $182.20 ($182.20) $182.20 TOTAL $190,575.00 .$190,575.00 $190,575.00 100% $19,057.50 $19,057.50 1 $19,057.50 SCHEDULE OF VALUES AlA DOCUMENT G703 Project Name: Legacy TIF-Cherry Creek Blvd and Cherry Tree Road Improvements OWNER: Falcon Nest II,LIC Construction Mngr: Platinum Properties Mgrnt CONTRACTOR: Globe asphalt Paving Co.. Inc. Invoice No: C-142592RET CONTACT: Rajai Zumol Contact: Tim Walter CONTACT Bill Shumaker Application Date: 12/17/2014 ADDRESS: 1356 Beverly Rd.Suite 300 Address 9757 Westpaint Dr.,Ste.600 ADDRESS 6445 E.30th St. Retainage: McLean,VA 22101 Indianapolis,IN 46256 Indianapolis,IN 46219 Approved By: Phone: Phone 317-518-2900,590.6617(m) Phone: 317-568-4344,568-4277(1) Date: A B C D E G I E G H=E+F+G I= •/D J K L=J+K M=D-H+L N Project Cost Scheduled WORK COMPLETED Materials Total Completed And % Previous Retainage This Net Pay This Code Code DESCRIPTION OF WORK Unit Price Value -- Stored Stored to Date Compl. Retainage Period Total Retained BAL.TO PAY Month PREVIOUS THIS Legacy TIF-Cherry Creek Blvd.and Cherry Tree Road Improvements Lgy TIF 4a Demo(Asphalt&Curb Removal) NIA $ 11.330.00 $ 11,330 00 5 $ 11,330.00 100% 1,133.00 $ - $ - $ - $ 1,133.00 Lgy TIF 4b Earthwork N/A 5 57,555.00 $ 57,555.00 $ - $ 57,555,00 100% 5,755.50 $ - $ - $ - $ 5,755.50 Lgy TIF 6a Storm Sewer N/A $ 6,103.00 $ 6,103.00 $ ; $ 6,103.00 100% 610.30 $ - $ - $ - $ 010.30 Lgy T1F 6b Subsurface Drain N/A $ 2,925.00 $ 2,925.00 5 2,925.00 100% 292.50 $ - $ - $ - $ 292.50 Lgy TIF 9a Paving(Stone,base&binder) NIA 5 83,006.00 $ 83,006.00 $ $ 03.006.00 100% 8,300.60 $ - $ - $ - $ 8,300.60 Lgy TIF 9b Paving(Surface Coal) N/A $ 23,483.00 $ 23,483.00 $ - $ 23,483.00 100% 2.348.30 $ - $ - $ - $ 2,348 30 Ext 01 Streamside undercut N/A $ 4,351.00 5 4,351 00 $ 5 4,351.00 100% 435.10 3 - 5 3 - $ 435.10 Ex102 Full width milling to fix curbs N/A $ 1,822.00 poured too high $ 1,822.00 5 $ 1,822.00 100% 182.20 $ - 5 $ - $ 18220 TOTAL PROJECT S 190,575.00 $ 190,575.00 $ 190.575.00 100% $ 19,057.50 $ $ $ 5 19,057.50 • n : im d y CO ,R ■ P.O. BOX 19168 Phone: (317) 568-4344 . '4- Indianapolis, IN 46219 Fax: (317) 568-4277 fie, �'�:pl LAI r ',`kVNG r -` DoNA ou it s °*�., AFFIDAVIT AND WAIVER OF LIEN ® Final ❑ Partial IX.1 Payment to Follow State of Indiana, County of Marion, SS: William A.Shumaker being duly sworn states that he is the President of Globe Asphalt Paving Co.,Inc. having contracted with Platinum Properties to furnish certain materials and/or labor as follows: Asphalt Paving for the project known as Legacy TIF-Cherry Tree Blvd and Cherry Tree Road Improvements located at Hazel Dell and Cherry Creek Blvd, and owned Falcon Nest IL LLC and does hereby further state on behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) that the balance due is the sum of ($ ,in words: ). ❑ receipt of which is hereby acknowledged;or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for said amount,effective upon receipt of such payment; (FINAL WAIVER) that the final balance due is the sum of: ($19,057.50 , in words:Nineteen Thousand Fifty-seven Dollars and 50/100 ). ❑ 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 to and for said amount,effective upon receipt of such payment. THEREFORE, 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 on account of Labor or material or both furnished by the undersigned thereto,and further certifies that no other part has any claim or right to a lien on account of any work performed or material furnished to the under ' ed for said project and within the scope o this affidavit and waiver. Globe Asphalt Paving Co. Isis By a/0 -,444-'"` C - Title: President Gl p g y (Name of Claimant Firm) William A.Shumaker \``,,„,.1911x1,1,,r/, WITNESS MY HAND AND NOTORT��,,`�L 4L, '4 ay of December,2014. `, �N.