HomeMy WebLinkAboutProject Completion Affidavit - Century Center Masonry Restoration Proj No 117-037 - Ziolkowski Construction Inc.1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BoULEVARD
SOUTu Bi-ND. INDIANA 46601-1830
SPIN, INI 0 � ffil MeiM
January 23, 2018
Bill Favors
Ziolkowski Construction, Inc.
4050 Ralph Jones Drive
South Bend, IN 46628
PHONE 574/235-9251
FAX 574/ 235-9171
RE: Project Completion Affidavit — Century Center Masonry Restoration — Project No.
117-037
Dear Mr. Favors:
The Board of Public Works, at its meeting held on January 23, 2018, approved the Project
Completion Affidavit for this project in the amount of $170,454.
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: Toy Villa, Engineering
Leanna Belew, Century Center
GA i�y A. G I LOT SUZANNA M. FRITZBER(i EuZABEi'i,i A. MARADIK JAMEs A. MUELLm THERESE J. DORAU
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
PROJECT COMPLETION AFFIDAVIT
PROJECT NAME -Century Center Masonry Restoration: Phase III
PROJECT NO 117-037 FINAL COST $170,454.00
CONTRACT SIGNED 6/27/2017 MAINTENANCE AGREEMENT ENDS
PROJECT DESCRIPTION Rework deteriorated masonry areas and clean tarnished areas at the Century Center.
WITN'ESSETH:
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.
Executed this 21st day of December .2017 Ziolkowski Construction Inc.
Company Name
e
SigAature 4050 Ralph Jones Drive
Bi,11--Favors, President Company Address
Printed Name South Bend, IN, 46628
City, State, Zip
WITNESSESS
Before me, the undersigned Notary Public in, and for said a d
Rj 1 1 tiasrnr and acknowledged his/her s,ignat re to the SAMSF BACNCompletion A 'davit on
1H
the 21st day of Decembg-r—,2017 Notary Public- Seal
State of Indiana
commission comission Expire,�, Mar 1, H2O
Signature my Jrw ]2n
Shannon Reidenbach
Printed Name
County of Residence St. Joseph
If the Contractor is a corporation, the following certificate will be executed.
... .. . .............Chap lec! T.ow4c2 certify that I am Secretary of the Corporation executing this release; that
B 1- 11 TR A. 17 0 r S who signed this release on Ibehalf of the contractor was then
Presi-d-ent I'll of said Corporation; that said release was duly signed for and on behalf of said
qprp?ratio,n by Authority of its J verning body, and is within the scope of corporate powers:
Secretary's Si'gnature Corporate Seal
Charles Lewis
Printed Name
DEPARTMENT OF PUBLIC WORKS APPROVAL
This project is acceptable to fir I approval and we recommend to the Board of Public Works that it be ordained so.
Date:
Constructio��)fl�-ger
,BOARD t3F PUBLIC WORKS APPROVAL Date:
Gary A. Gilot, President Suzanna M. Fritzberg, Member Efiia15eth A. Maradik, Member
Therese J. D6Kau, M6mber James A. Mueller, Member
IJ96a M. Martin, Cle�k
ZIOLKOWSKI
Conseruceiiiion, Inc.
General Construction & Design/Build,
BUIlding Strong Relationships Since 1974,
State of Indiana, County of St. Joseph, SS:
Dawn Miko beings duly sworn states that she is the Assistant Controller of
Ziolkowskii Construction, Inc. having contracted with City of South Bend/
Board of Public Works to furnish certain imateriaill and/or labor for a project known as:
Century Center / Masonry Restoration - Phase Two / #117-037
located at South Bend, IN and owned by City of South Bend/Board of Public
Works and does hereby further state on behalf of said Contractor that our construction
lien rights against such property are hereby waived and released as noted:
THIS WAIVER IS CONDITIONAL UPON PAYMENT OF $17,045.40
Then, UNCONDITIONAL for the full contract amount of $170,464.00
ZX&KQWSK%�'%nc.
By:
/ Dawn Miko, A`ssii§6'nt Controller
WITNESS MY HAND, AND NOTARIAL SEAL this 10th day of January, 2018
Debra L. Johnson, Notary Public
My commission expires March 27, 2024 DEBRA L JOHNSON:
Seat
Residing in Marshall County, Indiana Notary Public - State of Indiana
Marshall County
My Commission Expires Mar 27, 2024
lm;zl
ZIOLKOWSKI
Constructlan, Inc.
