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Home My WebLink AboutChange Order & PCA - 2016 Downspout Disconnect Program Proj No 115-098 - Acorn Landscaping LLC1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS February 28, 2017 Jeff Ritschard Acorn Landscaping LLC 3680 W Sample Street South Bend, IN 46619 RE: Change Order No. 1 (Final)/Project Completion Affidavit 2016 Downspout Disconnect Program - Project No. 115-098 Dear Mr. Ritschard: PHONE 574/235-9251 FAX 574/235-9171 The Board of Public Works, at its meeting held on February 28, 2017, approved the Final Change Order for this project, for a decrease of $39,294.80. The new contract sum is $9,060.20. In addition, the Project Completion Affidavit for this project was approved in the amount of $9,060.20. 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, Linda M. Martin, Clerk Enclosures c: Hana Parkhill, Engineering Toy Villa, Engineering GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMEs A. MUELLER THERESE J. DORAU CITY OF SOUTH BEND, INDIANA DEPARTMENT OF PUBLIC WORKS dl PROJECT CHANGE ORDER Bess DATE: 1 /21 /2017 PROJECT NO: 115-098 PROJECT NAME: 2016 Downspout Disconnect Program CONTRACT DATE: 6/28/2016 CHANGE ORDER NO: 1 (Final) SUBJECT OF CHANGE ORDER: PCR #1-Final Quantites All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns. The original contract sum $ 48,355.00 Net change by previously authorized change orders $ 0.00 The contract sum prior to this change order $ 48,355.00 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 Original contracted completion date/time Extension of date/time by previous change orders Date/time extension by this change order New completion date/time ON RACT R'' V/Mw�-� Contra or signature Printed Name and Title Acorn Landscaping LLC Company Name 3680 W. Sample St Address South Bend, IN, 46619 City, State, Zip ❑ Increased X] Decreased $ 39,294.80 $ 9,060.20 -81.26 % -81.26 % 1 /21 /2017 0 days 0 days 1 /21 /2017 RECOMMENDED FOR /APPROVAL V CONSTR ON MANAGER CITY OF SOUTH BEND BOARD OF PUBLIC WORT S Approved Date: Gary A. Gilot, President C, Maradik, Member Therese J. Do au, Vember James A. Mueller, Member ON. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKSPROJECT COMPLETION AFFIDAVIT PROJECT NAME 2016 Downspout Disconnect Program PROJECT NO 115-098 FINAL COST $9,060.20 CONTRACT SIGNED 6/28/2016 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Remove downspouts connected to the combined sewer from willing resident dwellings 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 at Bend wh' h were a art roof the above Contract. 201�. Acorn Landscaping LLC Company Name Si atu 3680 W. Sample St lrf N o E ,, LINDAJ GILROY Company Address Public, State of Indiana Printed Name nr.n:•, St. Joseph County South Bend, IN, 46619 . —^� '�' Commission N 629162 . SEAS, toy commission Expires City, State, Zip WITNESSETS: '%.,;No August 31, 2019 mrrt"` Before me, the undersi ned Notary u is in and for said country and state, personally appeared .r%�� ATIVCRANand acknowledged his/her signature to the above Project Completion Affidavit on the day ofadX,11%Cy,201_�. L/ : Notary Signatu My Commission Expires 00 - to— ,Aw,9 Printed Name County of Residence , 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 final approval and we recommend to the Board of Public Works that it be ordained so. Date:IZ Constructio onager 4An BOARD OF PUBLIC WORKS APPROVAL Date: � �6� Gary A. Gilot, President /ll�`� )`Suzanne NyFritzberd, Merler Elizabeth A. Maradik, Member Therese J. Dor u, Member \ James A. Mueller, Member d M. Martin, Clerk AFFIDAVIT AND WAIVER OF LIEN State of Indiana, County of I 1 l�Q �`� SS: // '�� Q ZTf GH��✓J being duly sworn that he/she is the '&4—1 e (Name of Officer) / / n (Title) of A fCA/�l/1%�y G.G having contracted with ieZ7 e (Subcontractor/Supplier) (Contractor) to furnish certain materials and/or labor as follows: 1&2A%Lf 10'4AT"' o Mz9a Aas n (Description) for a project known as a( �%�lo ✓/�/%iIf—or" 'r- Atep myiC7 located at and owned by (Name of Project) 4.9.Q.sDds ,000.47XO�1t1' T� fDyriH �ld�a/,D� 1, /� and does hereby further state on the behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there is due fi'om the Contractor the sum of Dollars ❑ receipt 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 is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; WAIVER) that the final balance due from the contractor is the slim of ❑ receipt 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 10 become effective only upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever on the above -described properly and improvements thereon an account of labor or material or both, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certified ttlaxo other party has arty im or right to a lien on account of an work performed or material furnished to the undersigned for said ro'e t, a d t t the sc e o this Affidavit y P Y l Jp and Waiver of Lien. ,1 % l "IC `• qyv (Firm) �arr�r�oF LINDA J GIa�te, (Authorized Representative) STATE OF INDIANA ) " • Notary Public. Stat ;.�ownv •, St. Joseph C SS: "x: xc Commission N ST. JOSEPH COUNTY ). SEAS r My Commissio ��' .... •P �� Before me, the undersigned, a N tat %fuUitL man ersonally appeared and acknowledged the execution of the foregoing f ldavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the day of Notary Public $ gnatm•e Z My Commission Expires: l3� _ z o/� / 61, /1=��V y (9 Residing in f f, JQf E P11 County, T /%zMIA Notary Public Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 02/7/17 Name Toy Villa Department Engineering BPW Date 02/17/17 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 ❑ 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. 1 Final ❑ PCA ❑ Ease/Encroach. ❑ Traffic Control I-1 Other: Company or Vendor Name New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number Required Information Acorn Landscaping LLC ❑ Yes ® No ❑ If Yes, Approved by Pu ❑ MBE ❑ WBE ❑ No ❑ Yes Name of Company 2016 Downspout Disconnect Program 115-098 Funding Source Wastewater Other Contractuals Account No. 641.0630.793.63.35 Amount $ Terms of Contract Purpose/Description ❑ 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 $ 39,294.80 Previous Amount $ 48,355.00 Current Percent of Change: 81.26% New Amount $ 9,060.20 Total Percent of Change: 81.26% Dispersal After Approval Copy Original ❑ ❑ ❑ ❑ ❑ ❑