•.�nv Cpl•. / ,r L , Notary Public. _ \__.., Seal (Notary f Ublif�! My Commission Expires: 9/30/20T = Printed: Alma D.Wiggins .•.0 kPIRb\,� Residing in Shelby County ..•,-ro_ZO.. �Y\„; www.globeasphalt.corrm APPLICATION FOR PAYMENT PROJECT NAM Legacy TIF-Cherry Creek Blvd and Cherry Tree Road Improvements OWNER: Falcon Nest II.LLC CONSTRUCTION MANAGER: Platinum Properties Mgmt Co., LLC CONTRACTOR: Globe Asphalt Paving Co.,Inc. INVOICE NO C-142591 CONTACT: Rajai Zumol CONTACT:Tim Walter CONTACT:Bill Shumaker APPLICATION DATE: 1 2/1 71201 4 ADDRESS. 1356 Beverly Road,Suite 300 ADDRESS:9757 Westpoint Drive,Suite 600 ADDRESS:6445 E.30th Street RETAINAGE 10% McLean,VA 22101 Indianapolis,IN 46256 -- r P Indianapolis,IN 46219 APPROVED BY. ,�;� Phone: Phone:(317)818-2900,590-8817(M) Phone:(317)564-4344(o)568-4277(f DATE A _ B Ci Cs 0 E I F G H=E+F+G I=H/D J _ K L=J+K M=D-I-f L N ' Project Cost Work Descrlptbn Unit Scheduled Work Completed Materials Total Completed % Previous Retainage Total BAL.TO Net Pay Code Code Price Value Previous This Stored And stored To Date Comp!. Retainage This Period Retained PAY This Month Legacy TIF-Cherry Creek Blvd and Cherry Tree Road Improvemen _gy TIF 4a demo(Asphalt&Curb Removal) NA $11,330.00 $11,330.00 $11,330.00 100% $1,133.00 $1,133.00 $1,133.00 $10,197.00 _gyTlf 4e Earthwork NA $57,555.00 $57,555.00 $57,555.00 100% $5,755.50 $5,755.50 $5,755.50 $51,799.50 _gy TIF 6a Storm Sewer NA $6,103.00 $6,103.00 $6,103.00 100% $610.30 $610-30 $610.30 . $5,492.70 _gy TIF 6b Subsurface Drain NA $2,925.00 $2,925.00 $2,925.00 100% $292.50 $292.50 $292.50 $2,632.50 -gy Tlf 9a Paving(Stone,base&binder) NA $83,006.00 $83,006.00 $83,006.00 100% $8,300.60 $8,300.60 $8,300.60 $74,705.40 ,_gy TIF 9b Paving(Surface Coat) NA $23,483.00 $23,483.00 $23,483.00 100% $2,348.30 $2,348.30 $2,348.30 $21,134.70 CO#1 •Undercut and milling _gy TIF 4h Subgrade Undercut NA $4,351.00 $4,351.00 $4,351.00 100% $435.10 $435.10 , $435.10 $3,915.90 _gy TIF 9h Add't milling to adjust grade NA $1,822.00 $1,822.00 $1,822.00 too/ $182.20 $182.20 $182.20 $1,639.80 TOTAL $190,575.00 $190,575.00 $190,575.00 _ 100% $19,057.50 $19,057.50 $19,057.50 $171,517.50 APPLICATION AND CERTIFICATE FOR PAYMENT AlA DOCUMENT 0702 PAGE ONE OF 2 PAGES Project Name: Legacy TIF-Cherry Creek Blvd and Cherry Tree Road Improvements OWNER: Falcon Nest II,LLC Construction Mngr: Platinum Properties Mgmt CONTRACTOR: Globe asphalt Paving Co.,Inc. Invoice No: C-142591 CONTACT: Raja:Zumol Contact Tim Walter CONTACT Bill Shumaker Application Date: 12/17/2014 ADDRESS: 1356 Beverly Rd.Suite 300 Address 9757 Westpoint Dr..Ste.600 ADDRESS 6445 E.30th St. Retainage: 10% McLean,VA 22101 Indianapolis, IN 46256 Indianapolis,IN 46219 Approved By: Phone; Phone 317-818-2900,590-6617(m) Phone: 317-568-4344,568-4277(f) Date: CONTRACT FOR:Asphalt Paving&Related Work CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,infor- Application is made for Payment,as shown below,in connection with the Contract mation and belief the Work covered by this Application for Payment has been completed Continuation Sheet,AIA Document G703,is attached. in accordance with the Contract Document,that all amounts have been paid by the 1. ORIGINAL CONTRACT SUM $ 190,575.00 Contractor for Work which previous Certificates for Payment were issued and pay- ments received from the Owner,and that current payment shown herein is now due. 2. Net change by Change Orders $ - CONTRAC R: lobe asphalt Paving Co.,Inc. 3. CONTRACT SUM TO DATE(Line 1 +2) $ 190,575.00 // i•z j / By A Ns-- Date: 1` 2.0 i C71-. 4. TOTAL COMPLETED&STORED TO DATE 190,575.00 William A.Shumaker,President . 5. RETAINAGE: State of: Indiana \eU+I If Ili+r,r a. %of Completed Work $ 19,057.50 County at Marion ,r/ i \,\ \. p, D. r r%', (Columns D +Eon G703) Subscribed and sworn to before this/i7-day of s_,.z-,::.;-:�,'_. ''°\ � 'etb - /C� ''� b- %of Stored Material 5r V Co.., (Column F on G703) Notary Public: F _ ! �,> No7o '• Z Total Retainage(Line 5a+5b or - _ n,;< Alma D.Wiggins 'j = sea/Uhhc Total in Column Ion 0703) 19,057.50 My Commission expires' September 30,2017 cr e, — _ '�' I•i.'/Res r ----..i„•/• '30-201_/..••' 6. TOTAL EARNED LESS RETAINAGE 171,517.50 ARCHITECTS CERTIFICATE FOR PAYMUF�.� .. ��-N, �� (Line 4 less Line 5 Total) In accordance with the Contract Documents,based on on-site observations and•fhe,diataD `% comprising this application,the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT' Architect's knowledge,information and belief the Work has progressed as indicated,the (Line 6 from prior Certificate) $ quality of the Work is in accordance with the Contract Documents,and the Contractor is entitled to payment of the AMOUNT CERTIFIED. 8. CURRENT PAYMENT DUE 5 171 51750 1 AMOUNT CERTIFIED $ I t�� v 9. BALANCE TO FINISH,INCLUDING RETAINAGE (Line 3 less Line 6) 19,057.50 {Attach explanation if amount certified differs from the amount applied for.Initial all figures on this Application and an the Continuation Sheet that are changed to CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS conform to the amount certified.) Total changes approved in ARCHITECT: 1 previous months by Owner By: T-.YtL.i Date: j} 3 /L Total approved this Month This Certificate is not negotiable.The AMOUNT RT IED is payable only to the Contractor TOTALS - - named herein.Issuance,payment and acceptance of payment are without prejudice to NET CHANGES by Change Order $ - - any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702'APPLICATION AND CERTIFICATE FOR PAYMENT'1992 EDITION "AIA*1992'THE AMERICAN INSTITUTE OF ARCHITECTS 1735 NEW YORK AVENUE,N.W.,WASHINGTON,D.C.20006-5292 , G702-1992 SCHEDULE OF VALUES AIA DOCUMENT G703 Project Name: Legacy TIF-Cherry Creek Blvd and Cherry Tree Road Improvements OWNER: Falcon Nest II,LLC Construction Mngr: Platinum Properties Mgmt CONTRACTOR:Globe asphalt Paving Co.,Inc. Invoice No: C-142591 CONTACT: Rajai Zumol Contact Tim Walter CONTACT Bill Shumaker Application Date: 12/17/2014 ADDRESS: 1356 Beverly Rd.Suite 300 Address 9757 Westpoint Dr.,Ste.600 ADDRESS 6445 E.30th St Retainage: 10% McLean,VA 