HomeMy WebLinkAboutProject Completion Affidavit - East Bank Sewer Separation Phase V Proj No 114-062B - Walsh & Kelly Inc1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOUL�::VARD
SOUTii BEND. INDIANA,16601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
April 10, 2018
Dustin Hilary
Walsh & Kelly, Inc.
24358 State Road 23
South Bend, IN 46614
PHONE, 574/235-9251
FAX 574/ 235-9,171
RE: Project Completion Affidavit — East Bank Sewer Separation, Phase V — Project No.
114-062B
Dear Mr. Hilary:
The Board of Public Works, at its meeting held on April 10, 2018, approved the Project
Completion Affidavit for this project in the amount of $5,511,798.78.
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
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMEs A, MUELLER THERESE J. DORAU
'z
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
PROJECT COMPLETION AFFIDAVIT
PROJECT NAME -East Bank Sewer Separation - Phase 5 (Division B)
PROJECT NO 114-0�62B FINAL COST $5,511,798.78
CONTRACT SIGNED 1/26/2016 MAINTENANCE AGREEMENT ENDS
PROJECT DESCRIPTION Separation of the storm and sanitary sewers along East Bank.
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 whiere a part above Contract.
Executed thil d of CO Walsh Kelly Inc.
ch
Company Name
, South Bend Area
Name
WITNESSESS:
Before me, the undersigned Notary Public in
Dustin Hilary , and acknowledged,,
the 15th
ME
24358 State Road 23
Company Address
South Bend, IN 46614
City, State, Zip
and for said country and state, personally appeared
I ijAtUp r , ; Completion Affidavit on
ALISHA KBUEGE
P & '
Nota(y Ribflc, state of Indiana
AL' st. Joseph county
My p9Go�mpp
mission Expires
Com
June 5, 2022
Alisha Krueger
Printed Name County of Residence St. Joseph
If the Contractor is a corporation, the following certificate will be executed.
J. Michael Schaum
certify that I am Secretary of the Corporation executing this release; that
Dustin Hilary
who signed this release on behalf of the contractor was thVR�4i
South Berid—Area Managex.,
of said Corporation; that said release was duly signed for and Orl"a hqg 0'jq
C poraronip)hority W verning
body, and nd is within the scope of corporate powers:
Secrete %nature
�hael
Co it Seat'
J. Schaurn
Printed Name
Zkl
A
DEPARTMENT OF PUBLIC WORKS APPROVAL jt
This project is acceptable for fin approval and we recommend to the Board of Public Works that it be ordalne&b'd.mW0
Date:
Construction'§gdN
L�-
BOARD ;'UBLI WORKS PROVAL Date: I z/0'
Gary A. Gi;ilot, t5resident
n a F6(zberg, MemYbr Elizabeth A. Ma'6d!k, Member
Therese J. Dorft, Meffil5er
Jame A. Mueller, Member Lidda M. Martin, Cll"r
Maintenance Bond
That we,
Surety O +908.903.3485
202B Halts Mill Road, Pp Box 1650 F + 908.903.3656
Whitehouse Station, NJ 08889-1650
Federal Insurance Company
Bond No. M NT 8244-11-48 Amount $551,179.88
Know All Men By These Presents,
Walsh & Kelly, Inc,
24368 State Road 23
South Bend, IN 46614
(hereinafter called the Principal), as Principal, and the FEDERAL INSURANCE COMPANY, a corporation duly organized
under the laws of the State of Indiana, (hereinunder called the Surety), as Surety, are held and firmly bound unto
City of South Bend, Board of Public Works
227 W. Jefferson Blvd.
South Bend, IN 46601
Five Hundred Fifty One Thousand One Hundred Seventy
(hereinafter called the Obligee), in the amount of Nine Dollars and 881100 ($551,179.88 },
for the payment of which we, the said Principal and the said Surety, bind ourselves, our heirs, Sealed with our seals
and dated this 20th day of March, 2018.
WHEREAS, the said Principal has entered into a contract dated January26 2016
for: East Bank Separation, Phase 5, Division B, Project No. 1144-062
And
WHEREAS, the said Principal is required to guarantee the East Bank Separation, Phase 5, Division B, Project No. 114-062
installed under said contract, against defects in materials or workmanship, which may develop during the
period March 20, 2018
to March 20, 2021
Form 15.02.0075FED (Rev. 5/17)
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal shall faithfully carry out and
perform the said guarantee, and shall, on due notice, repair and make good atits own expense any and all defects in materials
or workmanship in the said work which may develop during the period March 20, 2018 to March 20, 2021
or shall pay over, or make good and reimburse to the said Obligee all loss and damage which said Obligee may sustain
by reason or default of said Principal so to do, then this obligation shall be null and void; otherwise shall remain in full
force and effect.
