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Home My WebLink AboutPCA - Ireland Road Storm Repairs Proj No 116-083G - Walsh & Kelly, 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 January 10, 2017 Dustin Hilary Walsh &Kelly, Inc. 24358 State Road 23 South Bend, IN 46614 PHONE 574/235-9251 FAX 574/235-9171 RE: Project Completion Affidavit — Ireland Road Storm Repairs - Project No. 116-083G Dear Mr. Hilary: The Board of Public Works, at its meeting held on January 10, 2017, approved the Project Completion Affidavit for this project in the amount of $92,258.25. 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, Jl Linda M. Martin, Clerk Enclosure c: Toy Villa, Engineering GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARAwK JAMES A. MUELLER THERESE J. DORAU PROJECT NAME PROJECT NO CONTRACT SIGNED PROJECT DESCRIPTION W ITNESSETH: CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS' 1= PROJECT COMPLETION AFFIDAVIT ,a� 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 which we a part of the above Contract, day of Dacemhpr 2016 Name WITNESSESS: Before me, the undersigned Notary Public in Dustin Hilary , and acknowledged theT1 th day of December , 201 b Printed Name County of Residence Walsh Kelly Inc. Company Name 24358 State Road 23 Company Address South Bend, IN 46614 City, State, Zip sally appeared Completion Affidavit on If the Contractor is a corporation, the following certificate will be executed. I, —1 Mi chaps Leh&HID certify that I am Secretary of the Corporation executing this release; that —Diistin u; 1 a y who signed this release on behalf of the contractor was then of said Corporation; that said release was duly signed for and on`�JIb4}b�ly� �Gorpg i ^ by Authgyty oOs governing body, and is within the scope of corporate powers: �� KEQ(, ij 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 or 1 Date: Constructi nager .BOARD OF PUBLIC WORKS APPROVAL Date: / to Gary A. . itz President Suzanna erg, M ber Elizabeth A. Mara( Therese J. Dorau, Member James A. Mueller, Member Ljhda M. Martin, C RPORATF �-rguate Scal .SEAT-" Member A AssuredPartners of Indiana TOBIAS INSURANCE GROUP December 15, 2016 Mr. Mike Schaum Walsh & Kelly, Inc. 24358 State Road 23 South Bend, IN 46614 Re: Type of Bond: Maintenance AssuredPartners of Indiana, LLC Tobias Insurance Group 10401 N. Meridian Streets Suite 300 Indianapolis, IN 46290 Phone:317-844-7759 Fax: 317-815-6036 www.tobiasxom Bond Number: 8244-90-51 Obligee: City of South Bend, Indiana, Board of Public Works Description: Ireland Road Storm Repairs, Project No.: 116-083G Bond Amount: $9,225.83 Premium Due: $250.00 r -7- h4wE X1" i MA We are pleased to enclose the bond you requested. The bond issued was based upon the information you provided. We suggest you check all the documents enclosed, including the Power of Attorney, signatures, dates, amounts, description, and any other attachments. Please verify that the bond form attached is the form required, and be sure to execute the bond with the proper signature and seal. Thank you and please call me should you have any questions. Sincerely, AssuredPartners of Indiana, LLC Tobias Insurance Group TArryR.urst Enclosures CHUBB GROUP OF INSURANCE COMPANIES Surety Department, 15 Mountain View Road, P.O. Box 1615, warren, NJ 07061-1615 CMIJBB Phone: (908) 903.3405 • Facsimile: (90e) 903-3856 FEDERAL INSURANCE COMPANY MAINTENANCE BOND Bond No. 8244-90-51 Amount $ 9,225.83 Know All Men By These Presents, That we Walsh & Kelly, Inc. 24358 State Road 23, South Bend, IN 46614 (hereinafter called the Principal), as Principal, and the FEDERAL INSURANCE COMPANY, Warren, New Jersey, a corporation duly organized under the taws 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., Room 1316, South Bend, IN 46601 (hereinafter called the Obligee), In the sum of Nine Thousand Two Hundred Twenty Five Dollars and 83/100 Dollars ($ 9,225.83 ), 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 15th day of December, 2016 WHEREAS, the said Principal has heretofore entered into a contract with said Obligee dated , for Ireland Road Storm Repairs, Project No.: 116-083G ; and WHEREAS, the said Principal is required to guarantee the Ireland Road Storm Repairs, Project No.: 116-083G installed under said contract, against defects in materials or workmanship, which may develop during the period of 3 years. (over) Form 15-02.0075(Re. 1b99) 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 Obligee 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. Walsh & Kelly Inc. _ �Pn al Bye J. Ichae! 