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2012 CRC Nash Building pay request 03 QE�ELOPMENr PF CO,; Public/Private $, P��annershiPP //11 City of Cannel Indiana CARMEL REDEVELOPMENT COMMISSION Disbursement Number#3 E-Mail the signed Disbursement Direction to: James Brainard Mayor Huntington National bank Corporate Trust Department (INHP22) Commissioners Attn: Kim Wilson kim.wilson @huntington.com (317) 229-4094 William Hammer Ellen Campbell Ellen.campbell @huntington.com (616) 235-5941 President David Bowers Vice President Re: Depository Agreement between the City of Carmel and Huntington National Bradley Meyer Bank, dated December 31, 2012-Trust#4087000414 Secretary Tom Crowley Commissioner Dear Kim: Jeff Worrell On December 30, 2013,you are hereby authorized and directed, as the Depositary Commissioner under the above referenced Agreement,to pay the amounts set forth on the attached Register of Claims from the above-referenced Trust account and overnight Gregory Phillips checks to: Commissioner Carmel Redevelopment Commission Attention: Mike Lee Les Olds,AIA 30 W Main Street, Suite 220 Executive Director Carmel, IN 46032 City of Carmel, IN By: Diana L. Cord ray, Clerk-Treasurer 30 WEST MAIN STREET, SUITE 220, CARMEL, IN 46032 OFFICE 317.571.ARTS (2787) FAX 317.571.2789 CARMEL REDEVELOPMENT COMMISSION Register of Claims 12/30/2013 Payment Request#3 Amount of Wire Vendor Address Invoice Description Instructions 720 3rd Ave SW Carmel, IN pay app 3,Nash garage Signature Construction Services 46032 $ 19,384.50 construction mgt IF NEEDED 2932 N.Webster Ave. Gibraltar Construction Corp Indianapolis,IN 46219 $ 155,700.00 Pay app 2,Garage&ramp IF NEEDED 2933 N.Webster Ave. Gibraltar Construction Corp Indianapolis,IN 46219 $ 60,300.00 Pay app 3,Garage&ramp IF NEEDED 2934 N.Webster Ave. Gibraltar Construction Corp Indianapolis,IN 46219 $ 320,090.00 Pay app 4,Garage&ramp IF NEEDED Total: $ 555,474.50 ALLOWANCE OF CLAIMS We have examined the claims listed on the above Register of Claims,consisting of 1 page(s),and except for claims not allowed as shown on the register such claims are hereby allowed in the total amount of: $ 555,474.50 .- Zi Director of the C•C Date APPLICATION AND CERTIFICATION FOR PAYMENT ,4la DOCUIvIENTG702 PAGE ONE OF 2 PAGES2 TO OWNER CRC at City of Carmel PROJECT: Nash Garage APPLICATION NO:Application 5 3 Distribution to: Carmel Indiana 46032 Signature costs OWNER J ARCI-I ITECT PERIOD TO: 12/16/2013 X 1CONTRACTOR FROM CONTRACTOR: VIA ARCHITECT: Pedcor Design Signature Construction Services LLC 1 720 3rd Avenue S.W. PROJECT NOS: Carmel,Indiana 46032 CONTRACT FOR: CONTRACT DATE: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been Continuation Sheet,AIA Document G703,is attached completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due- I. ORIGINAL CONTRACT SUM S 156,776.00 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3 CONTRACT SUM TO DATE(Line I±2) S 156,776.00 4 TOTAL COMPLETED&STORED TO $ 128,345.40 j 1� By /2-( / Date: � 17 5. RETAINAGE: Thoma oontz,President a. 10%of Completed Work $ 0 ubscribed an sworn to before me this day of (Column D+Eon G703) b. %of Stored Material (Column F on G703) Total Retainage(Lines 5a+5b or Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 128,345.40 In accordance with the Contract Documents,based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application,the Architect certifies to the Owner that to the best of the 7 LESS PREVIOUS CERTIFICATES FOR Architect's knowledge,information and belief the Work has progressed as indicated, PAYMENT(Line 6 from prior Certificate) S 108,960.90 the quality of the Work is in accordance with the Contract Documents,and the Contractor 8. CURRENT PAYMENT DUE S 19,384.50 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH,INCLUDING RETAINAGE S 28,430.60 1q1 5� (Line 3 less Line 6) AMOUNT CERTIFIED....... ...