Walsh & Kelly, Inc. c-:
By
Jo eisker, VP of Asphalt: Operations
J�"
Form 15-02'0075FED (Rev. $117)
C H U CB E °
Power of Attorney
Federal Insurance Company j Vigilant Insurance Company I Pacific Indemnity Company
Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC
INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Terry R. Hurst
as their true and lawful Attorney -in -Fact to execute under such deslgnatlon in their names and to affix their corporate seals to and deliver for and on their behalfas surety thereon or
otherwise, bonds and undertakings and other writings obligatory In the nature thereof (other than bail bonds) given or executed in the course of business, and any Instruments
amending or altering the same, and consents to the modification oralteration ofany Instrument referred to In said bonds orobligations,
Surety Bond Number: MNT8244-11-48
Obligee: City of South Bend, Board of Public Wofks
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY C051PANY have each executed and attested these
presents and affixed their corporate seals on this 6thday of January, 2017.
Dawn M. Chloros, Assistant Secretary
STATE OF NEW JERSEY
County of Hunterdon SS.
Stephen M. Haney, Vice President
0 0 0
On this 61h day of January, 2017 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE
COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros,
being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY
COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney arc such corporate seals and were thereto affixed by authority of said
Companies; and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and thatshe Is acquainted with Stephen M. Haney, and knows him
to be Vice President of Bald Companies; and that the signature of Stephen M. Haney, subscribed to said Power of Attorney Is In the genuine handwriting of Stephen M. Haney, and was
thereto subscribed by authority of said Companies and In deponents presence.
Notarial Seal a
KATHERINEJ, AIIELAAR
NOTARY PUBLIC OF NEW JERSEYNo.231BU65commteslon
Expires July 16, 2019 NotaryFuhllc
CERTIFICATION
Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016:
'RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, recognizances, contracts and other written commitments of the Company
entered into In the ordinary course of business (each a 'Written Commitment'):
(1) Each of the Chairman, the President and the Vice Presidents of the Company Is hereby authorized to execute any Written Commitment forandanbehalrofthecompany, underthe
seal of tho Company or otherwise.
(2) Each duly appointed attorneyln-factoftheCompany$aherebyauthorizedtoexecuteanyWrittenCommitmentforandanbehalfoftheCompany,underthesealofthecompanyorotherwise,
to the extent that such action Is authorized by the grant of powers provided for in such person'swritten appointment as such attorney-Wram
(3) Each of the Chairman, the President and the Vice Presidents of the Company Is herebyautharlted,for arid on behalf of the Company, to appoint In writing any person the anorneyin-
fact of the Company with full power and authority to execute, for and on behalf of the Company, under the seat of the Company or otherwise, such Written Commitments of the
Company as may be specified In such wriuen appointment, which spedEcation may be by general type or class of Written CommInnents or by specification of one or more particular
Written commitments.
(4) Each of the Chairman, the President and the Wee Presidents of the Company Is hereby authtirked, forand on behall'ofthe Company. to delegate In wrift to any otherofficor of the
Company the authority to execute, for and on behalf of the Company, under the Company's seal or otherwise, such Written Commitments of the Company as are specified in such
written delegation, which specification may be by general typeer class of Written Commitments or by specification ofoneormore particularWrlttenCommitments.
(5) The signature of any officer or other person ex=Ung any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, may be affixed by
facsimile on such Written Commitment orwritten appointment ordelegation,
FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statementofthepowers and authority ofofficers, employees and otherpersons to act for and on bohalfof the
Company, and such Resolution shall notlimlt or otherwise affect the exerciseof any such power or authority otherwise vaHdlygranted orvested.'
1, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies') do hereby
certify that
(1) the foregoing Resolutions adopted by the Board of DirectorsoftheCompaniesaretrue,correctandInfullforceandeffect,
(11) the Companies are duly licensed and authorized to transact surety business In all 50 of the United States of America and the District of Columbia and are
authorized by the ITS. Treasury Department; further, Federal and Vigilant are licensed in the U.S. Virgin Islands, and Federal Is licensed in Guam, Puerto Rico,
and each ofthe Provinces of Canada except Prince Edward Island; and
tide foregoing Power ofAttorney is true, correct and in full force and effect.
