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Home My WebLink AboutChange Order No. 3 - Project Completion Affidavit - Calvert Street Lift Station Replacement Project No 116-053 - HRP Construction Inc.7 M. s 1147 , I�_a a F Final Waiver of Lien STATE OF INDIANA, as: Whereas, the undersigned HRP CONSTRUCTION INC. has been heretofore em- ployed by City of South Bend Board of Public Works to furnish certain material and labor, to -wit: Calvert St. Lift Station Replacement, Project No. 116-053, St. Joseph County, Indiana for the property owned by City of South Bend and located on Calvert Street City of South Bend , County of St. Joseph , State of Indiana. Now 'I'HrREIi oPE, KNow YE, That the undersigned, for and in consideration of $ 45, 814.42 Dollars, the receipt of which is hereby acknowledged, hereby and now waives and releases unto the said owner of said premises, any and all lien, right of lien or claim of -whatsoever kind of character on the above described building and real estate, TOAND.t OR SAIDAMOUNT, on account of any and all labor material, or both, furnished for or incorporated into said building by the undersigned, up to this date, and they further certify that the consideration moving to the undersigned for executing this FINAL WAIVE of LiFN has been mutually given and accepted as a part payment to or on account of the said Owner for said building and real estate. Signed, sealed and delivered this 16th day of October , 20 17 Signed Nanc Kna ik Personally appeared before me this 16th day of October 20 17 Nancy Knapik who, being duly sworn on oath, says: That he is Controller of the HRP CONSTRUCTION INC. and that he hereby acknowledges the execution of the foregoing instrument far and on behalf of said Corporation and at their special instance and request. My Commission Expires 3/06/24 Vataheste This instrument prepared by: Nancy Knapik Notary Public .» .. ? d.•C��/- `�� 5nop. < » �w - ��z\�� ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by MICHAEL BOND, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Barbara E. PEARSON, Nicole L. BICKNELL, Mark E. WOBBE, Debra K. HULL, Jennifer L. KASZNIA, William J. CERNEY, III, Theresa M. BURNS and Megan E. RIESENBERG, all of South Bend, Indiana, EACH its true and lawful agent and Attorney -in -Fact, to snake, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 14th day of April, A.D. 2016. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND �ya� F�gc.t/pj� itiNS"'. SEAL a,e,n ,4rlj •.....s *��, c1b f) i �Y Secretary Vice President Michael McKibben Michael Bond State of Maryland County of Baltimore On this 14th day of April, A.D. 2016, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, MICHAEL BOND, Vice President, and MICHAEL MCKIBBEN, Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ti` �'llCit�J'�Yir Y r��r lilt %%�`,� Maria D, Adamski, Notary Public My Commission Expires: July 8, 2019 POA-F 044-4495 CONSTRUCTION1 EXCAVATING•SEWERS•WATERMAINS "QVoJtn3 90 J-11 0 f ,Saw ,,- REQUEST FOR CHANGE ORDER TO: City of South' Bend Attn:_aacob Klosinski 3113 Riverside Drive South Bend, IN 46628 PROJECT: Calvert Street Lift Station HRP Project: 1483 RE: Request for compensation for electric related items DATE: September 1, 2017 RFCO M. 8 0 OWNER: City of South Bend ENGINEER: DLZ Description of Request: A. To have Michlana Contracting provide and install an additional conduit stubbed out of the control cabinet for future use. B. To have Michiana Contracting lower the weather station for better access by City personnel. C. Reimbursement to HRP for lift station operation incurred through AEP delay. Basis of Proposal: A. Requested by Owner. B. Requested by Owner. C. Owner was receiving benefit of station. Description QQt Unit Unit Price Extension A. Michiana Contracting proposal with HRP 1 LS $129.00 $129.00 mark-up. See attached. B. Michiana Contracting proposal with HRP 1 LS LS 6a.0g. 00 $. SILO .00 mark-up. See attached. C. AEP charges with HRP mark-up. See 34 Day $13.21 $449.00 attached. Total for Change Order $786.00 Joe Saggars — HRP Construction Inc Date Shipping: 5777 Cleveland Road South Bend, IN 46628-9418 Phone 574-271.