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HomeMy WebLinkAboutChange Order No. 1-PCA - Fellows St. & Dubail St. Neighborhood Improvements - Fuerbringer Landscaping & Design€ 3 E 6 COON n -0I r 13U€LDING 227 W. I EFITRsoN BomI HARD Sounl Bim),INDIANA 4660E-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS December 22, 2016 Dan Fuerbringer Fuerbringer Landscaping & Design, Inc. 22530 Brick Road South Bend, IN 46628 PHONH574,1235-925E FAX 574/ 235-9171 RE: Change Order No. 1 (Final)/Project Completion Affidavit - Fellows Sheet and Dubail Street Neighborhood Improvements, Division B - Project No. 116-041A Dear Mr. Fuerbringer: The Board of Public Works, at its meeting held on December 22, 2016, approved the Final Change Order for this project, for a decrease of $1,380 for a new contract sum of $46,210. In addition, the Project Completion Affidavit for this project was approved in the amount of $46,210. Copies of the Change Order and Project Completion Affidavit are enclosed for your records. If you have any further questions regarding this hatter, please call this office at (574) 235- 9251. Sincerely, Linda M. Martin, Clerk Enclosures c: Toy Villa, Engineering Elizabeth Maradik, Community Investment Roger Nawrot, Engineering GARY A. GILD'r SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMEs A. MUELLER T14ERESE J. DoRAU Oh�60UTH8.d CITY OF SOUTH BEND, INDIANA DEPARTMENT OF PUBLIC WORKS,r PROJECT CHANGE ORDER DATE: 11/30/2016 PROJECT NO: 116-041A (Division B) PROJECT NAME: Fellows Street and Dubail Street Neighborhood Improvements CONTRACT DATE: 9/13/2016 CHANGE ORDER NO: 1 (Final) SUBJECT OF CHANGE ORDER: PCR #1-Final Quantities All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns. The original contract sum $ 47,590.00 Net change by previously authorized change orders $ 0.00 The contract sum prior to this change order $ 47,590.00 By this Change Order, the project amount is The new contract sum including this change order This Change Order represents a total change of Total change for entire project increased X�Decreased $ 1,380.00 $ 46,210.00 -2.90 % Original contracted completion date/time 11/30/2016 Extension of date/time by previous change orders 0 days Date/time extension by this change order 0 days New completion date/time 11/30/2016 CONTRACTOR Contract Signature D&A +�"b-c n- ./' �StD�nl4 Printed Name and Title Fuerbringer Landscaping & Design, Inc. Company Name 22530 Brick Road Address South Bend, IN 46628 City, State, Zip -2.90 % RECOMMENDED FOR APPROVAL �t CONVSTRdCTION MANAGER CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Approved Date: / 2' 1 6 Gary A. Gilot, President Suzanna M. Fritzberg, Member Elizabeth A. Maradik, Member Therese J. Dor:(u, Member p s -7-, James A. Mueller, Member Oq 60E1TN `�O. CITY OF SOUTH BEND, INDIANA E�d BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT,ro� PROJECT NAME Fellows Street and Dubail Street Neighborhood Improvements PROJECT NO 116-041A (Division B) FINAL COST $46,210.00 CONTRACT SIGNED 9/13/2016 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Remove trees and plant new trees alonq Fellows Street and Dean Johnson Parkwav 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 t %30U day of 0V 201 b Fuerbringer Landscaping & Design, Inc. Company Name Signaattu" e 1 22530 Brick Road 1xr-, T Company Address Printed Name South Bend, IN 46628 City, State, Zip WITNESSETS: Before me, the undersigned Notary Public in and for said country and state, personally appeared 1`7uA der r , and acknowledged his/her signature to the above Project Completion Affidavit on the _&O day of 201�,_. -MC- !&&, Notary Signature My Commission Expires 6a r 4 kLIL'r m. mcte l.2,n II Printed Name County of Residence �7 , J6 =Wh 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 Corporate Seal Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for fin I approval and we recommend to the Board of Public Works that it be ordained so. c °�/- Date: t z, C> • t G Construction Mal eager BOARD OF PUBLIC WORKS APPROVAL Date: / 2 L IC, Gary A. Grilot, President Suzanne M. Fritzberg, Member Elizabeth A. Maradik, Member Therese J.01orau, Member Jarris A. Mueller, Member nda M. Martin, Clerk AFFIDAVIT AND WAIVER OF LIEN PROJECT NUMBER: State of INDIANA, County of ST. JOSEPH as: The undersigned, being first duly sworn, states, warrants and deposes, personally and as a duly authorized officer or representative of the Subcontractor as designated below (referred to herein as "Subcontractor') as follows: Desianation of Instrument This is a: []Partial (Affidavit & Waiver of Claims) ®Final (Affidavit & Waiver of Claims) And is: ®Conditional (Payment To Fallow) ❑Unconditional (Payment Received) This Instrument Pertains To The Foilowino: Subcontractor Name: If Subcontractor Address:_ Name of Person Signing: Project (Name): Fellow: Project Location/Address; Owner: Payable through the period ending (date): December 13, 2016 The Timms of This Instrument Are: as the "Effective Date") 1. Subcontractor has contracted with Contractor to furnish labor, materials, equipment and/or services in furtherance of Contractor's contractual obligations for the described project. 