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Home My WebLink AboutPCA - Ignition Park Identity Signage Proj No 115-103 - Poblocki Sign Co., LLC1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 Justin Stuebs Poblocki Sign Co., LLC 922 S 70"' Street Milwaukee, WI 53214 ISpUTH B O _ U rends a 1865 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS November 22, 2016 RE: Project Completion Affidavit — Ignition Park Identity Signage Project No. 115-103 Dear Mr. Stuebs: PHONE 574/235-9251 FAx 574/235-9171 The Board of Public Works, at its meeting held on November 22, 2016, approved the Project Completion Affidavit for this project in the amount of $141,437.00. 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 c: Aaron Kobb, Community Investment Toy Villa, Engineering GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU 45ouTkg'��. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS ., PROJECT COMPLETION AFFIDAVIT �,abs PROJECT NAME PROJECT NO CONTRACT SIGNED PROJECT DESCRIPTION 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, 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. Executed this day of _50 42MJA5M, 201 Lo Poblocki Sign Co. L L C. Company Name Signature 922 S. 70th Street Company Address Printed Name Milwaukee_ WI 53214 .•`�_.wt WEN., Vr WITNESSESS: f ?OTAq y '•: Before me, the undersigned Notary Public in and for said country and state, personally appea d i -.-- llbeanl 641ums. and acknowledged his/her signature to the above Project Completion mAffN�QvitAon I '� the & 11'I' day of 5MW-,6of g. , 201 1p �y I. 9T Notary Signature My Commission Expires OU5114 ►a"I=Rr Printed Name County of Residence ��wga N-�t, WAS f,pwS±vy If the Contractor is a corporation, the following certificate will be executed. I. certify that I am Secretary of the Corporation executing this release; that who signed this release on behalf of the contractor was then of said Corporation; that said release was duly signed for and on behalf of said Corporation by Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL Corporate Seal This project is acceptable for f' al approval and we recommend to the Board of Public Works that it be ordained so. a Date: 8 • I ei-- I (- Construction & ager / BOARD PUBLIC WORKS APPROVAL Date: Gary A. Gilot, President ,IuZA,,,,. vA.�mber Elizabeth A. Maradik, Member Therese J. Dora ber James A. Mueller, Member Linda M. Martin, Clerk Bond No. 2204368 MAINTENANCE North American Specialty Insurance Company BOND Manchester, New Hampshire 03101 KNOW ALL MEN BY THESE PRESENTS; That We, Pohlorki Sign Company I I C 992 Scn ith 70th 3trent of Milwaukee, WI , (hereinafter called the "Principal"), as Principal, and North American Specialty Insurance Company, of Manchester, New Hampshire, a New Hampshire corporation duly licensed to transact business in the State of Indiana , (hereinafter called the "Surety"), as Surety, are held and firmly bound City of South Bend Board of Public Works 1316 County City Building 227 W. Jefferson Street South Bend IN 46601-1830 (hereinafter called the "Obligee"), in the sum of Thirteen Thousand Five Hundred Sixty and 30/100ths Dollars ($ 13,560.30 ), for the payment of which sum well and truly to be made, we, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Sealed with our seals and dated this Twenty Third date of Seotember A.D. Two Thousand and Sixteen WHEREAS, the said Principal has heretofore entered into a contract with said Obligee dated 27th day of October 20 16 for: Project No. 115-103 Ignition Park Identity Signage South Bend Indiana WHEREAS, the said Principal is required to guarantee the installed under said contract, against defects in materials or workmanship which may develop during the period beginning on the 15th day of August 20 16 and ending on the 15th day of August 20 19 In no event shall losses paid under this bond aggregate more than the amount of this bond. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that said 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 specified above or shall pay over, make good and reimburse to the said obligee all losses sustained 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 effect. BND 2515 REV (09101) Poblocki Sign Comgany LLC Specialty Insurance Company Andrew P. Krane ACKNOWLEDGMENT OF SURETY State of Minnesota County of Le Sueur On this 23rd day of September , 2016, before me personally appeared Andrew P. Krane to me known, who, being by me duly sworn, did depose and say: that s/he resides at Minnetonka, Minnesota , that s/he is the Attorney -in -Fact of North American Specialty Insurance Company , the corporation described in and which executed the annexed instrument; that s/he knows the corporate seal of said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation; that s/he signed his/her name thereto by like order; and that the liabilities of said corporation do not exceed it assets as ascertained in the manner provided by law. NICOLE C. VACEK NOTARY PUBLIC ��/ Q I*-. MINNESOTAMy Commission Expires Jan. 31, 2021 Notary Public ACKNOWLEDGMENT OF CORPORATION WiSCoyls-i 1 State of Minnesota ) County of M'IlWGi01 t On this 23rd `^^ day of September , 2016, before me personally appeared V'%r 1., , 't rs , to me known, who bein by me first duly sworn, did depose and say that s/he resides in K%\ AV\Q�� I that s/he is the C Fo of Poblocki Sign Company the corporation described in and which executed the foregoing instrument; that s/he knows the corporate seal of said corporation, that the corporate seal affixed to said instrument is such corporate seal, that it was so affixed by order and authority of the Board of directors of said corporation, and that s/he signed his/her name thereto by like order and authority. T A R tary Public = My umm"SS vl-expictS on 03- )5-20zo O . 2 clji,PUB%.% NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: RICHARD J. AHMANN, III, GARY McBRIDE, CARL GODZIEK, ANDREW P. KRANE, MARY JO DINGWALL, SEAN McBRIDE and DEAN R. HILDEBRANDT JOINTLY OR SEVERALLY Its true and lawful Attomey(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9" of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." `natlnlnll11MA/"�', 0' qy `� ZG1Aune "Wass a6QHPpg1:'S.PG b .,dptlONgt ry 3 TF},p G 4i TY sip BY ♦:•tPRPORvr'eG @?'a SEAL.n= Steven P. Aotlersan, Senior Vice President of Washiu Ivternatlooal lvsurmce Com @qSEAL F'+ %9 a Ona &Senior Vice Presidevtof North Amerlean Specalty Insurance Company Pany `�c� .n,_ By 4AaybGN+ �OVVO Michael A. Ito, Semor Vice PreAdeoi�too Mlernationattasaranae racepany con " & Senior Vie, President ofNnnh Aaxriean Specialty Insuraaee Campany IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington Intemational Insurance Company have caused thew official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 23rd day of October 2015 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 23rd day of October , 201.5 before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington Intemational Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A. Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M KENNY NOTARY PUBLIC, STATE OF IWNOIS M. Kenny, Notary Public MY COMMISSION EXPIRES 12/04/2017 I, Jeffrey Goldberg ,the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 23rday of Septwber , 2016 . ]earay Goldberg, Vice President & Assistant Secretary of Washinglon Intemational Insurance Company & North American Specialty Insurance Company AHMANNNARTIN RISK & BENEFITS CONSULTING September 23, 2016 Samet Corporation P.O. Box 8050 Greensboro, NC 27419 RE: Poblocki Sign Company LLC West Allis, Wisconsin To Whom It May Concern: Poblocki Sign Company LLC is a valued client of The Guarantee Company of North America USA. We have the privilege of providing their bonds. At the present time, they have capacity of $3,000,000 single job/$6,000,000 aggregate backlog. Accordingly, we would not anticipate any difficulty in providing the performance and payment bonds should they be awarded a contract. The Guarantee Company of North America USA is an "A" AM Best rated company and is listed on the U.S. Treasury Department's Listing of Approved Sureties (Circular 570). The Guarantee Company of North America USA would consider contract bonds on a case by case basis subject to our usual and customary underwriting considerations, acceptable contract documents and funding verification. Any final decision to provide bonds is strictly between the surety and Poblocki Sign Company LLC and not subject to third party review. This letter is not an assumption of liability, nor is it a bid or performance bond. It is issued only as a bonding