HomeMy WebLinkAboutChange Order No. 1 - Project Completion Affidavit - Newman Center Roof Repair Project No 116-131 - Northern Indiana Roofing & Sheet Metal CorpI,�__�
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SURETY
MAINTENANCE BOND
601114277
, Roofing & Sheet Metal Corp
W ALL MEN BY THESE PRESENTS that we Northern Indiana Roo ,,-
4320 Ardmore Ave., Fort Wayne IN 46802
as Principal, and The Ohio Casualty Insurance Company, as Surety, are held and firmly bound unto
The City of South Bend Board of Public Works
(hereinafter called the Obligee), in the penal sum of Ninety Thousand Two Hundred y- Dollars And
„ , n re Seventy-one , , ,
Ninety-nine Cents Dollars$90,271.99
for the payment of which, well and truly to be made, we do hereby bind ourselves, our heirs, executors,
administrators, successors and assigns, jointly and severally, firmly by these presents.
Dated: September 26, 2017
WHEREAS, the said Principal has heretofore entered into a contract with the Obligee for Newman Center roof repair
and,
WHEREAS, the work called for under said contract has now been completed and accepted by said Obligee;
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal shall for a
Principal shall for a period of Three years from and after the date of the completion of the contract indemnify
the Obligee against any loss or damage directly arising by reason of any defect in the material or workmanship that may
be discovered within the period aforesaid, then this obligation shall be void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER, that in the event of any default on the part of the Principal, written statement of the
particular facts showing such default and the date thereof shall be delivered to the Surety by registered mail, at its
home office in the city of Keene, New Hampshire promptly and in any event within ten (10) days after the Obligee or
his representative shall learn of such default; and that no claim, suit or action by reason of any default of the Principal
shall be brought hereunder after the expiration of thirty days from the end of the maintenance period as herein set
forth.
Northern Indiana Roofing & Sheet Metal Corp
4320 Ardmore Ave., Fort Wayne IN 46802 The Ohio Casualty Insurance Company
(Principal)
By:
S-177
POWER OF ATTORNEY
The Ohio Casualty Insurance Company Bond Number:601114277
Principal: Northern Indiana Roofing & Sheet Metal Cor 4320 Ardmore Ave,, Fort Wayne IN 46802
Agency Name: NxtGen LLC
Obligee: The City of South Bend Board of Public Works Agent Code; IZQ17t3
Know All Men by These Presents: That The Ohio Casualty Insurance Company, pursuant to the authority granted by Article IV, Section 12 of the Code of Regulations and
By -Laws of The Ohio Casualty Insurance Company, do hereby nominate, constitute and appoint: David Relue; Donald H. Stoneburner; Emily Kitchens; Heather R. Pieper; Jeff
Pikel; Karen S. Wallace, Martha Kinast; Mindy Zielke; Renada Kelley; Sandy Roth of Fort Wayne, Indiana its true and lawful agent(s) and attorney(ies)-in-fact, to make, execute,
seat and deliver for and on its behalf as surety, and as its act and deed any and all BONDS, UNDERTAKINGS, and RECOGNIZANCES, excluding, however, any bond(s) or
undertaking(s) guaranteeing the payment of notes and interest thereon.
And the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Company, as fully and amply, to all intents and purposes, as if
they had been duly executed and acknowledged by the regularly elected officers of said Company at their administrative offices in Keene, New Hampshire, in their own proper
persons. The authority granted hereunder supersedes any previous authority heretofore granted the above named attorney(ies)-in-fact.
In WITNESS WHEREOF, the undersigned officer of the said The Ohio Casualty Insurance Company has hereunto subscribed his name and affixed the Corporate Seal of
said Company this 26th day of September, 2016.
