P86 Carmel Clay SchoolsINSTRUCTIONS:
Sign all copies.
Keep one copy for your records.
Return two copies in the enclosed stamped return envelope.
Section 6045 of the Internal Revenue Code, as amended by the Tax Reform Act of 1986,
requires the reporting of certain information on every real estate transaction. The information
provided below, except for the tax identification number, is adequate information to provide to a
tax professional.
FEE OWNER: Carmel Clay Schools
ADDRESS: SWQ of N. Keystone Avenue and East 136th Street
DESCRIPTION OF PROPERTY: A part of the NE Quarter of Section 30, Twp 18N, Range
4E, Hamilton County, Indiana
PROJECT: Keystone Parkway
PARCEL: 86 COUNTY: Hamilton
PURCHASE PRICE: $15,200.00
ADMINISTRATIVE SETTLEMENT: -0-
LAND AND /OR
IMPROVEMENTS: $15,200.00 DAMAGES: -0-
I (we) certify that the
Fee Owner(s)
ve is tru: and correct an. (we) are in receipt of check.
4 -1- >/.01
Signature
Signature
CLOSING STATEMENT
Date
Date
CITY OF CARMEL
BUYER'S REPORT (1)
PROJECT 07 -08; Keystone Parkway 136' St. PARCEL 86 COUNTY Hamilton
NAME ADDRESS OF OWNER Carmel Clay Schools, an Indiana political subdivision
5201 East 131s Street, Carmel, IN 46033
NAME ADDRESS OF PERSON CONTACTED Ron Farrand
5185 East 131 Street, Carmel, IN 46033
(List other interested parties on reverse side including nature of their interest)
DATE ASSIGNED 1/6/09 DATE OF CONTACT 1/14/09 TIME OF CONTACT
OFFER 15,200.00 TYPE OF CONTACT: PERSONAL VISIT, (X) TELEPHONE CALL, (X) MAIL
Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space:
1. YES Checked Abstract with owner? 13. N/A Sent Daily Notice to Relocation Section?
2. N/A Any affidavits taken? 14. NO Secured W -9 Form?
3. N/A Any mortgage(s)?
4. N/A Any other liens, judgments, etc.?
5. N/A Showed plans? Explained take?
6. N/A Explained about retentions?
7. N/A Any major item retained?
8. N/A Any minor item retained?
9. N/A Walked over property?
10. N/A Arranged for owner to pay taxes?
11. NO Secured Right -of -Entry?
12. N/A Secured Driveway Right -of -Entry?
Status of Parcel: Secured, Condemned, -Other (Explain)
Distribution Made:
(X) Parcel Attorney
(X) Owner Other (Specify)
Weekly Summary
State Form 2601 (R2/3 -91)
PHONE 317.844.9962
PHONE 317.815.3962
a
2:25 pm
Page 1 of 2
CODE N/A
LEFT FOLLOWING PAPERS WITH OWNERS: MAILED
15. YES Written Offer?
16. YES Land Acquisition Brochure?
17. NO Retention Letter?
18. YES Statement of Just Compensation?
19. N/A Tax memo (interim period)?
20. NO Receipt of Conveyance Instrument?
21. YES Copy of Conveyance Instrument?
22. YES Owner's Appraisal Letter?
23. N/A Brochure, "Relocation You
REMARKS: As directed, I telephoned Mr. Roger McMichael's office and was provided Mr. Ron Farrand's number.
Subsequently, I contacted Mr. Farrand. I explained that I am assisting the City of Carmel with the acquisition
phase of the Keystone Parkway and 136 Street improvement project. In conjunction with the project I need to
present a monetary offer for the additional right -of -way required for the project. I provided the option to have the
offer presented in person or via "certified" mail. Mr. Farrand preferred mailing and provided an address.
Ownership was confirmed. However, prior to mailing Mr. Jeremy Kashman, the Keystone Project Manager,
telephoned and requested that the offer be given to him and he would provide the offer packet to the owner.
Included within the packet were the following forms /documents: an introductory letter, the booklet, "ACQUISITION,
Acquiring Real Property for Federal And Federal -Aid Programs and Projects and the letter acknowledging its
receipt the Confirmation of Opportunity to Accompany Appraiser on Inspection, the Statement of the Basis for
Just Compensation, the Appraisal Report, the Uniform Property or Easement Acquisition Offer letter, the Warranty
Deed with Exhibits A" and "B the Sales Disclosure Form, the Accounts Payable Voucher, the Request for
(Sign 'ture) Elizabeth A. Sullivan
State Form 20625 (R/5 -90)
BUYER'S REPORT (1)
PROJECT 07 -08; Keystone Parkway and 136 St. PARCEL 86 COUNTY Hamilton CODE N/A
REMARKS (Cont'd): Taxpayer Identification Number and Certification (Form W -9), the "Owner's Private Appraisal
Letter and the Right -of -Entry. The Uniform Property or Easement Acquisition Offer letter, in accordance with I.C.