$ 4 1� CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Total changes approved Application and inuation Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECIL Total approved this Month By: Date: \2311 1 1 TOTALS $0.00 $0.00 This Cc icate i not negotiable. The AMOUNT CERTIFIED is payable only t'o the Contractor herein.Issuance,payment and acceptance of payment are without NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT-1992 EDITION'AIA'©1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292 Users may obtain validation of this document by requesting a completed AIA Document D401-Certification of Document's Authenticity from the Licensee. 4 SIGNATURE CONSTRUCTION LLC 720 3rd Avenue, S. W. Carmel, Indiana 46032 Application # 3 12/16/13 Nash Garage Carmel , Indiana Revised WORK COMPLETED TOTAL BALANCE TO DESCRIPTION OF SCHEDULED Change SCHEDULED FROM PREVIOUS THIS COMPLETED AND FINISH WORK VALUE Orders VALUE APPLICATIONS PERIOD STORED TO DATE % LESS RETAINAGE RETAINAGE General Conditions 92,161.00 92,161.00 92,161.00 0.00 92,161.00 100% 0.00 0.00 Construction Management Fee 64,615.00 64,615.00 16,799.90 19,384.50 36,184.40 56% 28,430.60 0.00 156,776.00 0.00 156,776.00 108,960.90 19,384.50 128,345.40 82% 28,430.60 0.00 i !& Document G732TM - 2009 Application and Certificate for Payment, Construction Manager as Adviser Edition TO OWNER:.City.of Carmel Redevelopment Comm PROJECT: Parcel 9-54 Parking Garage&Ramp APPLICATION NO: 2 DISTRIBUTION TO: One Civic Square :.::._ OWNER Carmel, IN 46032 r PERIOD TO 10/31/13 CONSTRUCTION MANAGER FROM Gibraltar Construction Corp VIA CONSTRUCTION CONTRACT DATE: 5/2/13 ARCHITECT _ CONTRACTOR 2932 N.Webster Ave: MANAGER: PROJECT NOS: l / CONTRACTOR Indianapolis, IN 46219 — FIELD CONTRACT FOR: 9 Garage VIA ARCHITECT: OTHER •Nash Gara e CONTRACTOR'S APPLICATION FOR PAYMENT: The undersigned Contractor pert' es that to the best of the Contractor's knowledge,information and belief the Work covered by this • ..Iication for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contract: Contract Documents,that all am. is have been paid by the Contractor for Work for which previous AIA Document G7O3TM,Continuation Sheet,is attached. ° Certificates for Payment were iss i-i and payments received from the Owner,and that current payment 1.ORIGINAL CONTRACT SLIM $ 1,476,000.00 shown herein is now due.`' 3.CONTRACT SUM TO DATE(Line I±2) $-1,476,000.00 CONTRACTOR: Gibr 1 on. uction Corp //„ Date: ,f/� 9��4Y3 Q.TOTAL COMPLETED AND STORED TO DATE(Column G on G703) $ 516,900.00 State of: ,'4 if 4 5.RETAINAGE. County of: 1/rt i „,,PRY" E( BRIAN R MCBRIDE a. %of Completed Work Subscribed an sw, be ore Res, of Hancock Cour/ p * 'sl (Column l?+Eon G703) $ 51,690.00 me this 9” / day of/' C;.r8y�e�� My Comm. E, 11-29-2017 b. %of Stored Material Nota D I •t4' CO mmi SS1Cn # 611862 (ColumnF on G703) S My Commission expires l..- . --/ ff Total Retainage(Lines 5a+5b,or Total in Column Ion G703) $ CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 465,210.00 In accordance with the Contract Documents,based on evaluations of the Work and the data comprising (Line 4 minus Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT 309,510.00 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 AMOUNT 8.CURRENT PAYMENT DUE $ 155,700.00 CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED —C700 IC700 (Attach explanation ifamount certified differs from the amount applied.Initial all figures on this (Line 3 minus Line 6) $ 1,010,790.00 Application and on the Continuation Sheet that are changed to conform with'the amount certified.) CONSTRUCTIO. ,., , ER B Y � � Date. /.l/✓J la SUMMARY OF CHANGES IN THE WORK ADDITIONS - DEDUCTIONS ARCHITE ',:t1Til If Multiple Prime Contra tors are responsible for performing portions of the Total changes approved in previous months by Owner $ $ Project t ie chit Certification is not required) Total approved this month including Construction B ...A Date: rci k Change