HomeMy WebLinkAboutProject Completion Affidavit - Olive & Sample Street Overpass Proj No 113-002 - Lawson Fisher & INDOT1316 CouN ry-Cri'y BUJI,I)IN(i
227 W. JETFERSON BOULEVARD PRAC
Sot ui I BEND. INDIANA 46601-1830
CITY OF Sou'ri-i BEND PETE BUT'I'MIE0, MAYOR
BOARD OF PUBLIC WORKS
December 12,2017
Don Deity
Lawson -Fisher Associates
525 W Washington Avenue
South Bend, IN 46601
PHONE, 574/235-9251
FAX 574/ 235-9171
RE: Project Completion Affidavit — INDOT - Olive/Sample Street Overpass — Project
No. 113-002
Dear Mr. Deitz:
The Board of Public Works, at its meeting held on December 12, 2017, approved the Project
Completion Affidavit for final inspection and recommendation for acceptance. The project
completion date is November 14, 2017
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,
Linda M. Martin, Clerk
Enclosure
c: Roger Nawrot, Engineering
CHARY A. GILOT SUZANNA M. FRITZBERG ELIZABETii A. MARADIK JAMEs A. MUELLER THERESE J. DORAU
SMIC 639
Indiana Department Of Transportation
Report of Contract Final Inspection and
Recommendation for Acceptance
Contract R -35727
Date Construction Substantially Completed: 07/2512017
(The contract is sufficiently completed so that it can be used for its intended! purpose.)
All Contract Work Complete Date 017/25/2017
(The date all items were complete, except punchlist and removal of traffic control devices.)
Pre -Final Inspection made by y /A05A1!JVAe-W—P<)'i_/
'R v vvit(a Laul e,- (Wo [VLcA,,_o(S,
ej�tr, on 07/2512017
Date Punch List Items Completed: 08/1212,1017
. . ........... .
Sod Maintenance Expired on 09/18/20117
... . .... .. .
Date Failed Material! Replaced: 00/00/0000
Final Inspection made by:
on 11/14/2017
and all work was found to be satisfactory from Station 14 50 to (V I A-tio a
Date Construction Signs and Temporary Traffic Control Devices Removed:: 07/14/2017
Pavement Markings (have) () been placed in accordance with the IMUTCD manual or as
directed by the District Traffic Engineer, Hqve-
Right-of-Way (is) (RNkmTclear of all encroachments. 15
Date of Last Work: 11/1412017
LOCAL PUBLIC AGENCY
DISTRICT CONSTRUCTION ENGINEER
0 Bya
*County or City signatures A BY:
when requiired (at least two).
* By:
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date December 4, 2017
Name Roger Nawrot
Department
Division/Bureau
Public Works
Engineering
❑ Agreement Amendment
H Contract LJ Proposal Addendum
❑
Professional Services
❑ Resolution
❑
Bid Opening
❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet
❑
Quote Opening
❑ Quote Award
❑ Change Order No.
❑
CIO & PCA No. ❑ PCA
❑ Ease/Encroach.
❑
Traffic Control:
RI Other: Recommendation for Acceptance
Company or Vendor Name
New Vendor
MBEANBE Contractor
MBEIWBE Contractor Requested
Project Name
Project Number
Indiana Department of Transportation
❑ Yes ❑ No ❑ If Yes, Approved by
Purchasing
❑ MBE ❑ WBE
❑ No ❑ Yes Name of Company
Olive -Sample Overpass
113-002
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Change: %
Dispersal After Approval
Copy Original
❑ ❑
❑ ❑