32 -24 -1, provides only 30 days from its receipt to accept or reject the City's offer. The 30 days may be waived and
the offer accepted or rejected now or at anytime during this period. It was also indicated that the legally protected
rights and options under Indiana's eminent domain law are set forth on page two of the Uniform Land or Easement
Offer Letter, as well as within the booklet, "ACQUISITION, Acquiring Real Property for Federal and Federal -Aid
Programs and Projects It was explained that typically, the City makes payment within 90 days after receiving the
secured parcel file from the consultant and Indiana law dictates that possession of the property will transfer to the
City thirty (30) days after payment is received. The introductory letter mailed in conjunction with the offer explained
that the project is to improve N. Keystone Parkway and 136 Street. More specifically, a portion of the subject
property is required as permanent (fee simple) right -of -way. The permanent acquisition, known as Parcel 86
contains 0.156 acres, of which 0.006 acres is existing right -of -way. As explained in the form, "Owner's Private
Appraisal Letter the owner may submit an independent appraisal for review at their own expense. The
forms /documents requiring signatures and notarization were indicated. The owner or a representative was
encouraged to call with any questions.
.2/41'01
Signature Elizabeth A. Sullivan Date
CITY OF CARMEL
BUYER'S REPORT (2)
PROJECT 07 -08; Keystone Parkway 136 St. PARCEL 86 COUNTY Hamilton CODE N/A
NAME ADDRESS OF OWNER Carmel Clay Schools, an Indiana political subdivision
5201 East 131" Street, Carmel, IN 46033 PHONE 317.844.9962
NAME ADDRESS OF PERSON CONTACTED Joyce Myers, Secretary to Roger McMichael
5201 East 131' Street, Carmel, IN 46033 PHONE 317.571.4005 ext. 81072
(List other interested parties on reverse side including nature of their interest)
DATE ASSIGNED 1/6/09 DATE OF CONTACT 1/26/09 TIME OF CONTACT 8:50 pm
OFFER 15,200.00 TYPE OF CONTACT: PERSONAL VISIT, (X) TELEPHONE CALL, (X) MAIL
Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space:
1. N/A Checked Abstract with owner? 13. N/A Sent Daily Notice to Relocation Section?
2. N/A Any affidavits taken? 14. YES Secured W -9 Form?
3. N/A Any mortgage(s)?
4. N/A Any other liens, judgments, etc.?
5. N/A Showed plans? Explained take?
6. N/A Explained about retentions?
7. N/A Any major item retained?
8. N/A Any minor item retained?
9. N/A Walked over property?
10. N/A Arranged for owner to pay taxes?
11. YES Secured Right -of -Entry?
12. N/A Secured Driveway Right -of -Entry?
LEFT FOLLOWING PAPERS WITH OWNERS: MAILED
15. N/A Written Offer?
16. N/A Land Acquisition Brochure?
17. NO Retention Letter?
18. N/A Statement of Just Compensation?
19. N/A Tax memo (interim period)?
20. YES Receipt of Conveyance Instrument?
21. N/A Copy of Conveyance Instrument?
22. N/A Owner's Appraisal Letter?
23. N/A Brochure, "Relocation You
REMARKS: Ms. Joyce Myers, secretary for Roger McMichael, telephoned and inquired of the number of
signatures required. I explained that one signature is sufficient as long as the person signing is an elected officer
who has full corporate capacity to convey the real estate. The Right -of -Entry was later received. However, Ms.
Myers telephoned and stated that the Right -of -Entry document previously received was not valid. It was requested
that a duplicate form be forwarded for execution. Subsequently, the document was emailed to Ms. Myers. Without
further correspondence, the fully executed documents were received. I contacted that Hamilton County Treasurer
Department and verified that the real estate taxes are paid current. The Receipt of Conveyance was mailed to Mr.
McMichael.