Directives $ $ Th . Certifica'e is cT go .le:The AMOUNT CERTIFIED is payable my the Contractor named TOTALS $ $ herei Issuan'e,payment and acceptance of payment are without prejudice to any rights of the Owner NET CHANGES IN THE WORK $ or Contrac 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 G732""—2009(formerly G702r",CMa—1992).Copyright©1992 and 2009 by The American Institute of Architects.All rights reserved.WARNING:This Ale 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 civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AEA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright @aia.org. CONT4N&JATION SHEET Page 2 of 3 APPLICATION NO. 2 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 10/23/2013 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 10/31/2013 ARCHITECT'S PROJECT NO. : A B C D E F G H I - WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE N0. DESCRIPTION OF WORK VALUE FINISH (IF VARIABLE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G 1 C) (C-G) RATE) (D.+E) DORE) (D+E+F) 1 Mobilization 25,000 $15,000 $15,000 60% 10,000.00 1,500 2 General Conditions 42,000 $16,500 $12,000.00 $28,500 68% 13,500.00 2,850 3 Engineering and Layout 8,100 $6,400 $500.00 $6,900 85% 1,200.00 690 4 Mass Excavation 135,000 $135,000 $135,000 100% - 13,500 V 5 Mass Backfill 86,000 $0 0% 86,000.00 - 6 Foundations- Material 52,000 $25,000 $13,500.00 $38,500 74% 13,500.00 3,850 7 Foundations- Labor 42,000 21,000 10,000 $31,000 74% 11,000 3,100 8 Cast in Place Walls- Material 76,000 12,000 45,000 $57,000 75% 19,000 5,700 9 Cast in Place Walls - Labor 124,000 19,500 70,000 $89,500 72% 34,500 8,950 10 Elevator Pit- Material 2,000 $0 0% 2,000 - 11 Elevator Pit- labor 3,000 $0 0% 3,000 - 12 Slab on Grade- Material 41,000 $0 0% 41,000 - 13 Slab on Grade - Labor 31,000 $0 0% 31,000 - 14 Topping Slab- Material 55,000 _ $0 0% 55,000 - 15 Topping Slab- Labor 22,000 - $0 0% 22,000 - 16 Metal Pan Stairs- Material 2,400 $0 0% 2,400 - 17 Metal Pan Stairs-Labor 6,500 $0 0% 6,500 - 18 Precast Hollow Core Planks 161,000 $0 0% 161,000 - 19 Masonry 142,000 $0 0% 142,000 - 20 Structural Steel Material 195,000 21,000 $21,000 11% 174,000 2,100 21 Structural Steel Labor 34,000 $0 0% 34,000 - 22 Earthwork and Site Utilities 85,000 $0 0% 85,000 - 23 Rebar Material 52,000 38,000 10,000 $48,000 92% 4,000 4,800 24 Rebar Install 29,000 9,500 12,000 $21,500 74% 7,500 2,150 25 Allowances 25,000 25,000 $25,000 100% - 2,500 $1,476,000 $343,900 $173,000 $0 $516,900 35% $959,100 $51,690 ISA Form # 1-402 . M AFFIDAVIT AND WAIVER OF LIEN Ii FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and /or labor for a project known as Parcel 9-54 Garage & Ramp and owned by City of Carmel— Redevelopment Commission and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of One Hundred Fifty Five Thousand Seven Hundred and No/100 Dollars ($155,700.00) ❑ receipt of which is hereby acknowledged; or Pq the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER)that the final balance due from the Owner is the sum of Dollars ($ .00) Ti receipt of which is hereby acknowledged; or n the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto the Ow'er of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon ac( •unt of LABOR or material or both, furnished by the undersigned thereto, subject to limitations of conditions express-1 herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work perfor eo or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By i1 Title President WITNESS MY HAND AND NOTORIAL SEAL, this 4'7,1/4 Ilemb\7r, 2013. (Notary Public) to (9,79 dN'DIA A SUBCONTRACTORS ASSOCIATION INCORPORATES) / P BRIAN R. MCBRIDE 4 UnPoihsr•rad OltOTORki it r, Psoh.b,+e0 = R,s. of Hancock County R1,7 1040 My Comm. Exp. 11-29-2017 p,at" Commission # 611862 r = r ti ® tylf., A,, I i t\ t i 0732TM ® 20®9 Application and Certificate for Payment, Construction Manager as Adviser Edition TO OWNER:City