411 INS&,
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0.t a*p tads David M. Carey, Assistant Secretary
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
On this 26th day of September, 2016 before the subscriber, a Notary Public of the State of Pennsylvania, in and for the County of Montgomery, duly commissioned and qualified,
came David M. Carey, Assistant Secretary of The Ohio Casualty Insurance Company, to me personally known to be the individual and officer described in, and who executed the
preceding instrument, and he acknowledged the execution of the same, and being by me duly sworn deposes and says that he is the officer of the Company aforesaid, and that the
seal affixed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affixed and subscribed to the said
instrument by the authority and direction of the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal at the City of King of Prussia, State of Pennsylvania, the day and year first above
written.
Sp, PAST
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COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
OF
Teresa Peslelle, Nalery Pubrc
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Upper MerionTwp., Montgomery County
My Commisslon Explres March 2a, 2vx I
Member, PennayNenfa AssodeUon
Notary Public in and for County of Montgomery, State of Pennsylvania
CRY FU
o£Noletlss
My Commission expires March 28, 2021
This power of attorney is granted under and by authority of Article IV, Section 12 of the By -Laws of The Ohio Casualty Insurance Company, extracts from which read:
ARTICLE IV - Officers: Section 12, Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or President
may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seat, acknowledge and deliver as surety any and all
undertakings, bond, recognizances and other surety obligations, Such attorneys -in -Fact, subject to the limitations set forth in their respective powers ofattorney, shall have full
power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall
be as binding as if signed by the President and attested to by the Secretary.
Any power or authority granted to any representative or attorney -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President
or by the officer or officers granting such power or authority.
This certificate and the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of the following vote of the board of
directors of The Ohio Casualty Insurance Company effective on the 15th day of February, 2011:
VOTED that the facsimile or mechanically reproduced signature of any assistant secretary of the company, wherever appearing upon a certified copy of any power of attomey
issued by the company in connection with surety bonds, shall be valid and binding upon the company with the same force and effect as though manually affixed.
CERTIFICATE
I , the undersigned Assistant Secretary of The Ohio Casualty Insurance Company, do hereby certify that the foregoing power of attorney, the referenced By -Laws of the Company
and the above resolution of their Board of Directors are true and correct copies and are in full force and effect on this date.
IN WITNESS WHEREOF, I have hereunto set my hand and the seal of the Company this 26th
day of September 2017 .
4SY INS11
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Renee C. Llewellyn, Assistant Secretary
Final Waiver of Lien
State ofXruiiana, County of _ ) (-[.. � y-� SS,
Ca • J�Fxcry being duly sworn th4 she is the P44-S I
(Name of officer) (Title)
of No&ttt ' 414►+k Qooh,+s- having contracted With aI N or- J'o«r W 4..aA
(Contractor) (Owner)
to h nlsh certain materials and/or labor as follows; 2po F A^U 44 *'JA keptA Gtyy Ew f
(Description)
for a project known as N r• yy,, C jrV j-j�x, (Z.aF /4-PAI -
(Natne Of>7raject)
located at fo
and owned by
(Owner)
and dogs hereby further state on the behalf ofthe aforementioned subcontractor/oupplfer:
(PARTIAL WAIVER) that there is due from the Contractor the sum of
Dollars —
❑ receipt of which is hereby aoinzowledged; or
❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver oft fen -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 WAIVER) that the final balance due from the contractor is the sum of
❑ receipt ofwluch is hereby acknowledged; or
[� the pay►neat of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall
become effective onlyuponnoeipt of such payment.
TIM1113FORE, the undersigned waives and releases unto the Owner of said premises, any and all lions or claims whatsoever
on the above -described property and improvements thereon at account of labor or material or both, furnished b the undersigned
thereto, subject to limitations or conditions expressed herein, if any; and further certified thatno other party has any claim or right to x
Tien on account of any work perfiolmod or maternal furnished to the undersigned for saidproject; and within the scope of Us Affidavit
and WaiverofLlen.
(Finn) (Authorized Re entative)
STATB OF WOA
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ST, JOSEPH COUNTY }
Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared44'�� E..')
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and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. r
IN WITNESS OF, I have hereunto subscribed my name and affixed my official seq on the day Of
o roblio Signature
My CommissionExpfros:
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