22101 Indianapolis,IN 46256 Indianapolis,IN 46219 Approved By: Phone: Phone 317-818-2900,590-6617(m) Phone: 317-568-4344,588-4277(f) Date: A B C D E G 1 E G H=E+F+G 1=1-1/D J K L=J+K M=D-H+L N Project Cost DESCRIPTION OF WORK Unit Price Scheduled WORK COMPLETED Materials Total Completed % Previous Retainage This Net Pay This Code Code Value ' Stored And Stored to Date Comp!. Retainage Period Total Retained BAL.TO PAY Month PREVIOUS THIS , Legacy TIF-Cherry Creek Blvd.and Cherry Tree Road Improvements Lgy TIF 4a Demo(Asphalt&Curb Removal) N/A S 11,330.00 $ 11,330.00 $ 11,330.00 100% $ 1,133.00 $ 1,133.00 $ 1,133.00 $ 10,197.00 Lgy TIF 4b Earthwork N/A S 57,555.00 $ 57,555.00 $ 57,555.00 100% $ 5,755.50 5 5,755.50 $ 5,755.50 $ 51,799.50 Lgy TIF 6a Storm Sewer N/A $ 6,103.00 $ 6,103.00 $ 6,103.00 100% $ 610.30 $ 610.30 $ 610.30 $ 5.492.70 Lgy TIF 6b Subsurface Drain N/A $ 2,925.00 2,925.00 $ 2.925.00 100% $ 292.50 $ 292.50 $ 292.50 $ 2,632.50 Lgy TIF 9a Paving(Stone,base&binder) N/A $ 83,006.00 $ 83,006.00 $ 83,006.00 100% $ 8,300.60 $ 8,300.60 $ 8,300.60 $ 74,705.40 Lgy TIF 9b Paving(Surface Coal) N/A $ 23,483.00 $ 23,483.00 $ 23,483.00 100% $ 2,348.30 $ 2,348.30 $ 2,348.30 $ 21,134.70 Ext 01 Streamside undercut N/A $ 4,351.00 $ 4,351.00 $ 4,351 00 100% S 435.10 $ 435.10 $ 435.10 $ 3,915.90 Ext 02 Full width milling to fix curbs NIA poured too high $ 1,822.00 $ 1,822.00 $ 1,822.00 100% S 182.20 S 182.20 $ 182.20 $ 1,639.80 TOTAL PROJECT - $ 190,575.00 0 $ 190,575.00 $ 190,575.00 100% - S 19,057.50.$ 19,057.50 $ 19,057.50 $ 171,517.50 1 GLOBE;. . P.O. BOX 19168 Phone: (317) 568-4344 '° Indianapolis, IN 46219 Fax: (317) 568-4277 s ASP11A1.r:'nvi K.'i ';a AFFIDAVIT AND WAIVER OF LIEN ❑ Final El Partial 21 Payment to Follow State of Indiana, County of Marion, SS: William A.Shumaker being duly sworn states that he is the President of Globe Asphalt Paving Co.,Inc. having contracted with Platinum Properties to furnish certain materials and/or labor as follows: Asphalt Paving for the project known as Legacy TIF-Cherry Tree Blvd and Cherry Tree Road Improvements located at Hazel Dell and Cherry Creek Blvd. and owned Falcon Nest II,LLC and does hereby further state on behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) that the balance due is the sum of($ 1.71,517.50 , in words: One Hundred Seventy-one Thousand.Five Hundred Seventee Dollars and 50/100 ). ❑ receipt of which is hereby acknowledged;or Z the payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for said amount,effective upon receipt of such payment; . (FINAL WAIVER) that the final balance due is the sum of: ($ , in words ). ❑ 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 to and for said amount,effective upon receipt of such payment. THEREFORE,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 on account of Labor or material or both furnished by the undersigned thereto,and further certifies that no other party h s any claim or right to a lien on account of any work performed or material furnished to the under ' ned f r said p oject and within the scope o this affidavit and waiver. Globe Asphalt Paving Co.,Inc. By L c.....