of Carmel-Redevelopment Comm PROJECT: Parcel 9-54 Parking Garage&Ramp APPLICATION NO: 3 DISTRIBUTION TO: One Civic Square OWNER —Carmel,IN 46032 PERIOD TO: 11/30/13 CONSTRUCTION MANAGER — FROM Gibraltar Construction Corp VIA CONSTRUCTION CONTRACT DATE: 5/2/13 ARCHITECT CONTRACTOR: 2932 N.Webster Ave. MANAGER: PROJECT NOS: / / CONTRACTOR Indianapolis,IN 46219 — FIELD _ CONTRACT FOR: Nash Parking Garage VIA ARCHITECT: OTHER CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifieithat to the best of the Contractor's knowledge,information and belief the Vt,'oik covered by this App cation for Payment has been completed in accordance with the Application is made for payment,as shown below,in connection with the Contact. Contract Documents,that all mount I have been paid by the Contractor for Work for which previous AIA Document G703TM,Continuation Sheet,is attached. Certificates for Payment we ".sue nd payments received from the Owner,and that current payment 1.ORIGINAL CONTRACT SUM $ 1;476,000.00 shown herein is now due. ; 2.NET CHANGES IN THE WORK $ 0.00 CONTRACTOR: Gibralta•, on,ruction Corp 3.CONTRACT SUM TO DATE(Line I±2) 5 1,476,000.00 By: !!/ Date: _ -, 4.TOTAL COMPLETED AND STORED TO DATE(Column G on 6703) $ 583,900.00 State of:. �/, go�•� 5.RETAINAGE: County of: ��/�a// .J y a. %of Completed Work Subscribed and s f' 'to ■ foie e�� PUS BRAN tSR fAN R. M C BRi DE '' rrh3S. . Han",o k County (Column D Eon G703) $ 58,390.00 me this,' day of/t/ %). ;� 't �y Comm. Exp. 11-29-2017 b. %of Stored Material Notary Public: (Column F on(c703) $ M Commission ex.ires: D I 0 rCmmSSIOR # 6 B62 Total Retainage(Lines Sa+5b,or Total in Column Ion G703) $ - CERTIFICATE FOR PAYMENT 6.TOTAL EARNED LESS RETAINAGE $ 525,510.00 In accordance with the Contract Documents,based on evaluations of the Work and the data comprising (Line 4 minus Line 5 Total) this application,the Construction Manager and Architect certify to the Owner that to the best of their 7,LESS PREVIOUS CERTIFICATES FOR PAYMENT 465,210.00 knowledge,information and belief the Work has progressed as indicated,the quality of the Work is in (Line 6 from prior Certificate) accordance H ith the Contract Documents,and the Contractor is entitled to payment of the AMOUNT 8.CURRENT PAYMENT DUE IS 60,300.00 CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ (P, 1 3b0 (Attach explanation if amount certified differs from the amount applied.Initial all figures on this (Line 3 minus Line 6) $ 950,490.00 Application and on the Continuation Sheet that are changed to conform with the amount certified.) CONSTRUCTIOi NAG 1 By: _j;�' Date: t 127/3 SUMMARY OF CHANGES IN TEE WORK ADDITIONS DEDUCTIONS ARCHI C , 'tl , triple Prime Contractors are responsible •r performing portions of the Total changes approved in previous months by Owner $ $ Pro Jett,the 4r. ;le ts:I,ifcation is not required.) Total approved this month,including Construction B • .00---4 Date: Change Directives $ $ is Certifica J not nYP t able.The AMOUNT CERTIFIED is pavab e o y to t e ontractor named TOT ALS $ $ h=em.Issuan e,payment and acceptance of payment are without prejudice o an rights of the Owner NET CHANGES IN THE WORK $ or C. ctor nder this Contract. CAUTION:You should sign an original AIA Contract Document,on which'this teat appears in RED.An original assures that changes will not be obscured. AIA Document G732T'—2009(formerly G702.4"CMa—1992).Copyright X31992 and 2009 by The American Institute of Architects All rights reserved,WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorised reproduction or distribution of this Ale Document,or any portion of it,may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce len(10)copies of this document when completed.To report copyright violations of AIA Contract Documents e-mail The American Institute of Architects'legal counsel,copyright @aia.erg. CONTINUATION SHEET Page 2 of 3 APPLICATION NO 2 APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contractor's signed Certification, is APPLICATION DATE: 11/20/2013 attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts PERIOD TO: 11/30/2013 where variable retainage for line items may apply ARCHITECT'S PROJECT NO. : A B C D E F G H i v - WORK COMPLETED MATERIALS TOTAL ITEM PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS FINISH (IF VARIABLE NO. VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (G!C) (C-G) RATE) (3+E) DORE) (D+E+F) 1 Mobilization 25,000 $15,000 $5,000.00 $20,000 80% 5,000.00 2,000 2 General Conditions 42,000 $28,500 $4,500.00 $33,000 79% 9,000.00 3,300 3 Engineering and Layout - 8,100 $6,900 $6,900 85% 1,200.00 690 4 Mass Excavation 135,000 $135,000 $135,000 100% - 13,500 5 Mass Backfill 86,000 $0 0% 86,000.00 - _ 6 Foundations- Material 52,000 $38,500 $8,500.00 $47,000 r 90% 5,000.00 4,700 7 Foundations-Labor 42,000 31,000 7,000 $38,000 90% 4,000 3,800 8 Cast in Place Walls-Material 76,000 57,000 12,000 $69,000_ 91% 7,000 6,900 9 Cast in Place Walls- Labor 124,000 89,500 21,000 $110,500 89% 13,500 11,050 ` 10 Elevator Pit-Material 2,000 500 $500 25% 1,500 50 11 Elevator Pit-labor 3,000 1,000 $1,000 33% 2,000 100 12 Slab on Grade- Material 41,000 $0 0% 41,000 - 13 Slab on Grade-Labor 31,000 $0 0% 31,000 - 14 Topping Slab- Material 55,000 $0 0% 55,000 - 15 Topping Slab-Labor 22,000 $0 0% 22,000 - 16 Metal Pan Stairs- Material 2,400 $0 0% 2,400 - 17 Metal Pan Stairs-Labor 6,500 $0 0% 6,500 - 18 Precast Hollow Core Planks 161,000 _ $0 r 0% 161,000 - 19 Masonry 142,000 $0 0% 142,000 - 20 Structural Steel Material 195,000 21,000 $21,000 11% 174,000 2,100 21 Structural Steel Labor 34,000 $0 0% 34,000 - 22 Earthwork and Site Utilities 85,000 $0 0% 85,000 _ - 23 Rebar Material 52,000 48,000 2,000 $50,000 96% 2,000 5,000 24 Rebar Install 29,000 21,500_ 5,500 $27,000 93% 2,000 2,700 25 Allowances 25,000 25,000 - $25,000 100% - 2,500 $1,476,000 $516,900 $67,000 $0 $583,900 40% $892,100 $58,390 ISA Form # I-402 i i-' { 'd: 1 ,3I 1{ I N , 1 ( 1:.,, AFFIDAVIT AND WAIVER OF LIEN n FINAL ® PARTIAL ® PAYMENT TO FOLLOW State of Indiana, County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and/or labor for a project known as Parcel 9-54 Garage & Ramp and owned by City of Carmel-- Redevelopment Commission and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of Sixty Thousand Three Hundred and -No/100 Dollars ($60,300.00) n receipt of which is hereby acknowledged;or ® the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due from the Owner is the sum of Dollars ($ .00) n 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 shall become effective upon receipt of such payment. THERFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements there n account of LABOR or material or both,furnished by the undersigned thereto, subject to limitations of conditions ex ressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work pe rmed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By I� p y Title President MH WITNESS MY HAND AND NOTORIAL SEAL, ttyis ' d of November, 2013. I ', (Notary Public) r, 1979 cw'.)',444A SUBi;)NTRACtC3a$ ASSOCIATION IN[(}gP7R0.tEi7 ,,c12'''� =:.E� BRIAN R. MCBRIDE U^aulha, ,a.l ner,,,h..c,.hs, P•c,,.,:1ed Res. of Hancock County p., I:>:; My Comm. Exp. 11-29-2017 NI- p V 0.N. Commission # 611862 ' _ jr 3'4tt �+.�F✓>i c- t_ . ^s a. A .' ^ fC`i! ;.r* et a e p 1:- `<'ob , J.i. L,-4- = try y .' '.a 0.'r ner‘u i a1 .`,. - *1 a �,r�, bl�.a-,��.''; -r�a-` PAS :.• :.'`` A�af+21 •.*kt.:'G .i - -4 r,. `k 4',0:;r'+ 1> .'"'y 'T F 1 :�cs4 S -'' ' i.fs � '� .1 ,�L^a k. Ft sN .'w t _'. 7 ,. '',. ,,�� 7¢ri ` sfi 4 .� t 3, a ' k '°i L r if N ' .r � �� s r s a .tom yt�- Y N A .�"h' fh t S f -y Y r t '-''. +g!"n moment 'b-7 a amr 1.x J<L f'• �y f y Y i tys l ,'k 'p - 4-5 i�'if3 R .. � . :-:,, -.. ht , ;i s ,-., r.,'• . x i t#.—:E�c`i ar tit..Fs f,- :'u �" .,,s�?, c3L,.,4 s. -' �;.is; ..-"11.44-144011-1V-4. 