Status of Parcel: (X)- Secured, Condemned, -Other (Explain)
Distribution Made:
(X) Parcel
(X) Owner
Weekly Summary
State Form 2601 (R2/3 -91)
Attorney
Other (Specify)
(Signature) Elizabeth A. Sullivan
Page 1 of 1
'ORIGINAL;CHECK HAS A COLORED_ BACKGROUND .P.RINTEDION:,CHEMICAL.. REACTIVE; PAPER SEE
CE OETACHAND RETAIN FOR YOURRECORC
'CITY OF CARMEL, INDIANA
ONE`CIVIC`SQUARE
CARM E LL.IND IANA46032
CHECK AMOUNT: $16,200.00
CHECK NUMBER: 170276
CHECK DATE: 4/1/2009
PO NUMBER! INVOICE NUMBER AMOUNT DESCRIPTION
200 136TH /KEYSTONE R
11'17027611' I :0749085941:
VENDOR: 00351526 Page 1 of 1
CARMEL CLAY SCHOOLS
5201 E 131ST ST
ATTN. ACCT RECEIVABLE.
CARMELIN 46033
99931.934 I1'
Title:
DULY ENTERED FOR TAXATION 6
Subject to final acce tance for transfer
2' day of 20
cQ Auditor of Hamilton County
Tx=
Parcel
WARRANTY DEED
2009023596 WARR DEED $24.00
04/24/2009 09:04:54A 5 PGS
Jennifer J Hayden
HAMILTON County Recorder IN
Recorded as Presented
Project: 07 -08; Keystone Pkwy 136 St.
Parcel: 86
THIS INDENTURE WITNESSETH THAT Carmel Clay Schools, an Indiana political subdivision
(individually and collectively the "Grantor convey and warrant to the City of Carmel, Indiana (the
"Grantee for the sum of Fifteen Thousand Two Hundred and NO /100 Dollars ($15,200.00 and other
valuable consideration, "for use as a state highway or for highway purposes" the receipt and sufficiency of
which is hereby acknowledged, the following described real estate in Hamilton County, State of Indiana:
See attached Exhibits A and B, which is attached hereto and incorporated herein
Subject to any and all easements, agreements, restrictions and other matters of record.
It is understood between the parties hereto, and their successors in title, and made a covenant herein
which shall run with the land, that all real estate herein described (excepting any parcels or portions thereof that
are specifically and expressly designated as easements or temporary rights of way) are conveyed in fee simple
and not merely for right of way purposes, and that no reversionary rights whatsoever are intended to remain in
the Grantor.
IN WITNESS WHEREOF, Grantor has caused this Warranty Deed to be executed this w day of
1 2009.
GRANTOR: Carmel Clay Schools, an Indiana political subdivision
By:
By:
Printed: 'Q, rr Y I e VYl I e tI t e/ Printed:
�SI�� 9{ e r` i niLvt f -Per as hiss Title:
County of Residence:
831464v1
SS:
Before me the undersigned, a Notary Public in and for said County and State, personally appeared
Carmel Clay Schools, an Indiana political subdivision, By: RD &c it. 01° M icH Act iv, 1\S5►SrnP
SiacrLiN i GNDFoi r 0us• SS
who acknowledged the execution of the foregoing Warranty Deed for and on behalf of such Grantor, and who,
having been duly sworn, stated that the representations therein contained are true.
WITNESS my hand and Notarial Seal this cy,.? day of
My Commission Expires:
Send tax bills to: One Civic Square, Carmel, IN 46032
NOTARY CERTIFICATION
Notary Signature
2009.
Notary Printed Name
This instrument was prepared by Douglas C. Haney, Carmel City Attorney, City Hall, One Civic Square,
Carmel, Indiana 46032
After recording, return deed to: Douglas C. Haney, Carmel City Attorney, City Hall, One Civic Square, Carmel,
Indiana 46032
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each and every Social
Security number from this document, unless it is required by law. 1 N44 Ncoa 12
Project: 07 -08
Parcel 86
EXHIBIT "A"
Sheet 1 of 1
Fee Simple
A part of the Northeast Quarter of Section 30, Township 18 North, Range 4 East, Hamilton
County, Indiana and being that part of the grantor's land lying within the right of way lines
depicted on the attached Right of Way. Parcel. Plat, marked EXHIBIT. "B described.as follows:
Beginning at a point on the North line of the Northeast quarter of Section 30, Township 18
North, Range 4 East, said point being North 90 degrees 00 minutes 00 seconds West (assumed
bearing) 2261.00 feet from the Northeast corner thereof (the foregoing portion of this description
beginning with the words "Beginning at a point" is quoted from Instrument Number
200400069000 in the Office of the Recorder of Hamilton County) to the east line of said
grantor's land and the point of beginning of this description: thence South 1 degree 13 minutes
22 seconds East 16.50 feet along said east line to the south boundary of 136" Street; thence
continuing South 1 degree 13 minutes 22 seconds East 28.99 feet; thence South 89 degrees 39
minutes 10 seconds West 148.99 feet to the west line of said grantor's land; thence North 1
degree 13 minutes 22 seconds West 29.52 feet along said west line to the south boundary of said
136` Street; thence continuing North 1 degree 13 minutes 22 seconds West 16.50 feet along said
west line to the north line of said quarter section; thence North 89 degrees 51 minutes 20 seconds
East 149.00 feet along said north line to the point of beginning and containing 0.156 acres, more
or less, inclusive of the presently existing right -or -way, which contains 0.056 acres, more or less.