referenced letter from us for our client. Sincerely, The Guarantee Company of Northmerica USA By: 4Erary-TvlcBPrde Attomey-in-Fact Ahmann-Martin • 7555 Market Place Drive • Eden Prairie, MN 55344 • P 952 947 9700 • www.ahmannmartin.com STATE OF WISCONSIN WAIVER OF LIEN TO DATE )SS COUNTY OF MILWAUKEE Gtyk 8936986 Escrow# 201412688.001 TO WHOM IT MAY CONCERN: WHEREAS the undersigned has been employed by CITY OF SOUTH BEND -DEPARTMENT OF PUBLIC WORKS to furnish IGNITION PARK IDENITY SIGNAGE for the premises known as IGNITION PARK of which CITY OF SOUTH BEND - DEPARTMENT OF PUBLIC WORKS is the owner. THE undersigned, for and in consideration of ONE HUNDRED FORTY ONE THOUSAND FOUR HUNDRED THIRTY SEVEN DOLLARS AND 001100 ($141,437.00) Dollars, and other good and valuable considerations, the receipt whereof is hereby acknowledged, do(es) hereby waive and release any and all lien or claim of, or right to, lien, under the statutes of the State of Illinois, relating to mechanics' liens, with respect to and on said above -described premises, and the improvement thereon, and on the material, fixtures, apparatus or machinery furnished, and on the moneys, funds or other considerations due or to become due from the owner, on account of all labor, services, material, fixtures, apparatus or machinery, furnished to this date by the undersigned for the above -described premises, INCLUDING EXTRAS.* DATE: 8.12.2016 COMPANY NAME: POBLOCKI SIGN COMPANY ADDRESS: 922 S. 70Ta STREET MILWAUKEE WI 53214 SIGNATURE TITLE CFO *EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT. ^ STATE OF WISCONSIN CONTRACTOR'S AFFIDAVIT }SS COUNTY OF MILWAUKEE TO WHOM IT MAY CONCERN: THE UNDERSIGNED, (NAME) RICH WACHTER BEING DULY SWORN, DEPOSES AND SAYS THAT HE OR SHE IS (POSITION) CFO OF (COMPANY NAME) POBLOCKI SIGN COMPANY WHO IS THE CONTRACTOR FURNISHING EXTERIOR IGNITION PARK IDENITY SIGNAGE WORK ON THE BUILDING LOCATED AT IGNITION DRIVE S, SOUTH BEND IN 46601 OWNED BY CITY OF SOUTH BEND -DEPARTMENT OF PUBLIC WORKS That the total amount of the contract including extras* is $141,437.00 on which he or she has received payment of $ 0 prior to this payment. That all waivers are true, correct and genuine and delivered unconditionally and that there is no claim either legal or equitable to defect the validity of said waivers. That the following are the names and addresses of all parties who have furnished material or labor, or both, for said work and all parties having contracts or sub contracts for specific portions of said work or for material entering into the construction thereof and the amount due or to become due to each, and that the items mentioned include all labor and material required to complete said work according to plans and specifications: NAMES AND ADDRESSES WHAT FOR CONTRACT PRICE INCLUDING EXTRAS" AMOUNT PAID THIS PAYMENT BALANCE DUE POBLOCKI SIGN COMPANY SIGNS & INSTALL $141,437.0 $ $141,437.0 $0.0 TOTAL LABOR AND MATERIAL INCLUDING EXTRAS* TO COMPLETE That there are no other contracts for said work outstanding, and that there is nothing due or to become due to any person for materitjAor or other work of any kind done or to be done upon or in connection with Isjork other th9p above stated. ,,1.�""''eN' N W 11"014 o`�g�f"".....Nc�� DATE II:I i I I � SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME THIS 27,1 DAY OF Se 4N^ 6w , 20 16 NOTARY PUBLIC My cow"*;sj,sh evp,&s 7Iq/20M %%0 j SEAL: ��'�AVBL%o /" . BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 11/09/16 Name Toy Villa Department Engineering BPW Date 11/22/16 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 ❑ Other: I Required Information Company or Vendor Name Poblocki Sign Co. New Vendor ❑ Yes No ❑ If Yes Approved by Purchasing MBE/WBE Contractor ❑ MBE ❑ WBE MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company Project Name Ignition Park Identity Signage Project Number 115-103 Funding Source RWDA TIF Account No. 324.1050.450.42.03 Amount $ 141,437.00 Terms of Contract Purpose/Description Project Closeout ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. Required— Change Orders Only Amount of ❑ Increase $ ❑ Decrease $ Previous Amount $ Current Percent of Change: % New Amount $ Total Percent of Change: % Dispersal After Approval Copy Original ® ❑ Aaron Kobb ® ❑ Toy Villa ❑ ❑