2 il.4A` X, a:gfn s6 yP j aY'i 7:,. ' 1I:4, �,Al..• .• tron.andi��e F j e '1?aymen# C.. i„,... alter as lr,;'Edi#one � t x = "'""PTO OWNER:eit916f Gartner'Redevelo ent't om'rti PROUEE7: `Paresl 9=54aParking Oarage�S Ramp . A T 4 ,B.�._ �•;� zQn= ivi` quare , , - . . ... .; .,. ,• �� J � .:� �.� .�., . DIS IBU;T10NhT0:' Ay■ e : nm� :-.+..+J,.r #.., ? .� -e+, ,m ..$,,- r,#�`',7,' .5� k .:,fir �i , {r?. ;w✓ a, '}.:Carr;,_ IN '�.' a 4 r .`or 't..+C' �5� : .4., *.'' TA, 5 '1 ..- w "a:.-.$4,-. :0. QWNER Lvi ��. '. 4609 ,�'$ ,,- . ..• i 4 „�� �. .- � t,;�s�ros _ �ja. �„� k-*,^01 T.,e ..,e .2 .. , �3, t .a s r.1 t -w PERIOD TD 1 J•v„, `=, ' ' ;.0 `I > ""GE ,,- IRROM�:ter , .;.- ..;-tar Gons44.., n � r �, ;-1-< ., . . {,, „, a ONSTR0%4..I MANAGER ,,:l . .4 �/ :.-:..; t-C m ' ,VIA CONSTRUCTION " "b . ' , t ' _" .-:. r CONTRAC A 5/V�3 � . :,CONTRA/yy��T� OR`-2932 N.Webster Ave. 4, ,1;■■■'��.�11��,��`:9., 4? .A� , a .,`ir /,u--11 s <s : ; t, .sa:r ' -*-.....1...:t. _ C1-IiTECC-F tR .,?-6M,isrdsT,,: ,� �'s vt•-.c•.. VER:.* a� n ,.- , .a `ku - ''a-4', �. ,,I'ROJEYT.NOS . /. - _.:, y�..r 1 , c- RA ce r= ,.1-'' ind ancipalis, x,4629 - a'i + s!?„^ 4, y4. ,4'.; , t'`S i' ti i. .•4 • .��-µ '1.4 Ed VO 1rV9C -,pis wa ,--,-.. •.. 3;' ...n.. ':,1 t. ;t,-: r' S iy..i- ii `', ' ' .. e5 • =iw pth�. e n .iw1 ;� ;•,'' A..,•i " ;. . x�' i(-. ,"�',:v "4-4%-0,.f.',1-/f,?....- ,� _ l yre�; r 11 3.. .`k:,',1 .f ! .4 ti CONTRAC FO •Nash Perking Garage " '� � ,, Pz k , > �. -FIELDs , . . ii. 'VIAVARCHITECT i; �t ,, TIiER1 i r ;tt,�� .tea u - �� ..x ...� �:?;r3-c..� 1,.n.' _. tr�rxc�r,•�t� -s`�,+� f •ZL§� ..w'�� x'�63-e.��'�e.��t ,e�, r �.��'� "r�'«.:. � �-!�zr '�!3F .n�r'ru Env.,'•:.., r ��1 > � c ' C N_IT�RI,�CT�RaS APP reTal -Oft PAYMENT 4 •�h na ; l�awcofl ea�n�t ta�the>> Taf:lte c �,a ton } ` . .y am -. I. l �-' - .�. ,ter _ ''"', e.,:;,,, $ . : t,1F , a,: ;belief tftc Wotkfc�o�`vered th < ♦ trac s lcnowlaii r LA i FA licaho Isima ' � _. ?�a. �t . r - .-w�,� f'�„ . w � a°° r,s Apphcatron`for Pay., - .,b .corepl eccordanceawith the pP paym t,as shown below to connechoniwith•the Contract, i t is a• ,. - - c. - • i ;.,; p ALii-b ilt G7 pnua is attach'cd�° Ai' 1 '- `�" ocwttarits,t. t.2. l-tea is have b"ear,:pa .by the Consra�eto'r for Work,fo;whrch prevrous • r ¢�� ' `tt it o ' C-.0.- Certrficates for^P,a ent we. t � and a is mewed fmin-the--........,1 wns andith t_stFr ear.>_a'::. 9 r 1"2tta". !s K•w e"r1`.� ,y-:+" t' ' ,4' :e: °' t rr Y: .P. .-�- �r , -- p mt 1 tORIGtNALCQNTRACTSUi �$ 1000 ,shovvtiihera now duc. �� �' ' a a- k m ,478 r � T 'i CHANGES N THE YVORK �, A' '' v'i '''�i ^ -_ _ ,. o "rsd: .,,CSI --'2.1%?;---17, . _. Z YNEw,iT C ,,..,t x ` .1 .$ - CONTRACTOR;oral ;�' ctl�CtP,�. � � • 3,CONTRACT SUM TO DATE. ine l f l ' ; v ', 6 ' a .� r r s -,-� , k, i r;, ' �.,,1. _ '� ,u. 4iTOTAL 1' , 4 -tnW, `g_ 1„ ,-,,,,,,,,,,,,,,,,'1,-1,7'-w,-00 00 f s ©. t ,� y..-i 2x '.1a8 a� / COMP 1 ED AND STORED TOAI,t1Ej(Columtontao i G703)3.r. ..,..41. 1.19, . ,, ta f` l°�`'/„ =s., �,"`"1 ;: ' - t ,. - •,g k'1,9 3 k _C.P, .7'''-igw-1-4 .,.JA'.•i`i "�, :4^ 6,.rv... '971: ! • /�J '. Y1 ]1 •t':� -.'` Mr.. 4 t ', .l � G. � C i�?-.•t:., y�-.', .tr•'. ., !'.... � :�..,, .. .e `�� ,�. .7�� .� k:•°4. 3 �.^f.. r RETAINA E.f �,',".'1,44..-t .ig ',,,t, ,;f {� .7 • ._ ..�,ps `..tt:.Countyof. �� wt ,:,4' sip r^ :' '' , � t, , SR,.,ti. �., Lam' . , ,:�_ i ' : .. .vt r �, � --ATI . MCBRIDE a. fo3OT.Completed'Wark r, :: „y`, z, 9 ` : 'SubsQcn`bed }"..ry�,c2 pew `p '':«ry,,`,` _ 8 :u /��1r-r�/t��' r r•rtl 5 -. i",,,, .. `�C •,..;. ,-,.J 'Y k� 3`i. 1 , .n %'4,--J%-f '4. 3•T t ' �I� 1 I^^--/il M ,, (Golu►nrilD Ean,G$03) ,:i ;$,, r :r7380000. i methis *�d ,t nxdayoft� 'Sr� of H w b %50fi$[Oi 'MBtenal 1 ,'' ' ,s':- , !' L,• y::a2 . a- c'1., I-;: 4 aiMicOla 1/ h •e711,% 'MY atFmn ss��1 .t82, '- �. yt ";•+ '°."'s'_, ._ F u r �': ..,�,.R r }:•-;NotaryP.ttblica lip i> ;tF. 'td. a :�4`9.'aK _-rP'.r,;p... .