All bearings in this description which are not quoted from previous instruments are based on the
bearing system for City of Carmel Project 07 -08.
This description was prepared for the City of Carmel, Indiana by Tracy L. McGill, Indiana
Registered Land Surveyor, License Number LS20500009, on the 13 day of May, 2008.
qnt
op u�m A 'uruxi, v
No. :la: c_1419)_.
t1/1/.4110ii*,-45)44.4!"/
EXHIBIT "B" SHEET 1 OF 2
RIGHT -OF -WAY PARCEL PLAT
Prepared For The City of Carmel
by: AMERICAN
STRUCTUREPOINT
INC.
R/W
EXISTING R/W
EXISTING R/W
136th Street
Line "PR- S -9 -E"
1
149.00'
0 50'
100'
I
SCALE: 1" =100'
C
HATCHED AREA IS THE APPROXIMATE TAKING
J
i
OWNER:
PARCEL:
PROJECT:
ROAD:
COUNTY:
SECTION:
TOWNSHIP:
RANGE:
Carmel Clay Schools
86
07 -08
Keystone Parkway
Hamilton
30
18 NORTH
4 EAST
DRAWN BY: JEM
CHECKED BY: TLM
INSTRUMENT NUMBER 200400069000, DATED October 1, 2004
THIS PLAT WAS PREPARED FROM PUBLIC DOCUMENTS AND NOT CHECKED BY A FIELD SURVEY.)
1
Point
North
I East
1 Station
I Offset
1 C
70
71
See Location Control Route Survey Plat
82
91
181
31427.9320
15264.7050
Additional PLS Corner 5/8" Rebar 0.75" Down
500
31443.7014
12501.2105
39 +00.00
0'
PR S -9 -E
501
31449.4453
13449.1850
48 +47.99
0'
PR S -9 -E
526
31374.5682
12644.4756
+PL(40 +42.84)
70.00' RT
PR S -9 -E
527
31377.7622
'13171.6223
45 +70.00
70.00' RT
PR S -9 -E
EXHIBIT "B"
RIGHT -OF -WAY PARCEL PLAT
Prepared For The City of Carmel
by: AMERICAN
POINT REFERENCE CHART (Feet
SURVEYOR'S STATEMENT
To the best of my knowledge and belief, this plat, together with the "Location Control
Route Survey" recorded as Inst. No. 200200088040 in the Office of the Recorder of
Hamilton County, Indiana, incorporated and made a part hereof b
tY P P by reference,
comprise a Route Survey executed in accordance with Indiana Administrative Code
865 IAC 1 -12 ("Rule 12").
STRUCTUREPOINT
INC
/I1)/z
Tracy L. McGiII Date
Reg. Land Surveyor No. LS20500009
State of Indiana
SHEET 2 OF 2
4
No.
1 (205000091
STATE OF
6. v01.!DIA{�1,!"..
SURD ,t+.ti'''
1 IlfNlm"ssns0
NOTE: STATIONS AND OFFSETS ARE TO CONTROL OVER NORTH AND EAST COORDINATES.
OWNER:
PARCEL:
PROJECT:
ROAD:
COUNTY:
SECTION:
TOWNSHIP:
RANGE:
l
Carmel Clay Schools
86
07 -08
Keystone Parkway
Hamilton
30
18 NORTH
4 EAST
DRAWN BY: JEM
CHECKED BY: TLM
AMERICAN STRUCTUREPOINT, INC PROJECT NO. IN20030661
THIS PLAT WAS PREPARED FROM PUBLIC DOCUMENTS AND NOT CHECKED BY A FIELD SURVEY.)