5vla t:m, Set T usurer FEDERAL INSURANCE COMPANY By: 4 TernX. Hur Attorney -in -Fact Chubb POWER Federal Insurance Company Attn: Surety Department C OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company 19srrea, Ns 07059 Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporafion, VIGILANT INSURANCE COMPANY, a New York Corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Terry R. Hurst 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 : 8244-90.51 Obligee : City of South Bend, Indiana, Board of Public Works And the execution of such bond or obligation by such Attomey- in- Fact in the Company's name and on its behalf as surely 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 as. _4� - Richard A. Ciullo, Vice President On this 1St 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 Paver of Attorney, and the said Dawn M. Chloros, being by me duly swom, dtl 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. Ciullo, subscribed to said Power of Attorney is in the genuine handwriting of Richard A. Ciullo, and was thereto subscribed by authority of said By. Laws and in deponent's presence. Notarial 3�o`.E.. h' ms WENDIE WALSH Seal- NOT ` Notary Public, Stets of New Jersey runica ;e No. 0054504 ry' '. "1,!� Expires April 18, 2018 Public Notary CERTIFICATION Exfractfrom the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: '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 designations. The signature of such officers may be engraved, printed or 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 paver of allomey 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 -Companies-) do hereby certify that (1) the foregoing extract of the By. Laws of the Companies is Irue and correct, 01) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States or 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 V.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, coned and In full force and effect. Given under my hard and seals of said Companies at Warren, NJ this 15th day of December, 2016 . W� ro� 'r, Si • �k i'�1 , 1•mW4JWV 'A'OIANh M heN, �!- I Dawn M. Chloros, Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, 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@chubb.com Fom115-f0- 0154B. SUMPath (Rev. 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 City of South Bend. Indiana to furnish certain material and labor, to -wit: Asphalt, Patching and Concrete for the building owned by City of South Bend. Indiana and located on Ireland Road Storm Repairs South Bend, 46601 St. Joseph County Indiana Project # 116-083G 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 payment. Signed, sealed and delive=Thathe of D mber 2016 Iouth Bend Area Manager Personally appeared befoay of December. 2016 Dustin Hilary who being duly sworn on he is the South Bend Area Manager of the Walsh & Kelly, Inc. and that he reby acknowledges the execution of the foregoing instrument for and on behalf aid Walsh & Kell c, and at their special instance and request. My Commission Expires 06/07/2023 V This instrument prepared by: AET Am3rEfizabeth Turpin (Notary Public) AMY ELIbABETH iURPIN E Notary Public, State of Indiana Marshall County Commission Expires June 7, 2023 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 01/03/17 Name Toy Villa Department Engineering BPW Date 01/10/17 Phone Extension 5920 I 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 Professional Services Bid Opening Quote Opening Change Order No. 1 Ease/Encroach. 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 Amount of Contract Resolution Bid Award Quote Award C/O & PCA No. Traffic Control Kequired Information Walsh & Kelly, Inc. ❑ Yes ® No ❑ If Yes ❑ MBE I -I WBE ❑ Req. to Advertise ❑ No ❑ Yes Name of Company Ireland Road Storm Repairs 11 COIT 404.0602.431.31.06 Qao oru I)G Project Closeout Addendum ❑ Title Sheet ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. Increase Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ ❑ ❑ er Nawrot Villa Dispersal After