€ .. ( �n;F'Oni�ytCiZ0j),. c� it : r �Si,-4t g v 4„`f .� � 1.�. :�'rIv1 Y.iCotntalssion�ltDtres'������� °�ti�_ x..n^€�°.� s�:.� ,'ns!�...�.... ... w TOtBIiR.etain .'''?"'S'Sa+ b Ors•t i »Z. '. _+F, '' -. 3a -1 e t i .�,,...7, t w rf0 Ch-.N,; „ :,t ,t n iM* Total n Column I onZG7U3) .......!,S3-4.118..--i2.-.... .0.1..1. t.�CERTIFICATE FQR PAYMENT .* , ° ; f. .B�---r- r---- - RETAINAO 4'4i It 845;800?QO -,.6"... ...W .a + .v e it t. at-...0 :t.3".ta., - c 1. Ya _ y ••�,• ..5 ..¢ ? r-Vila accor'dance;withitthe'Contract Documents;based onrevaluahons'ofithe Work;and thetdata,com nsiri ^°`rte,°J` .._�, f _'' ? ;: Y 7 .� i +�.. L i ,-IT. . P 8 -� :t. �v u..t'7.-�"§�•.,+�t'+"4�:�"�:�'. �• �* E'er',based �L,>`41:.:';:- ��F - §3•.-. (L ne�4 mtnus Ln►e S To ol) t alt. t y : ' ' 'z. ,/e,,44 Fr' i-this application,theigonstruetton M manager and Areaitect cerury ttmne;Owner that!Dane best of their;_: ..,cf-a• ... a _ •�_i �k 7 .: .t V.4,^"^3" .10,1.7-a 1.1.4 b a is V—. - ""! s "v.'r#.» .' 1.1,-. .c•.: 7 LESS'f!REVIOUS GER7iF1CATESFOR PAl!MENT s _ - -St 525¢5i1rs 00 'kn wledge,mformatron dlbelief eiNork has prog anse Itas tndicatd the�quoityprte+Work9san ..zr �� ? .fir .. e (Line ti fram pnor Certificate, '=_mace . `. ^accordance wiythlthe Contract?Documents;landithe Contractor utleedittoipaymient oft ie/AMOUNT» 6 CURR IT'PAYM ,4'" .e , t k }' , GERTIFiED`" .3.'• ;.;f; „,,,,..-,94--:•= F + .'.'r _ _•ENT DUE .1SY- 320,090:006 4,; •:M < 9 B'11L CETO;FINISINCLtJD1NG Y ,s y �{ x x r I t RETAIN 4'. : y '' ,AMOUNT CERTIFIED r r $ ', � rY'a� :¢ c t. i i I' ” � " .�.:� - ir tx, j r:��$ �..4.".. u_�'`tM s-4-�'a$�.,� �»' . - ;5t;.�ter„ � _ IM'��!�„•t �,: r = '(Attachlex l martonr f anima cent ect dijjers fromithe minounl aprillaNghtdl�all, res on this: . -. ' `rnner3m . .:,; +,,�;- �� : � :t r F;r� € '�,�-�.,-^830�400� .!.„:"1.,...i 3t�1.„-; r � ,.,r:4,,>-.:>�-€si=;.�ti. x1�;,. ;, ;,.x�-1^a�,=='�. :; x',�.R:�w4 .;, a�-,.'�--:�8�..� R a _. (L inia7Lrne 6) $1.1,x4.) 3_. _ ,00 ;: Applicatmnrandyon the Continearwn.She t rhat'are,changed•to wnfor, tt►vttle!t..e amoi.nticertrnfred.' v °. /�� :ix " i�`t''J '^S r y.., ". , t1C�r"rf' }�2 1F ;3' iz• ra. r �:' '. Y.1 _ ) 'S"' I 5 ,t' 7.. aM O+ T y. .laY rf�F fir" t .Y -� 1( '.'#,.'1' =q�f' ~ a: �- '.7r. Tr'.it,-',';',"1" s • r -CONSTRUCTION AGE _ ,s� ''',...7 ( s: xx�� ._ ; .gam _ �— � _, ,a/,�> • •SUVE RYiOF i HA]VGES allilEiW,ORK4s:6'° ,; '.pDDTTI'ONS�,s l3DEDUCti71ONSij ;A{tC CT. 'oY IfMuttiplejPrime -ontiactors,areres onsiblel or'e"onnin ortions'o Owl. L.:' Total "�'et�tous4tnanths ly Ownert�S'Lt�•-� ; �-�$ ,��-i� r�P%/ect jth rch Ceruficatton u�,tat'requtre�d�� '�• '' �'` •Total ippitA d thiri ontly tncludiii ei nstnrnction Y ' F 3 p-.t.t.'• ,:4.. s- # ' ' , a; - +, F..s ,�_ .":1-1/43,A,-.•:, Sc a CJIdT E ;n~K ,• _� _; j GettiFi payatile - •theiContr-. r•--. ` ::� �� s s r 1,`i n I. r � ?_-,_.. .t_ .� , 't,r-".',I irOTALSit$ Ski,-, ., �.�i.!Ski : .1 h. ::, Is Cep a� �rgri trncep�+?y E lwu _,.��': i n ; HA?4 8 IINeTHE WORK ,-tr .-of. ent.are without �� the Owner NIETrC G 3 s ra ,.;�.�,�Ste._ ' ;.�. .� _ � t �. �. dcceptan paY►b ;,�preludscetoan n,,7,[s;of ,rt F'Xr4;;.:xti i!1.' W-t.;'s k.. Nc'. :4 1 V 5 ?: 1.•1,."%i' r•a. .J.;' 1.- + ,1:'i '�`'ar y.•.._ -,-•,-,1,S,,,,,;,,,t,...- '.:. .. CAUTION Youshoultlsign}att eW Inal 'P` 'y " �''a`� X r f# �AIIAyCgntractiOtrctunent,on Which.thfs�text appears in RED An?orlgtna!?gssures tllatechangearwiilynot beznbseused_. x A1A Doum t 6732 TM 2t lg itmrialy Oinkrate*s iiii COpyrietlt C 1.99 2 send 2009;try T,h'tAreriean,Indtlti teoAr_criit ecta All l Q• t•' ,e--ervod�WAR NNG Th ls=A IA l7oe u ent la prot este d RiyU S Copyright law'aid.' d , .M../0 ?'_y "-M'''' "�'=',n�� m= .. . :.". ./..