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Home My WebLink AboutPCA - Lafayette Falls Subdivision Pavement - Walsh & Kelly, Inc.<r 1316 COUNTY -CITY BUILDING UWISIN �d,_i PHONE 574/235-9251 227 W. JEFFERSON BOULEVARD FAX 574/ 235-9171 .SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS November 8, 2016 Dustin Hilary Walsh & Kelly, Inc. 24358 State Road 23 South Bend, IN 46614 RE: Project Completion Affidavit — Lafayette Falls Subdivision Pavement Project No. 115-086 Dear Mr. Hilary: The Board of Public Works, at its meeting held on November 8, 2016, approved the Project Completion Affidavit for this project in the amount of $260,694. 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 c: Toy Villa, Engineering Cecil Eastman, Code GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK TAMES A. MUELLER THERESE J. DORAU fSpurN ggry CITY OF SOUTH BEND, INDIANA F: BOARD OF PUBLIC WORKS "U PROJECT COMPLETION AFFIDAVIT PROJECT NAME Lafayette Falls Subdivision Pavement PROJECT NO 115-086 FINAL COST $260,694.00 CONTRACT SIGNED 6/14/2016 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Work includes Dlacement of the HMA surface Davement and adiustino all castings to grade WITNESSETH The work under the above contract between the City of South Bend and the undersigned contractor having been completed the City of South Bend, 0 officials and agents are hereby released from all claims and demands whatsoever arising under c by such contro�l1 and at the contractor performed the work within the scope of the Specifications and Standards of the Cit, of South Bgn'4hiq"ere a part of the above Contract. day October 2016 Walsh & Kelly Company Name t y 24358 State Road 23 Area Manager Company Address e South Bend, IN 46614 City, State, Zip WITNESSES: Before me, the undersigned Notary Public in and for said county and state, personally appeared Dustin Hilary , and acknowledged his/her signature to the above Project Completion Affidavit on Printed Name If the Contractor is 2016 Commission Expires May 4, 2018 St. Ja h county unty of Residence St Joseph R86/ItSt��.i3rlate ill be executed. I, J Michael Schaff - t I am Secretary of the Corporation executing this release; that Dustin Hilary who signed this release on behalf of the contractoJ WAt1t"0n,, Area Manacier of said Corporation; that said release was duly signed for,oFi61Pod Cor rati Autho 0of governing body, and is within the scope of corporate powers: ` r : ' tiO vi yORATF ' Secret 's Signature�0� Fgrpp t Seal: J. Mi ael Schaum S Printed Name �'.� .......... DEPARTMENT OF PUBLIC WORKS APPROVAL i,,�NDIt%%, This project is acceptable i*r l approval and we recommend to the Board of Public Works that it be ordaineso. Date: it. 1• 14 Constructi Kmo Hager / / BOARD OF PUBLIC WO KS APPROVAL Date: Gary A. Gilot, President Suzanna . Fritzber Member Elizabeff A Maradik, Member 'Therese J. Dor , Member James A. Mueller, Member -Hhha M. Martin, Clerk CHUBB GROUP OF INSURANCE COMPANIES Surety Department, 15 Mountain View Road. P.O, Box 1615, Women, NJ 07061-1615 CML!®8 phone: (908) 903.3485- Facsimile: (906) 003-3656 FEDERAL INSURANCE COMPANY MAINTENANCE BOND Bond No. 8244-90-40 Amount $ 26,069.40 Know All Men By These Presents, That we Walsh 8, Kelly, Inc. 24358 State Road 23, South Bend, IN 46614 (hereinafter called the Principal), as Principal, and the FEDERAL INSURANCE COMPANY, Warren, New Jersey, acorporation duly organized under the laws of the State of Indiana, (hereinafter called the Surety), as Surety, are held and firmly bound unto City of South Bend, Indiana, Board of Public Works 227 W. Jefferson Blvd., South Bend, IN 46601 (hereinafter called the Obligee), in the sum of Twenty Six Thousand Sixty Nine Dollars and 40/100 Dollars ($ 26,069.40 ), for the payment of which we, the said Principal and the said Surety, bind ourselves, our heirs, exectors, administrators, successors and assigns, jointly and severally, firmly by these presents. Sealed with our seals and dated this 26th day of October, 2016 WHEREAS, the said Principal has heretofore entered into a contract with said Obligee dated June 14, 2016 , for Lafayette Falls Subdivision Pavement, Project No. 115-086 and WHEREAS, the said Principal is required to guarantee the Lafayette Falls subdivision Pavement, Project No. 115-086 installed under said contract, against defects In materials or workmanship, which may develop during the period of 3 years. (over) Form 16-02.0075 mV. 11�9e) NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that If the Principal shall faithfully carry out and perform the said guarantee, and shall, on due notice, repair and make good at its own expense any and all defects in materials or workmanship in the said work which may develop during the period of 3 years. or shall pay over, make good and reimburse to the said Obligee all loss and damage which said Oblfgee may sustain by reason of failure or default of said Principal so to do, then this obligation shall be null and void; otherwise shall remain in full force and in effect. Dustin Hilary, INSURANCE COMPANY :'ram/i �tlGa..