2. If this Instrument Is designated as a Partial Affidavit and Waiver, the Payment Amount recited above is the current balance due the Subcontractor, and such amount, together with any and all previous payments received by Subcontractor, is the total sum due to Subcontractor, exclusive of contractually, provided retalnage, for all labor, materials, equipment or services furnished by or through Subcontractor to or for the Contractor In respect of the Project through the above stated Effective Date. If this Instrument Is designated a Final Affidavit and Waiver, the Payment Amount Is the full and final amount due the Subcontractor for any and all labor, materials, equipment or services furnished or to be furnished by or through the Subcontractor for the Project. 3. The listing on the attached Application For Payment form Is incorporated herein by reference and sets forth, fully and correctly, the names of sub -subcontractors, materialmen, equipment lessors and laborers engaged by or under the employ of Subcontractor and to whom monies are presently due and owing from Subcontractor for labor, materials, equipment or services furnished to or for the Project. Except as otherwise specifically stated in such listing in sub -subcontractors, materialmen and laborers engaged or employed by Subcontractor have been paid in full for all labor, materials, equipment or services furnished in respect of the Project. 4. In consideration of payment of the Payment Amount, the Subcontractor completely waives, discharges and releases the Contractor, any and all owners of any title or Interest in the real estate upon which the project Is situated, and their respective sureties, successors assigns, from all liens and claims whatsoever in respect of or arising from any and all labor, materials, equipment or services furnished by or through Subcontractor to or for the Project, including without limitation mechanics' lions and claims against any contract proceeds. If this Instrument Is designated as a Partial Affidavit and Waiver, the waiver, discharge and release provided by this paragraph shall apply only to labor, materials, equipment or services furnished on or before the Effective Date hereof. If this Instrument is designated as a Final Affidavit and Waiver, the waiver, discharge and. release provided by this paragraph shall notwithstanding the Effective Date of this Instrument. S. The undersigned and Subcontractor will Indemnity Contractor and hold it harmless again any loss, cost or expense, Including cost of bond premiums, litigation expenses and attorney fees, for and In respect of any breach of any covenant, representation or warranty contained herein or any lien or other claim asserted by any person In respect of labor, materials, equipment or services which are within the scope of this Instrument. 6. If this Instrument is Conditional, the terms hereof shall become effective upon payment of the Payment Amount to Subcontractor, or at Contractor's option, jointly to Subcontractor and any persons identified and In respective amounts as slated on the attached Application For Payment form, which payment shall the sole consideration of this Affidavit and Waiver. If this Instrument is designated above as Unconditional, the undersigned and Subcontractor acknowledge receipt "a Payment Amount and agree that this instrument shall be effective In all respects as of the date hereof. I - Subcontractotts Signature: Subscribed and Sworn to be me this 13 day of December 2016. rY; ' Notary Public Signature: ` 1.. My Qommission Expires: September 26, 2024 Printed Name: MICA M. McKinley - Residing n: St. Joseph County BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 12/13/16 Name Toy Villa Department Engineering BPW Date 12/27/16 Phone Extension 5920 Legal ❑ Attorney Name Controller El greater review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing ❑ "Agreement L] Contract L-J Proposal U Addendum ❑ Professional Services ❑ Resolution ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Change Order No. ® C/O & PCA No. 1 Final ❑ PCA ❑ Ease/Encroach. ❑ Traffic Control I -I 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 ❑ No ❑ Yes Name of Company Fellows Street and Dubai[ Street Neighborhood Improvements 116-041A— Division B RWDA TIF 324.1050.460.31,02 Project Closeout ❑ Required Contractor's Certification Form Attached (Non - Amount of H Increase $ ® Decrease $ 1,380 Previous Amount $ 47,590.00 Current Percent of Change: 2.90% New Amount $ 46,210.00 Total Percent of Chanae: 2.90% Copy Original ® ❑ Elizabeth Maradik Villa sr Nawrot