General Construction & Design/Build
13ulidIng strong Relatlonstilips Since 1974
4—A; 4 d FAMWI U kTJ
State of Indiana, County of St. Joseph, SS:
Dawn Miko being duly sworn states that she is the Assistant Controller of
Ziolkowski Construction, Inc. having contracted with City of South Bend/
Board of Public Works to furnish certain material and/or labor for a project known as:
Century Center / Masonry Restoration - Phase Two / #117-037
located at South Bend, IN and owned by City of South Bend/Board of Public
Works and does hereby further state on behalf of said Contractor 'that our construction
lien rights against such property are hereby waived and released as noted:
THIS WAIVER IS CONDITIONAL UPON PAYMENT OF
0
WITNESS MY HAND AND NOTARIAL, SEAL this
$12,038.40
10th day of January,, 2018
Debra L. Johnson, Notary (Public
My commission expires March 27, 2024 DEBRA L JOHNSON
Seal
Residing in Marshal:l County, Indiana Notary Public - state of Indiana
Marshall County
My Commission Expires Mar 27, 2024
1=
FA-W
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-ual-
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LF -
MAINTENANCE BOND
Bond Number: 285055071-M
Interchange Corporate Center
450 Plymouth Road, Suite 400
Plymouth Meeting, PA. 19462-1644
Ph, (610) 832-8240
KNOW ALL MEN BY THESE PRESENTS, that we Ziolkowski Construction, Inc.
4050 Ralph Jones Drive; South Bend, Indiana 46628
1 as principal (the "Principal"),
and Liberty Mutual Insurance Company, a Massachusetts stock insurance company, as surety (the "Surety"), are
held and firmly bound unto, City of South Bend Department of Public Works
in the penal sum of
as obligee (the "Obliged"),
-------------------------- Dollars ($ W,14b.bU
for the payment of which sum well and truly to be made, the Principal and the S,urety, bind ourselves, our heir:
executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal has by written agreement dated June 27,2017 , entered into a contract (the
"'Contract") with, the Obligee for Century Center Masonry Restoration - Project No. -11-7-037
which contract is by reference made a, part hereof.
NOW, THEREFORE, the condition, of this obligation is such that if the Principal shall remedy without cost to the
Obligee any defect which may develop, during a period of Three (3) year(s) from the date of completion and
acceptance of the work performed under the Contract, provided such, defects are caused by defective or inferior
materials or workmanship, then this obligation shall be null and void; otherwise, it shall be and remain in full force and'
effect.
PROVIDED AND SUBJECT TO THE CONDITIONS PRECEDENT:
1 Obligee shall provide both Principal and Surety with written notice of the discovery (Notice of Discovery) of
any item of defective or inferior materials or workmanship during the covered period (a "Covered Item"),
Should Principal improperly fail to remedy the Covered Item, then Obligee shall make a written demand
upon the Surety ("Demand") within ninety (90) days of the Obligee's issuance of the Notice of Discovery of
the Covered Item,
2. The Notice of Discovery and the Demand shall be in writing and via certified mail to the Principal' and to
the Surety. Notice to the Surety shall be delivered! to the attention of the Surety Law Department at the above
address,
3. No suit or action may be commenced by the Obligee against the Surety after the expiration of one (1) year (or
such lesser time period as otherwise permitted by relevant law) from the date of Obligee's discovery of
a Covered Item, If the provision of this paragraph is void or prohibited by law, the minimum period of
limitation available to sureties as a defense in the jurisdiction of the suit shall be applicable.
DATED as of this 20th day of December —, 20 17
WITNESS / ATTEST
gRannon Relclenbacta
Zio,lkowski Construction. Inc.
(Principal)
By: 41 "- _ (Seall)
Name: 13111 FaVOrS
Title: President
LIBERTY MUTUAL INSURANCE COMPANY
(Surety)
By: (Seal)
Attorney -in -Fact
Adrienne C. Stevenson
LMIIC-5300 Rev. 03104
1 !
wrSze] OKKI16111
I K J Sbarboro Foreit a Notary Public in and for said County, do hereby
certify that Adrienne C. Stevenson as ,attorney -in -Fact, who is personally
known to me to be the same person whose name is subscribed to the foregoing instrument,
appeared before me this day in person, and acknowledged that they signed, sealed, and
delivered said instrument for and on behalf of
for the uses and purposed therein set forth.
Given under my hand and notarial seal at my office in the City of Chicago _ in said County,
this 20th day of December A.D, 2017
Notary Public
OFFICIAL SEAL
K J SBARBORO FOREIT
LTARY PUBLIC
STATE 0 ILL1hlCIS
Y CCAMMISSM EXPIRES:10/04121
THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.. .
This Power of Attorney limits the acts of those named herein, and they.have no authority to bind the Company except in the manner and to. the extent herein stated,
Certificate No. 7862569
Liberty Mutual Insurance. Company
The Ohio Casualty Insurance Company West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS.BY THESE.PRESENTS; That The Ohio Casualty insurance Company is a.corporation duly organized.underthe laws of.lhe.State of Newt{ampshire, that.