„. Title: President (Name of Claimant Firm) William A.Shumaker WITNESS MY HAND AND NOTORIAI, A'b,I t II' '1'S, ay of Decen.iber,2014. - `E -,, Qy'.r9w CO&'>;;.,'. O� I _ :" 5 `'�' Nofory PUb4ic : (Notary Public) , ;,i- � My Commission Expires: 9/30/201# Sear = Printed: Alma D. Wiggins I(1 Residing in Shelby County sJ'.,O -tPIR as., % 9 T -:30:20 :• ., P c \' .`� \ 'ii, OF I ND , `,1/hllllllilll www.globeasphalt.corn ,` - Manley Finish (�radin Inc r +:—i=- .i. DATE i INVOICE# MI ..um 1/1212015 5942 • 7437 W. Banton Circle New Palestine, IN 46163 Phone & Fax (317) 895-8586 BILL.TO FALCON NEST U LLC CIO PLATINUM PROPERTIES 9757 WESTPOINT DR.SUITE 600 INDIANAPOLIS,IN.46256 P.O.NO. TERIAS PROJECT Ck3ERRY TREE DUE ON F ECEIP I CHERRY TREE 1. L41 77F; F QUANTITY DESCRIPTION RA1 E AMOUNT 19,000 S.F.OF PERMANL sIT SEEDING W/EROSION 0.15 2,850.00 BLANKET MISC. AREAS AND ALONG NEW CURBS I 8i ;(Nat1 ) Y th THANK YOU FOR YOUR BUSINESS rro & ( $2,850.00 Erosion Control, Retaining Walls, ' g Straw Mulch, Slit Seeding, Wetland & Prarie Grass Seeding f j3 -- AFFIDAVIT AND WAIVER OF LIEN FINAL x PARTIAL cYMENT TO FOLLOW JOHN _MANLEY _ being duly sworn,state that he/she is the PRESIDENT of MANLEY FINISH GRADING,INC.having contracted with FALCON NEST.1 LLC to furnish certain materials and/or labor as follows: ,5943.594.?15951 for a project known as LEGACY,located at CARMEL,IN. _,and asirted by FALCON NEST Il LLC ,and further sues: PARTIAL WAIVER: that the balance due by the owner is the stun of_ SEVEN THOUSAND SIX HUNDRED FIVE Dollars($7,605.00 ) Receipt of which is hereby acknowledged;or X The payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given to and for said amount, effective upon receipt of such payment. FINAL WAIVER: that the final balance due by the owner is the sum of ` Dollars($ ): 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 to and for said amount,affective upon receipt of such payment. THEREFORE,the undersigned waives and -closes c nto the Owner of said premises any ant all lien or claims whatsoever on the above-described property and improvements thereon on account of labor or material or both,fwnished by the undersigned thereto,and further certifies That no other party has any claim or right to a lien a:t account of any work performed or material furnished to the undersigned fcr said project,and within the scope of this affidavit and waiver. MANLEY FINISH GRADING INC. Co A':i Name liALA1s Authorized R-. •ntative PRESIDENT__ Title WITNESS: MAs,,«,,t4 5'14,attire LYNDA MANLEY _ Printed Name oi Witness INVOICE County Line Construction Co., Inc. 31 87 5868 E. 71st Street, Suite E224 • INDIANAPOLIS, INDIANA 46220 ph. (317) 926-9264 Platinum Properties LLC 12-31-2014 9757 Westpoint Dr. . Date TO: Suite 600 214032 Job No. Indianapolis, IN 46254 P.O. No. _ .,w... RE: Playschool @ Legacy • ESTIMATE NO: 1 Labor, material, equipment and accessory appurtenances in place or stored to date at the above referenced project: 14,160.00 Less 10 % retained 1,41 6.00 Total earned less retainer 12,744,00 Less Previous applications 0.00 TOTAL DUE THIS ESTIMATE NO: 1 12,744.00 • APPLICATION FOR PAYMENT PROJECT NAME: The Ptayschool at Legacy-Legacy Developer OWNER: Falcon Nest II,LLC CONSTRUCTION MANAGER: PiallnUrn Properties Mgmt Co.,LL(L'ONTRACTOR-County Line Construction Co..Inc_ INVOICE NO: 3187(app El) CONTACT: Raja'Zumot CONTACT:Tim Walter CONTACT: Greg Broady APPLICATION DATE: 12'31/2014 ADDRESS: 1356 Beverly Road,Suite 300 ADDRESS 9757 Westpoint Drive,Suite 600 ADDRESS:5868 East 71st Street,Suite E224 RETAINAGE: 10% i McLean,VA 22101 Indianapolis,IN 46256 Indianapolis,Indiana 46220 APPROVED BY: ,P;°'° t -�. Phone: Phone. 