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Home My WebLink AboutChange Order No. 1-PCA - 2017 Cold Milling Proj No 117-051 - J.L. Milling Inc1316 COUNTY -CITY BOILDMG 227 W. JEFFERSON BOULEVARD Soui'ti BEND. INDIANA 46,601-1830 CITY OF Souni BEND PETS, BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS March 27, 2018, Linda Schuring J.L. Milling, Inc. 15262 Industrial Drive Schooleraft, MI 49087 PHONE 574/235-9251 FAX 574/ 235-9171 RE: Change Order No. I (Final}/Project Completion Affidavit - 2017 Cold Milling — Project No, 117-051 Dear Ms. Schuring: The Board of Public Works, at its meeting held on March 27,2018, approved the Final Change Order for this project, for a decrease of $11,070.4 1. The new Contract sum is $51,129.59. In addition, the Project Completion Affidavit for this project was approved in the amount of $51,129.59. 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- 925L Sincerely, Linda M. Martin, Clerk Enclosures c: Toy Villa, Engineering Kara Boyles, Engineering Roger Nawrot, Engineering Pete Kaminski, Streets GARY A. Gii,o'r SUZANNAM.FRITZBERG ELIZABETi-jA.MARADIK JAMES A. WFILER DiFi RE s rJ, DORAU CITY OF SOUTH BEND, INDIANA DEPARTMENT OF PUBLIC WORKS WA PROJECT CHANGE ORDER DATE: 12/1/2017 0:00:00 PROJECT NO: 117-051 PROJECT NAME: 20117 Cold Milling CONTRACT DATE: 4/25/2,017 CHANGE ORDER NO: 1 (Final) SUBJECT OF CHANGE ORDER: PCR #1-Adjustment to Final Quantities. All items completed' substantially as planned. See attached Comparison of Estimate for overruns and underruns. The 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 is The new contract sum lincluding this change order, This Change Order represents a total change of Total change for entire project Original contracted completion date/time Extension of dateltime by previous change,orders Date/time extension by this change order New completion date/time CONTRACTOR Contractor Signature C, A, - _4.,td,4 I 0 && qv , /A ed Printed Name and Title I ' J.L. Milling, Inc. Company Name 15262 Industrial Drive Address Schoolcraft, MI 49087 City, State, Zip F-1 Increased FX] Decreased 62,200.00 0.00 $ 11,070,41 $ 51,129.59 -17.80 % -17.80 % 11/15/2017 0:00:00 0 days 0 days 11/15/2017 RECOMMENDED FOR APPROVAL CONSTRU,qON MANAGER CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Approved Date: Gary A. Gild, President Therese J. Dorafi, Member James A. Mueller, Member CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS, PROJECT COMPLETION AFFIDAVIT PROJECT NAME 2017 Cold Milling PROJECT NO 117-051 FINAL COST $51,129.59 CONTRACT SIGNED 4/25/2017 MAINTENANCE AGREEMENT ENDS Perform pavement cold milling services during the 2017 construction, season at various PROJECT DESCRIPTION locations throughout the City of South Bend. L011111111110� 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 y of De, e. 201 7 J1, Milling, Inc. Company Name Signature 15262 Industrial Drive Company Address Printed Name d( Schoolcraft, MI 49087 City, State, Zip WITNESSESS: Before T.,5, the undersigned Notary Public in and for said country and state, personally appeared Ilyk, 1-1XI 06 k 0 and acknowledged his/her signature to the above Project Completion Affidavit on .201 av of14'?1 LC_ the 62 ur My Commission Expires 31g Name County of Residence If the Contractor is a corporatio the lowing certificate will be executed, I.Ll certify that I am Secretary of the Corporation executing this release; that r 4, (4 XP who signed this release on behalf of the contractor was then �,r_ e- v f of said Corporation; that said release was duly signed for and on behalf of said Corporation by Authority of its governing body, and is within the scope of corporate powers: SK g nature Corporate Sea] Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable I approval and we recommend to the Board of Public Works that it be ordained so, Date: Constructi eager BOARD PUB WORS, APPROVAL Date: Gary A. Gilot, President SuzafinaM, Fdtzbergvm r ber Elizabeth A, I ara !ik, Member James A. Mueller, Member Therese J. Dor4u Memberda M. Martin, Clerk AFFIDAVIT'' AND WAIVER OF LIEN State of Indiana, County of MM 1,44 se- 1 114 al� I ' - being duly sworn that he/she is the (Name of Officer) (Title) of T. f- M ( ft ',",a 'r Ate- having contracted with &14 411,(*- �VV'lggr (,, 7e'l if (Subcontractor/S6pplier) (Contractor) " o 1,4 do 14 to furnish certain materials and/or labor as follows: for a project known as located at and owned by (Description) 0 Fe 04 (Name of Project) (Owner) and does hereby finther state on the behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there is due from the Contractor the sum of Dollars --($ - F-1 receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien 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 4 receipt of which is hereby acknowledged; or El the payment of which has been promised as, the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective only upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever on the above -described property and improvements thereon an account of laborormaterial or both, furnished b the undersigned thereto, subject 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 performed or material furnished to the undersigned for said project, and within the scope of this Affidavit and Waiver of Lien. r &C14' 2,41c, (Firm)/ 13Y (Authorized Replesentative) 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 WHEREOF, I have hereunto subscribed my name and affixed my official seal on the 200 Notary Public Signature My Commission Expires: day of Residing in County, Notary Public Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 03/13/2018 Department Public Works Name Toy Villa Division/Bureau Engineering BPW Date 03/27/2018 Phone Extension 5,920 Required, Prior to Submittal to, Board, Legal El Attorney Name: Controller F] Controller review is required for all Contracts $5,0100.00 or more and greater than one year in length per the City Purchasing Policy Purchasing El Agreement Amendment Professional Services Bidl Opening Quote Opening Change Order No. Ease/Encroach. Other: Company or Vendor Name New Vendor MBEANBE Contractor MBEANBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Contract Resolution Bid Award mmo. NEEMME =0 E] Req. to Advertise El Title Sheet um J.L, Milling, Inc. F1 Yes 0 No E] If Yes, Approved by Purchasing ❑ MBE [J WBE 0 No El Yes Name of Company 2017 Cold Milling 117-051 LRSA 251.0608.431.36.10 Project Closeout EJ Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) Amount of ❑ increase $ Decrease 11 $,070.41 , Previous Amount $ 62,200.00 Current Percent of Change: 17.80% New Amount $51,129.59 Total Percent of Change: 17.80% Copy Original F-1 Kara Boyles, PhD, PE, City Engiinieer Roger Nawrot, PE, PLS, Assistant City Engineer F-1 Pete Kaminski, Manager of Streets'