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Home My WebLink AboutChange Order No. 2 - PCA - Fellows St. and Dubail St. Neighborhood Improvements Proj No 116-041A - Airmarking Co., Inc.1316 COUNTY -CITY BUILDING 227 w. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS December 13, 2016 Greg Lowe Airmarking Co., Inc. PO Box 526 Rochester, IN 46975 PHONE 574/235-9251 FAX 574/235-9171 RE: Change Order No. 2 (Final)/Project Completion Affidavit Fellows Street and Dubail Street Neighborhood Improvements - Project No. 116-041A Dear Mr. Lowe: The Board of Public Works, at its meeting held on December 13, 2016, approved the Final Change Order for this project, for a decrease of $2,116.40. The new Contract sum is $54,217.75. In addition, the Project Completion Affidavit for this project was approved in the amount of $54,217.75. Copies of the Change Order and Project Completion Affidavit are enclosed for your records. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, s J— Linda M. Martin, Clerk Enclosures c: Toy Villa, Engineering Roger Nawrot, Engineering Elizabeth Maradik, Community Investment GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DoRAu CITY OF SOUTH BEND, INDIANA souxea °` F 7 DEPARTMENT OF PUBLIC WORKS PROJECT CHANGE ORDER DATE: 11 /20/2016 PROJECT NO: 116-041A (Division A) PROJECT NAME: Fellows Street and Dubail Street Neighborhood Improvements CONTRACT DATE: 9/13/2016 CHANGE ORDER NO: 2 (Final) SUBJECT OF CHANGE ORDER: PCR #4-Final Quantities All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns. The original contract sum $ 52,514.15 Net change by previously authorized change orders $ 3,820.00 The contract sum prior to this change order $ 56,334.15 By this Change Order, the project amount is Increased XD Decreased The new contract sum including this change order $ 2,116.40 $ 54,217.75 This Change Order represents a total change of -3.76 % Total change for entire project 3.24 % Original contracted completion date/time 11/1/2016 Extension of date/time by previous change orders 14 days Date/time extension by this change order 0 days ompletion date/ti 11/15/2016 N:on CO RACTOR RECOMMENDED FOR APPROVAL ac or�ignature CONST UCTION MANAGER S,R]L , L DBqT Printed Name and Title Airmarking Co., Inc. Company Name P.O. Box 526 Address Rochester, IN 46975 City, State, Zip CITY OF SOUTH BEND BOARD OF PUBLIC VVORKS Approved Date: Gary A. Gilot, President . ember A. Maradik, Therese J. Dora Member Jams A. Mueller, Member 4yOli ly._y� CITY OF SOUTH BEND, INDIANA a. `- BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME Fellows Street and Dubail Street Neighborhood Improvements PROJECT NO 116-041A (Division A) FINAL COST $54 217 75 CONTRACT SIGNED 9/13/2016 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Restripe Fellows Street and Dean Johnson Parkway Place new signage 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 c by such contract, and that -the contractor performed the work within the scope of the Specifications and Standards of the Cit, of South Bend which w e a part y�(r of the above Contract. Execute is - day ofU 'OVEr? RE;?, 201 a Airmarking Co. Inc. Company Name //��ignaturer/�+ P.O. Box 526 l_E co L 6 , E Company Address Printed Name Rochester, IN 46975 City, State, Zip WITNESSESS: efore me the undersigned Notary Public in and for said country and state, personally appeared DREG L OUE and acknowledged his/her signature to the above Project Completion Affidavit on the krday of B. R201(._. NotarySignature S My Commission Expires PE9W-4 L. PIKE Printed Name County of Residence M07of ing certificate will be executed. certify that I am Secretary of the Corporation executing this release; that who signed this release on behalf of the contractor was then said Corporation; that said release was duly signed for and on behalf of said ?Zqrporation by Authori o s 8 verning body, and is within the scope of corporate powers: Secretary's Sign a Corporate Seal PEN PWE Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. Date: 1 1 • ZL - 14 Construction a ager �� BOAR OF PUBLICr �WORKS APPROVAL Date: � "� / 3 /lc Gary A. Gilot, President Suzanna M. rritzbbeerg, M/e er Elizdbeth A. Maradik, Member Therese J. Do au, tuber Jame A. Mueller, Member Lfno M. Martin, Clerk AFFIDAVIT AND WAIVER OF LIEN State of Indiana, County of SS: frig Lowe being duly sworn that he/she is the President (Name of Officer) (Title) Of The Airmarkin Co. Inc. having contracted with The Airmarking Co.,Iuc. Subcontractor/Supplier) (Contractor) to furnish certain materials and/or labor as follows: Pavement Markings (Description) for a project known as Fellows Street and Dubail Street (116-041A) Division A (Name of Project) located at Fellows Street and Dean Johnson Parkway South Bend IN and owned by City of South Bend (owner) and does hereby further state on the behalf of the aforementioned subcontractor/supplier- (PARTIAL WAIVER)that there is due from the Contractor the sum of Dollars ($ ) Q receipt of which is herby acknowledged:or 0 the payment of which has been promised as the sole consideration for the 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 the undersigned; (FINAL WIAVER)that the final balance due from the contractor is the sum of FIFTY FOUR THOUSAND TWO HUNDRED SEVENTEEN DOLLARS AND SEVENTY FIVE CENTS ($ 54,217.75) Qreceipt 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 only upon receipt of such payment. Therefore,the undersigned waives and releases unto theownerof said premi_ses,any and all liens or claims whatsoever on the above -described property and improvements thereon an account of labor or material or both,furnished by 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 lien on account of any work performed or material furnis ed to the undersigned for said project,and within the scope of this Affidavit and Waiver of ien. f The Airmarking Co Inc By ' (Firm) Authorized Representative) STATE OF INDIANA ) Greg Lowe Sf SOSEPH CpktXC4 ) SS: Before me,the undersigned, a Notary Public,in and for said County and State, personally appeared Greg Lowe and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN 'WITNESS WREREOF,l have hereunto subscribed my name and affixed my official seal on the a L day of )DVCMSFR 20 U. My Commission Expires: September 21,2022 ) Residing in Rochester,IN County, Fulton Nota Pub Signature C. �P(h E Notary Public Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 12/06/16 Name Toy Villa Department Engineering BPW Date 12/13/16 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 Ai/ 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. 2 Final ❑ PCA ❑ Ease/Encroach. ❑ Traffic Control ❑ Other: 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 red Information marking Co., Inc. Yes ® No MBE ❑ WBE _U No ❑ Yes Name of Company Fellows Street and Dubail Street Neighborhood Improvements 116-041A— Division A RWDA TIF 324.1050.460.31.02 Project Closeout ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. Amount of ❑ Increase ® Decrease Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ ® ❑ ® ❑ 3.76% $ 54,2 3.24% For Chanqe Orders O ,116.40 4.15 7.75 Dispersal After Approval Elizabeth Maradik Nawrot