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Home My WebLink AboutPCA - Ritschard Bros - Demo of Vacant & Abandoned Houses, Phase VIII, Division D1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS September 13, 2016 Ms. Rachelle Dolniak Ritschard Bros., Inc. 1204 W. Sample St. South Bend, IN 46619 PHONE 574/235-9251 FAx 574/235-9171 RE: Project Completion Affidavit — Demolition of Vacant and Abandoned Houses, Phase VIII, Division D — Project No. 115-128 Dear Ms. Dolniak: The Board of Public Works, at its meeting held on September 13, 2016, approved the Project Completion Affidavit for this project in the amount of $94,926.00. A copy of the Project Completion Affidavit is enclosed for your records. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, Linda M. Martin, Clerk Enclosure GARY A. GILOT DAVID P. RELOs ELIZABETH A. MARADIK TAMES A. MUELLER THERESE J. DORAU PROJECT NAME PROJECT NO CONTRACT SIGNED PROJECT DESCRIPTION WITNESSETH: CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT Vacant and Abandoned and AGREEMENT The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. this 10 Rachelle L. Dolniak Printed Name 201 6 Ritschard Bros, Inc. Company Name 1204 W Sample St Company Address South Bend, IN 46619 City, State, Zip WITNESSESS: Before me, the undersigpned Notary Public in and for said country and state, personally appeared Rochelle L. Dolniakapd acknowledged his/her signature to the above Project Completion Affidavit on the th day of ne 2016 0%1RD l GN..... ERos N tarySignature MyCiss�b�B `29118/17 Robin Fozo "—•— Printed Name County orfl}2a i EkG Si. Joseph If the Contractor is a corporation, the following certificate will be'exed,�P Donald Ritschard, Jr. certify that I am ecr`etA*.... 4oration executing this release; that Rachelle L. Dolniak who signed thWeelease do behalf of the contractor was then e ' d nt 11 of said Corporation; that said release was duly signed for and on behalf of said Co or io by o rity ofSt go ding body, and is within the scope of corporate powers: Corporate Seal Donald Ritschard, Jr. Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acce�pta a for J1nal approval and we recommend to the Board of Public Works that it be ordained so. V `. Date: (0 • t a t (, Construction Vager BOARD OF PUBLIC WORKS APPROVAL Date: `I (3 / c (& Gary AGilo resident JV avid P. Relos, M ber E rza eth A Maradik, Member Therese J. Dlor ember James A. Mueller, Member a M. Martin, Clerk nu8. t. Lvvo 3;4)rivi If HP rvtl WUM 5 SAhEIY No.5866 P. 2 AFFIDAVIT AND 'WAIVER OF LIEN State of Indiana, County of St. Joseph SS: Rachelle L. Dolniak being duly sworn that he/she is the President (Name of Officer) (Title) of Ritschard Bros., Inc. having contracted with (Subcontractor/Supplier) to furnish certain materials and/or labor as follows: for a project known as Demolition of Vacant City of South Bend, Indiana (Contractor) of 7 Houses' (Description) Houses. Phase VIIT. Division D located at Various Addresses in the City and owned by City of South Bend (Owner) and does hereby further state on the behalf of the aforementioned subcontmctor(supplier: (PARTIAL WAIVER) that there is due from the Contractor 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. solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by she undersigned; (FINAL WAIVER) that the final balance due from the contractor is the sum of Ninety—four.. Thousand Nine Hundred Twenty—six Dollars -------------- -------- ($94,926.09 ❑ receipt of which is hereby acknowledged; or -_ ... . ❑ the payment of which has been promised as the sole consideration forthis Affidavit and Final Waiver ofLien which shall become effective only upon receipt of such payment TBEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever on the above -described property and improvements thereon an account of labor or material or both, famished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other party has any claim or right to a Hen on account of any work performed or material furnished to the understaled for said project, and within the scope of this Affidavit and Waiver of Lien. Ritschard Bros., Inc. By (Firm) (Authorized Representative) STATE Of INDIANA ) ) SS: ST. JOSEPH COUNTY ) Before me, the undersign4 a Notary Public, in and: for said County and State, personally appeared Rachel le L. Dolniak and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscp'bed my triune and affixed my offi ' seali the 30th day of April \` �p R2GYb . moo' S OTANotary o Public Si `_n'c My CommissionExpires: 9 / 18 / 17 = 08UG � Robin Fozo. Residingin St. Joseph County, Ind,' Notary Public Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 08/19/16 Name Toy Villa Department Engineering BPW Date 09/13/16 Phone Extension 5920 Required Prior to Submittal to Board Legal ❑ Attorney Name Controller ❑ Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing ❑ Check the Appropriate Item Type — Required for All Submissions ❑ Agreement ❑ Contract ❑ Proposal ❑ Addendum ❑ Professional Services ❑ Resolution ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Change Order No. ❑ C/O & PCA No. ® PCA ❑ Ease/Encroach. ❑ Traffic Control Company or Vendor Name New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Amount of Required Informa and Bros., Inc. No ❑ If E❑WBE ❑ No LJ Yes Name of Company Demolition of Vacant & Abandoned Houses — Division D 115-128 COIT 404.1201.415.39.87 $ 94,926.00 Project Closeout ❑ Required Contractor's Certification Form Attached (Non - Collusion. Non -Discrimination _ Nnn-r)Pharmanf F-\/arifv Iran ate Increase Decrease Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ ® ❑ ® ❑ For Change Orders Dispersal After Approval Elizabeth Maradik, Beth Leonard, Judy Love IVIIKe uar Tov Villa