31 T;818-2900,560-6817N) Phone:317-714-7233 DATE ( °7;e f A H Ci _ Cu D ._ E I f G H=ECF+G 1=}i/D _ J K L=J.K M=D-H+L N' t 1 Project Cost Work Description Unit Schedrded Work Completed Materials Total Cornpteted % Previous Relairrege Total BAL.TO Net Pay Code Code Price _ Value _ Previous This Stored And stored To Date Camp. Reteinage_ This Period Retained PAY This Month The Playschool at Legacy-Legacy Developer I Limestone Planters In Communit Drive Right-of-Way Lgy TIF(on-site) 12a Wooden Sidewalk Forms NA $700.00 $700.00 $700.00 100% $70.00 $70.00 $70.00 $630.00 Lgy TIF(on-site) 12a Planter Curbs and Foundations NA $13,460.00 $13.460.00 $13,460.00 100% $1,346.00 $1,346.00 $1,346.00 $12.114,00 1 1 • 1 • • • 1 I TOTAL $14,160.00 j$14,160.00 - $14,160.00 100% _$1,416.00_$1,416.00 $1,416.00 $12,744.00 Application and Certificate for Payment TO OWNER: PLATINUM PROPERTIES LLC PROJECT: PI AYSCHOOL @ LEGACY APPLICATION NO: I Distribution to: CUST4 PLA1 9757 WESTPOINTIIR. PERIOD TO: 12/31/2014 OWNER SUITE 600 INDIANAPOLIS IN 46254 CONTRACT FOR: ARCHITECT FROM CONTRACTOR: COUNTY LINE CONSTRUCTION VIA ARCHITECT CONTRACT DATE: 10/04/2014 CONTRACTOR 5868 E 71ST ST CIVIL SITE GROUP,INC SUITE E-224 PROJECT NOS: FIELD INDIANAPOLIS,IN 46220 PLAYSCHOOL @ LEGACY JOB t 214032 OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge. information Application is made for payment,as Shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for Continuation Sheet,is attached. 14,160.00 which p revious Certificates for Payment were issued and payments received from the Owner, and 1. CONTRACT SUM $ ____ that current payment shown herein is now due. 2.Net change by Change Orders o.00 9 Y 9 $ _ CONTRACTOR: County—Line Construction 14,160.00 3.CONTRACT SUM TO DATE(t.ine 12) $ gy;G- �� ?,�),. Da1e 12-31-2014 4.TOTAL COMPLETED&STORED TO DATE(Column G on 603LS1).... $ 14,160 00 State of Indiana 5.RETAINAGE: County of Marion a, 10.00%of Completed Work Subscribed and sworn to before 1,416.00 (Column D+E on 603LS1) $ me this 31st day of December 2014 b. .00%of Stored Material (Column Eon 603LS1) S Notary Public: c,,,.1-- i--,.' C_, My Commission expires: 5-5-2016 Total Retainage(Lines 5a+5b or Total in Column I of 603LS1)... $ 1,416_00 6.TOTAL EARNED LESS RETAINAGE $ 12,74400 ARCHITECTS CERTIFICATE FOR PAYMENT (Line 4 Less Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data composing 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 0.00 this application,the Architect certifies to the Owner that to the best of the Architects knowledge. $-- information and belief the Work has progressed as indicated, the quality of the Work is in (Line 6 from prior Certificate) accordance with the Contract Documents, and the Contractor is entitled to payment of the 8. CURRENT PAYMENT DUE $ 12,344.00 1 AMOUNT CERT1PLLD. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED S l w 1,416.00 (Attach etplanation if certified di ers rom rite ninrirnt a 3 tli.ci. Maio!ai! iplie%-on this (Line 3 less Line 6) $ ( 1 ff 1 !t f��, Application and on the Continuation Sheet that cue chcnrged fo Con;Urt11 nifh the ennonnt c•etfifiru: CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in previous months by Owner 5 0-00 s 0.00 i -� By 1 0.00 0.00 f)ntc:_ .. t t Total approved this Month $ $ r — TOTALS 5 0.00 0,00 This Certificate is not negotiable.The AMOUNT CERTIFIIII) is payable only to the Contractor named herein. Issuance,payment and acceptance of payment are wittluut prejudice to any rights of NET CIIANGES by Change Order S 0-00 the Owner or Contractor under this Contract. REORDER FORM NO 600.51 Continuation Sheet A!A Document G703-1992 (Instructions on reverse side.) Paige 1 of i ALA Document G702,APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION 110.• 1 containing Contractor's signed Certification,is attached APPLICATION DATE. In tabulations below,amounts are stated to the nearest dollar. 12/31/2014 Use Column 1 on Contracts where variable retainage for line items may apply. PERIOD T0: 12/31/2014 ARCHITECT'S PROJECT NO A B C D E F G H I 4 WORK COMPLETED MATERIALS TOTAL BALANCE HIM SCHEDULED PRESENTLY COMPLETED % RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS FINISH NO. VALUE RED AND STORED (G+C) TO STORED {Il:VARIABLE) APPLICATION THIS PERIOD (Nur IN TO DATE RATE) • (D+E) A OR E) CD+E+F) (C-C) 01 CMU LABOR 8,160.00 8,160.00 8.160.00 00.00 02 CMU MATERIAL 6,000.00 6,000.00 6,000.00 00.00 JOB TOTALS_ 14,160.00 .00 14,160.00 .00 14,160.00 .00 1,416.00 G703-1992 AFFIDAVIT AND WAIVER OF LIEN FINAL XX PARTIAL XX PAYMENT TO FOLLOW Greg Broady being duly sworn,state that he/she is the President of County Line Construction having contracted with Platinum Properties LLC to furnish certain materials and/or labor as follows: Masonry for a project known as Playschool @ Legacy located at 146th & Community Dr. ,and owned by P`alcon Nest II LLC ,and further states: PARTIAL WAIVER: that the balance due by the owner is the sum of Twelve Thousand Seven Hundred Fourty Four Dollars($ 12,744.00 ), 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 to and for said amount,effective upon receipt of such payment. FINAL WAIVER: that the final balance due by the owner is the sum of Dollars(S ). 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 to and for said amount,effective upon receipt of such payment. THEREFORE,the undersigned waives and releases unto the Owner of said premises any and all lien or claims whatsoever on the above-described property and improvements thereon on account of labor or material or both,furnished by the undersigned thereto,and further certifies that no other party has any 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. County Line Const. Company Name / ‘,�:�_ Authori zedRepresentati ve President Title WITNESS: Signature 1. Denise E. Broady Printed Name of Witness PLATINUM PROPERTIES MANAGEMENT COMPANY, LLC INVOICE 1076 January 13, 2015 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 January 2015 Construction Costs: CrossRoads Engineers, PC $ 4,600.00 Nelson & Frankenberger $ 2,975.50 Weihe Construction, Inc. $ 21,373.80 Globe Asphalt Paving Co, Inc. $ 190,575.00 Manley Finish Grading $ 2,850.00 County Line Construction $ 12,744.00 Total Monthly Costs $ 235,118.30 Development Fee © 7.5% $ 17,633.87 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