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Home My WebLink AboutChange Order & PCA - 12th Floor Remodel Proj No 116-125 - Brown & Brown General Contractors1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS March 28, 2017 Eric Brown Brown & Brown General Contractors, Inc. 124 S Elkhart Street Wakarusa, IN 46573 RE: Change Order No. 1 (Final)/Project Completion Affidavit 12111 Floor Remodel - Project No. 116-125 Dear Mr. Brown: PHONE 574/235-9251 FAX 574/235-9171 The Board of Public Works, at its meeting held on March 28, 2017, approved the Final Change Order for this project, for an increase of $1,175. The new Contract sum is $41,768. In addition, the Project Completion Affidavit for this project was approved in the amount of $41,768. 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 ll Enclosures c: Toy Villa, Engineering GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DGRAU CITY OF SOUTH BEND, INDIANA DEPARTMENT OF PUBLIC WORKSPROJECT U-N CHANGE ORDER DATE: 3/14/2017 PROJECT NO: 116-125 PROJECT NAME: 12th Floor Remodel CONTRACT DATE: 12/13/2016 CHANGE ORDER NO: 1 (Final) SUBJECT OF CHANGE ORDER: PCR #1-Add Wall Cap PCR #2-Add Fire Strobes PCR #3-Add Door Closer and Window All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns. The original contract sum $ 40,593.00 Net change by previously authorized change orders $ 0.00 The contract sum prior to this change order $ 40,593.00 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 contracted completion date/time Extension of date/time by previous change orders Date/time extension by this change order New completion date/time CONT84CTOR O&W41 Contractor ignatu e Eric Brown, President Printed Name and Title Brown & Brown General Contractors, Inc. Company Name 124 S. Elkhart Street Address Wakarusa, IN 46573 City, State, Zip X Increased Decreased $ 1,175.00 $ 41,768.00 2.89 % 2.89 % 2/9/2017 0 days 0 days 2/9/2017 RECOMMENDED FOR APPROVAL CONSTR ION MANAGER CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Approved Date: I Gary A. Gilot, President Suzanne M. Fritzberg, Member Elizabeth A. Maradik, Member Therese J. Do u, Member James A. Mueller, Member ,SOUiHg CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS ram° PROJECT COMPLETION AFFIDAVIT PROJECT NAME 12th Floor Remodel PROJECT NO 116-125 FINAL COST $41,768.00 CONTRACT SIGNED 12113/2016 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Remodel of the 12th floor. Tear down and build of several walls, carpet, and paint. 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. Execut ��__ ._ i� day of March , 201 7 Brown &Brown General Contractors, Inc. Company Name Signature 124 S. Elkhart Street Eric Brown Company Address Printed Name Wakarusa, IN 46573 City, State, Zip WITNESSESS: Before me, the uBrowndersigned Notary Public in and for said country and state, personally appeared Eric n and acknowledged his/her signature to the above Project Completion Affidavit on the 8th day of March 201 7 ®�sfLJ/'N Notary gnaturerM My Commission Expires Bradley A. Romine Printed Name County of Residence If the Contractor is a corporation, the following certificate will be executed. 3/1/2019 St. Joseph I, Benard W. Kreps certify that I am Secretary of the Corporation executing this release; that Eric Brown who signed this release on behalf of the contractor was then President of said Corporation; that said release was duly signed for and on behalf of said Corpo tion by Authority fits gover i body, and is within the scope of corporate powers: Secretary's Signature Corporate Seal Benard W. Kreps Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable fforAAnal approval and we recommend to the Board of Public Works that it be ordained so. UCX c Date: %j • G . 1-7 ConstructlortgFinager /r ,n BOARD OF PUBLIC WORKS APPROVAL Date: 3/�4 )1 �1 (Z LC + Gary A. Gilot, President Suzanne M. Fritzberg, Member Elizabeth A. Maradik, Memb Therese J. Dorau,pemVer James A. Mueller, Member Lin M. Martin, Clerk State of Indiana, County of Final Waiver of Lien Elkhart SS: Eric Brown being duly sworn that he/she is the President (Name of Officer) (Title) of Brown & Brown General Con tractKlrgcontracted with City of South Bend, IN (Contractor) (Owner) to famish certain materials and/or labor as follows: tear down and build of several walls, carpet, paint (Deacrlption) for a project known as Remodel of 12th floor (Name of Project) located at 227 W. Jefferson Blvd., South Bend, IN and owned by City of South Bend, IN (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 Forty-one thousand seven hundred sixty-eight and 00/100 Dollars _($ )00 ❑ receipt of which Is hereby acknowledged; or the payment of which lies been promised as the sole consideration for this Affidavit and Final Waiver of Lienwhich is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due from the contractor is the sum of _($ ] ❑ receipt of which is hereby acknowledged; or ❑ the payment of which has been promised as the sole consideration forthis Affidavit and Final Waiver of Lien which shall become effective onlyuponreceipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of sold promises, any aed all liens or claims whatsoever on the above -described property and improvements thereon an account of labor or material or both, furnished b the undersigned thereto, subj act 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 perfbnned or material famished to the undersigned for said project, and within the scope of this Affidavit and Waiver of Lien. Brown & Brown General Contractors, Inc. Ey I L (l) uthorize Representative) 9;,/ STATE OF INDIANA ) ) SS: ST. JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHSREOF, I have hereunto subscribed my name and affixed my official seal on the March 200 17 My Commission hkpirm: 3 / 1 / 2 019 Eric Brown Notary Public Signature -- Bradley A. Romine Residing in St. Joseph County, IN Notary Public Name 8th day of BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 03/10/17 Name Toy Villa Department Engineering BPW Date 03/28/17 Phone Extension 5920 Required Prior to Submittal to Board 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 ❑ 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 Brown & Brown General Contractors, Inc. ❑ Yes ® No ❑ If Yes, Approved by Purchasing MBE F1 WBE U No U Yes Name of Company 12t" Floor Remodel 116-125 Other Professional Services 101.0501.415.31.06 $ 41,768.00 ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) Required For Change Orders Only Amount of �I Increase $ 1,175.00 ❑ Decrease $ Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ ❑ ❑ $ 40,593.00 2.89% 41,768.00 Anne Fuchs Villa Dispersal After Approval