-7800 Mailing: P.O. Box 266 South Bend, IN 46624-0266 FAX 574-271-0524 Date Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM October 13. 2017 Jacob M. Klosinski Department Utilities Wastewater Purchasing ® Carol Kurzhal Check the Appropriate ltem 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. ® CIO & PCA No. 3, Final ❑ PCA ❑ Ease/Encroach. ❑ Traffic Control n Other: iKequirea intormation Company or Vendor Name HRP Construction, Inc. New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing MBEMIBE Contractor ❑ MBE ❑ WBE MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company Project Name Calvert Street Lift Station Replacement Project Number 116-053 Funding Source Wastewater Capital Account Account No, 642-0630-415-43-66 Amount $ Terms of Contract Lump Sum and Unit Prices Purpose/Description The Division of Utilities recommends the Board of Public Works approval of Change Order No. 3 which includes unit price adjustments (underruns, deducts) and adjustments for temporary Amount of " Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination. Non -Debarment, E-Verifv. [ran. etc. Increase $ Decrease $ 4,319.75 Previous Amount Current Percent of Change New Amount Total Percent of Change: Copy Original $ 920,608.20 -0.47% $ 916,288.45 -0.07% Dispersal After Approval Al Greek, Director of Utilities Jacob M. Klosinski, Assistant City Engineer Carol Kurzhal, Director of Financial Services, Environmental Services INTER -OFFICE MEMORANDUM DEPARTMENT OF PUBLIC WORKS DIVISION OF UTILITIES TO: Members of the Board of Public Works Eric Horvath, Director of Public Works Catherine Fanello, Board of Public Works Attorney FROM: A[ Greek, Director of Utilities Jacob M. Klosinski, Assistant City Engineer SUBJECT: Agenda Request Form -- Change Order No. 3 and Project Completion Affidavit Project No. 116-053: Calvert Street Lift Station Replacement DATE: October 13, 2017 The Division of Utilities is requesting the Board of Public Works approval of Change Order No. 3 for Project No. 116-053 Calvert Street Lift Station Replacement. Refer to attached documents for supporting details. Change Order No. 3 addresses the following changes: Item 8: Curb & Gutter Type "B" Original Quantity: 20 LF Adjusted Quantity: 14.50 Underrun 5.5 LF @ $150.00 per unit ($ 825.00) Item 9: Compacted Aggregate, No. 53, Base Original Quantity: 120 Tons Adjusted Quantity: 110.53 Tons Underrun 9.47 Tons @ $25.00 per unit ($ 236.75) Item 10: Concrete Pavement Patching Original Quantity: 80 SYS Adjusted Quantity: 64.00 SYS Underrun 16.00 SYS @ $110.00 per unit ($ 1,760.00) Item 11: PCCP for Drive, 9" Original Quantity: 280 SYS Adjusted Quantity: 279.00 SYS Underrun 1.00 SYS @ $100.00 per unit ($ 100.00) Item 12: Chain Link Fence, PVC Coated, 6' HT Original Quantity: 296 LF Adjusted Quantity: 280.00 LF Underrun 16.00 LF @ $36.50 per unit ($ 584.00) Item 14: Topsoil Original Quantity: 320 CY Adjusted Quantity: 0 CYS Underrun 320 CY @ $5.00 per unit ($ 1,600.00) PCO #8: Adjust Weather Station, Electrical Conduit, Temp. Electric $ 786.00 NET DECREASE FOR CHANGE ORDER NO. 3 ITEMS ($ 4,319.7S) Memorandum 2017.09.20 - Continued Original Contract Sum Net change by previously authorized change orders The contract sum prior to this change order By this change order, the project amount decreases by The new contract sum including this change order is This Change Order represents a total change of Total change for the entire project Time Extensions resulting from Change Order No. 3: Substantial Completion: Final Completion: $ 917,000.00 $ 3,608.20 $ 920,608.20 ($ 4,319.75.) $ 916,288.45 -0.47% -0.07% 0 days 0 days The funding sources for the construction of this project is Utilities, Wastewater Capital Account (642-0630-415-43-66). If there are questions regarding the subject change order, please contact Al Greek (Ext. 4210) or Jacob M. Klosinski (Ext. 9496) at the Division of Utilities.