-4r;;.; . . .,..,,...":S.';',.,„...."1"—A-•,,-_, 0 ,•,¢ , a_ l , .t : -i , mInieriatogelT reatieaUnauthorlsed3e pr duetlan ar,dlsMuionofthtsArA`UOeirtiont'pranyportion Of itmay;rit sult in,severe clytand;crtminglpenat klespndiviittel roaaec uted to t e:ma'ilii mexteht'posslble under he lint Prcha eersiti qp,eini tr�ia.".nniQstsni(l0)mplea ofthiIk mint Own colripieted Tareport'twpynght violatbna OVAJA Contnict lbcuments-i mall The Arriericarri rialtole:oBArchitecte'legal:counsei,copyonht®aie alt.• CONTINUATION SHEET Page 2 of 2 APPLICATION AND CERTIFICATE FOR PAYMENT,containing Contractor's signed Certification, is APPLICATION NO. : 3 attached. In tabulations below,amounts are stated to the nearest dollar. Use Column I on Contracts APPLICATION DATE: 12/12/2013 where variable retainage for line items may apply. PERIOD TO: 12/31/2013 ARCHITECTS PROJECT NO. : A B C D # E F G H _ I WORK COMPLETED MATERIALS TOTAL - ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED(NOT IN STORED TO DATE (01 C) FINISH (IF VARIABLE (D+E) D OR E) (D+E+F) lc G) RATE) 1 Mobilization 25,000 $20,000 $20,000 80% 5,000.00 2,000 2 General Conditions 42,000 $33,000 $2,500.00 $35,500 85% 6,500.00 3,550 3 Engineering and Layout 8,100 $6,900 _ $6,900 85% 1,200.00 690 4 Mass Excavation 135,000 $135,000 _ $135,000 100% 13,500 5 Mass Backfill 86,000 $28,000.00 $28,000 33% 58,000.00 2,800 6 Foundations-Material 52,000 $47,000 $5,000.00_ $52,000 100% 5,200 7 Foundations-Labor 42,000 38,000 4,000 $42,000 100% 4,200 8 Cast in Place Walls-Material 76,000 69,000 $69,000 91% 7,000 6,900 9 Cast in Place Walls-Labor _ 124,000 110,500 $110,500 89% 13,500 11,050 10 Elevator Pit-Material 2,000 500 1,500 1 $2,000 100% 200 11 Elevator Pit-labor 3,000 1,000 2,000 $3,000 100% 300 12 Slab on Grade-Material 41,000 16,000 $16,000 39% 25,000 1,600 13 Slab on Grade-Labor 31,000 V 5,500 _ $5,500 18%_ 25.500 550 14 Topping Slab-Material 55,000 $0 0% 55,000 15 Topping Slab-Labor 22,000 $0 0% 22,000 16 Metal Pan Stairs-Material 2,400 $0 0% 2,400 17 Metal Pan Stairs-Labor 6,500 $0 0% 6,500 18 Precast Hollow Core Planks 161,000 $0 0% 161,000 - 19 Masonry 142,000 52,000 v $52,000 37%_ 90,000 5,200 20 Structural Steel Material 195,000 21,000 174,000 $195,000 100% 16,060 21 Structural Steel Labor _ 34,000 30,000 $30,000 88% 4,000 22 Earthwork and Site Utilities 85,000 15,000 $15,000 18% 70,000 _ 23 Rebar Material 52,000 50,000 $50,000 96% 2,000 _ 24 Rebar Install 29,000 27,000 $27,000 93% 2,000 25 Allowances 25,000 25,000 $25,000 100% - $1,476,000 $583,900 $335,500 $0 $919,400 62% $556,600 $73,800 ISA Form tf I-402 • AFFIDAVIT AND WAIVER OF LIEN ❑ FINAL PARTIAL ® PAYMENT TO FOLLOW State of Indiana,County of Marion, SS Michael Smith being duly sworn state that he is the President of Gibraltar Construction Corp having contracted with the Owner to furnish certain materials and 1 or labor for a project known as Parcel 9-54 Garage&Ramp and owned by City of Carmel—Redevelopment Commission and does hereby further state on behalf of the aforementioned contractor: (PARTIAL WAIVER)that there is due from the Owner the sum of Three Hundred Twenty Thousand Ninety and No/100 Dollars ($320,090.00) ❑ receipt of which is hereby acknowledged;or 1 the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER)that the final balance due from the Owner is the sum of Dollars ($ .00) ❑ 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 shall become effective upon receipt of such payment. THERFORE,the undersigned waives and releases unto the,Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereoii .ccount of LABOR or material or both,furnished by the undersigned thereto, subject to limitations of conditions -xpr=ssed herein, if any;and further certifies that no other party has any claim or right to a lien on account of any wo ••-rf:r ed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Gibraltar Construction Corp By 1 Title President PIM WITNESS MY HAND AND NOTORIAL SEAL, ' i •i • December, 2013. (Notary Public) C 1919 1++Oi&NA Su9COw1AAE10AS OSSOCt4IiON AICOMOoai►teo :CO��Y pt Ras. R. MCBRIDE V•rutno,1*,Piplothotan ptan.i.tiA Rss. ui Hancock County R'" My Comm. Bp. 11-29-2017 Commission#611882