Liberty Mutual Insurance. Company is a corporationduly organized under the`laws:of the State of. Massachusetts, and.West American Insurance Companyis a corporation duly :-
organized. under €he laws of the State of Indiana {herein collectively called the .'Companies'), pursuarillo and by authority herein set forth, does hereby name, constitute and appoint,
Adrienne C. Stevenson, Amy B. Wickett; C. R. Hernandez; Gabriel Jacguez John K. Johnson; Katherine J. Boreit `Triniy Garcia
all of the city of. CHICAGO state of IL each Individually If there be more than one vented; its true andlawfuLaUorney €n fact to make, execu.le, seal, acknowledge .:
and deliver, for and on its behalf as surety and as -its act acid deed, anyand all undertakings; bands, recognizances and other surety obligations,in pursuance of these. presents. and shall
be as binding upon the Companies as if they have.bean duly signed.by the.ptesidenl and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF, this Power. of Attorney has been subscribed .by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto [his lath day of August .2017
r�
�SY Ugs..... ` it S[Jq tJ1NS[,K -
��"�„.r The Ohio Casualty Insurance.Company . N
ri Liberty Mutual Insurance Company rU
q
n Y 19» ; 3ate teal Westmerican
Insurance
By
� David M. Care , Assistant Secretary
STATE OF PENNSYLVANIA ss tC
COUNTY OF MONTGOMERY
o
im Onthis 19th day of August - , 2t117 , before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance v r
w..di Company,.The Ohio Casually Company, and West American insurance Company, and that he, as such being authorized so to do, executethe foregoing instrument. for the. purposes
O therein contained by signing on behalf of the corporations by himself as. a duly authorized officer.
C
u > IN WITNESS WHEREOF, I have hereunto subscribed my naive and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written .O �
y5N PA5r� COMMONWEALTH OF PENNSYLVANIA
o4,tvrr�F9r�{{ No€anat Seii N.k O
'j/j r- y p Teresa f'asle[ia, Not.ary Public By: - - --
Qup, er Merinri TwP., Monigomery Coursty Teresa Pastella, Notary Public
My Commission Expires
., .March 28, 2021
i. -; O
(�
E
r- M This Power of Attorney is made and.execuled pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casually Insurance Company, Liberty Mutual.. �W c
insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
e+s. ARTICLE IV- OFFICERS- Section 12. Power of Attorney. Any officer or other officiat of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject O c
a; to Such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may.be necessary to act in behalf of the Corporation to snake, execute seal,
O ,� acknowledge and deliver as surety any and all undertakings, bonds, recognizances and tither surely obligations. Such attorneys -in -fact, subject lathe limitations. set forth in their.respective. 'a
powers of attorney, shall have full power to bind the Corporation by their signature arid execution of any such instruments and to attach thereto the seal of the Corporation. When so `'� 41
`p executed, such instruments shall be as binding as if signed by the President and attested. to by the Secretary. Any power .or authority granted 10 any representative or attorney4ri-fact under > o
the provisions of [his 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. e1h
M G ARTICLE X11I -Execution of Contracts -- SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, E 00.
2 and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -foci, as may be necessary to act in behalf of the Company to make, execute, M
O sea€, acknowledge and deliver as surety any and .all undertakings, bonds, recognizances and other:surety obligations.:: Such attorneys -in -fact subject to. the. limitations.sel forth in their 00
Z .0 respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to atlach.thereto the seal of the Company.. When so v
executed such instruments shall be as binding as if signed byahe president and attested by the secretary, O to
Certificate of Designation -The President of the Company,:acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assislant:Secretary to appoint such attorneys -in-.
fact as may be necessary to act on behatf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings;. bonds, recognizances and other surety
obligations.
Authorization - By unanimous consent of lhe.Company s Board of Directors, the Company consents: that facsimile or meohanicallyreproduced signature 6f any assistant secretary of the .
Company, wherever appearing upon a certified copy of any. power of attorney 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.afffXed, ..
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty :Insurance Company, . Liberty Mutual Insurance Company, and : West American . lnsurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of. the Power of Attorney executed by said Companies, is in fall force and ofect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 20 day of D e Cje rn b_a >T 20 ` `17
JPyrYSI R /�'9 iP,�fYt1,c{p����7JJU111)�'�C._. • [, - �',� .,.�.+ f�-
p--19't9 - n 1912 r:19'11 o
s ° * y } Renee C. Llew ssistant Secretary
s
31�v,xvtF>a�C,LZ'
153 of 25t1
LMS 12873 022017.
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 01/11/2018 Department
Name Toy Villa Division/Bureau
Public Works
Engineering
BPW Date 01/23/2018 Phone Extension 5920
Required Prior to Submittal to 'Board
Legal F-1 Attorney Name:
Controller ❑ Controller review is required for all Contracts $5,000,00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing El
[❑I Agreement Amendment
F] Professional Services
F-1 Bid Opening
[I Quote Opening
F-1 Change Order No.
n Ease/Encroach.
F-1 Other:
Company or Vendor Name,
H Contract L] Proposal LJ Addendum
F1 Resolution
El Bid Award El Req. to Advertise El Title Sheet
El Quote Award
❑C/O & PCA No. Z PCA
❑ Traffic Control:
New Vendor
MBENVBE Contractor
MBE/1/BE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of L_J
El
Ziolkowski Construction, Inc.
El Yes Z No ❑ if Yes, Approved by
Purchasing
[:] MBE [:] WBE
n No El Yes Name of Company
Century Center Masonry Restoration
117-037
Hotel -Motel'
7304.42010.000.0099
31EWi 1 1 "•
Proiect Closeout
F-1 Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment. E-Verifv, Iran. etc.
I ncrease $
Decrease $
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Change: %
Copy
Original
F] Leanna Belew
El
El