•�� ✓G�! POWER Federal Insurance Company Attn: Surety Department Chubb C OF Vigilant Insurance Company 15 Mountain View Road $71rEiy ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin Corporation, do each hereby constitute and appoint Eric M. Wahlstrom as their true and lawful Attorney- in- Fact to execute under such designation In their names and to affix their Corporate seals to and deliver for and on their behalf as surety thereon or otherwise, the following Surety Bond Surety Bond Number 8244-90-40 Obligee City of South Bend, Indiana, Board of Public Works And the execution of such bond of obligation by such Attorney- in- Fact in the Company's name and on Its behalf as surety thereon or otherwise, under its corporate seal, in pursuance of the authority hereby conferred shall, upon delivery thereof, be valid and binding upon the Company. In witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 1St day of March 2013. Dawn M. Chloros, Assistant Secretary STATE OF NEW JERSEY County of Somerset ss. Richard A. Ciullo, Vice President On this 1 St day of March 2013 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros, being by me duly swam, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By- Laws of said Companies; and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that she Is acquainted with Richard A. Clullo, and knows him to be Vice President of said Companies; and that the signature of Richard A. Clullo, subscribed to said Power of Attorney is in the genuine handwriting of Richard A Clullo, and was theeto subscribed by authority of said By- Laws and in deponent's presence, Notarial ....�h' Seal '3"!=' `i - WENDIE WALSH = N0T"rxv ` Notary Public, State of New Jersey ruauc ; B` No. 0OU60&4504 ewj..... Expires April 18, 2018 Public CERTIFICATION Extactfrom the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: Notary 'All powers of attorney for and on behalf of the Company may and shall be executed in the name and on behalf of the Company, either by the Chairman or the President or a Vice President or an Assistant Vice President jointly with the Secretary or an Assistant Secretary, under their respective designation. The signature of such officers may be engraved, printed a lithographed, The signature of each of the following officers: Chairman, President, any Vice President, any Assistant Vice President any Secretary, any Assistant Secretary and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Assistant Secretaries or Attorneys- In. Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached' I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the'Companles°) do hereby certify that (i) the foregoing extract of the By. Lewis of the Companies is true and correct, (li) the Companies am duly licensed and authorized to tmnsact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S. Treasury Department further, Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands, and Federal is licensed in American Samoa, Guam, and each of the Provinces of Canada except Prince Edward Island; and (III) the foregoing Power of Attorney Is true, correct and In full force and effect. Given under my hand and seals of said Companies at Warren, NJ this 26th day of October, 2016. y�a3�� .sN"s #yuAaNaEn I,rS � ��` �r o� o ) —A— al� `,M, { 11A1x�1' (q7,' j1�1 It1 {(�]7(// W L � 5 Y r� - 1, 1� 8WAV Y- Y 116 � i • tt►`\qt�j tt atV V,rV(t`� 4xbIANh 'fi '� 'tirlWpPl- Dawn M. Chloros, Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAD, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908) 903- 3493 Fax (908) 903- 3656 e-mail: surety@dmbb. con Fenn 15-10-0154& SurePath (Ray. 03-13) CORP CONSENT WAIVER OF LIEN FINAL STATE OF INDIANA, ST. JOSEPH COUNTY: WHEREAS, the undersigned Walsh & Kelly, Inc. has been hereto employed by Citv of South Bend. Indiana to furnish certain material and labor, to -wit: Asphalt Milling and Paving for the building owned by City of South Bend, Indiana and located on Lafayette Falls Subdivision South Bend, 46601 St. Joseph County Indiana Protect # 115-086 NOW, THEREFORE, KNOW YE, That the undersigned, for a good and valuable consideration, the receipt of which is hereby acknowledged, hereby and now waives and releases unto the said Corporation, the owner of said premises, any and all lien, right of lien, or claim of whatsoever kind or character on the above described building and real estate, on account of any and all labor or materials, or both, furnished for or incorporated into said building by the undersigned; and we further certify that the consideration moving to the undersigned for executing this WAIVER OF LIEN has been mutually given and accepted as absolute cash payment and not as a conditional or part payment or as security for pa Signed, sealed and delivered this I t dav of Novembe! 2016 WAi:SH & LLY, t D n Hilary, Sciffh Bend Area Manager Personally appeared of a me this Ist day of November, 2016 Dustin Hilary who being duly swo��''nn� n oath, says: That he is the South Bend Area Manager of the Walsh & Ky, Inc. and that he hereby acknowledges the execution of the foregoing instrument for and on behalf of said Walsh & Kelly, Inc. and at their special instance and request. My Commission Expires 05/04/2018 This instrument prepared by: PJF Paula J. Fuc otary Public) PAULAJ FUCHS Notary Public, State of Indiana St. Joseph County Commission Expires May 4, 2018 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 11/01/16 Name Toy Villa Department Engineering BPW Date 11/08/16 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 Kequired Information Walsh & Kelly, Inc. ❑ Yes No ❑ If Yes. Aooroved by Purr•.hasinn ❑ No ❑ Yes Name of Company Lafayette Falls Subdivision Pavement Terms of Contract Purpose/Description Project Closeout ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. Required For Change Orders Only Amount of ❑ Increase $ ❑ Decrease $ Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ ® ❑ ❑ ❑ Cecil Eastman Toy Villa Dispersal After Approval