Gh, nuntter.amy(eWnW nd seals ofsaid,Compantes at Whitehouse Station, NJ, this March 20, 2018.
Dawn M. Chloros Assistant Secretary
IN ToE.EVENT YOV;-WISH TO NOTIFY US OF CtAIM, VERIFY Tit EAUTNENT] CITY 0FTHIS BOND 0R NOTIFY US OF ANY OTREll MATTER PLEASE CONTAcrus AT.
Tele hone 900903.3493 Fax 908 903-3656 a-mall:sure Rchubbxom
r
�omI It iO-QM. B U GkNCdNlfENT(rev.12.16)
Final Waiver, of Lien
State Of Indiallao County of St. Joseph SS:
John Peisker being duly awom thathelshe Is the Vice President of Asphalt Operations
(Name of Officer) (Title)
of Walsh & Kelly, Inc. having contracted with _ Cit�outh Bend, Indiana___
(Contractor) (Owner)
to furnish vottain inaterials andlor labor as follows; Asphalt Paving, Sanitary, Storm Sewer and Water
0) off on)
for a project known as —East Bank Sewer Separation, Phase 5, Division B, Project No. 114-062
(Namo ofprojeot)
located at Various locations jhroughout the City of South Bend, Indiana
and owned by __CitY_QLSDutbJaend, —1ndJLana
(owner)
and dons hereby further state on the lichalf of tile a!foromontionedstiboonttiotor/suppiter:
(PARTIAL WAIVER) that thero is duo from the Contractor the Bum of
Dollars
receipt Of winch is hereby a0knoWledged; or
El the payment otw1ilch lais bcon promised as the mole consideration for this Affidavit and Final Waiver of Lion which Is given
solely Will, respect to said amount, and which waivcr 8111111 be effective Only upon rocolpt of payment thereof by the
undersigned;
(FINAL WAIVER) that the: final balance duo Rom the contractor Is the sum of
El receipt of which Is hereby acknowledged; or
the, payment of which has been promised Or, the sole consideration for this Affidavit and Final Walvor of Lion which shelf
become affective only vponrecoipt of such payment,
T1,03REFORE, the undersigned waives mid releaseimto the Owner of Bald promises, any one, all lions or claims wilatsoever
on the above-deserlbed prop" and improventantalthero6n,ail pcvbinit of labor or material or both, funrishod b the underalped
thorolo, qubJ cot to limitations or conditions OXPr9 certified that no other party has any claim orright to it
lien on "count of any work performed or gnat e, fished to 14MJf&Jguer[ for said projoct, And within the scope of this Affidavlt
mid Waiver ofl,fon.
CP
Walsh & Kelly, Inc. I
(Firm) SEAS ....#y
10
STAT13 OF INDIANA 00, ............
SS: 0.* '�J' IIVL)
ST. JOSEPH CO1JNT`Y 111111111110
Before map the undarsigued, a Notary public, In and for said County and State, personally appeared Joh n Peisker
and nolatowledged the execution of the foregoing Affidavit and Waiver of Lion,
IN WITNIRS8 WIRREOP, I have hereunto subsorlbod tray namo and affixed in "'a' of
-March . 200
otuy Pat,
MycomnifigionExpiros, June 07, 2023
m Elizabeth Turpin
Residing fit
-,_JndiaML,._, County, Notary
RPIN
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW RE QUEST FORM
Date 03/29/2018 Department Public Works
Name Toy Villa Division/Bureau Engineering
BPW Date 04/10/2018 Phone Extension 5920
Legal F-1 Attorney Name:
Controller El 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
H Agreement Amendment
H Contract LJ Proposal H Addendum
E] Professional Services
F Resolution
F-1 Bid Opening
El Bid Award E] Req. to Advertise ❑ Title Sheet
F Quote Opening
[:] Quote Award
F-1 Change Order No.
D C/O & PCA No. PCA
F Ease/E,ncroach,
F-1 Traffic Control:
F-1 Other:
Company or Vendor Name
New Vendor
MBENVBE Contractor
MBEANBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Walsh & Kelly, Inc.
El Yes N No El If Yes, Approved by Purchasi
MBE M WBE
No [:] Yes Name of Company
East Bank Sewer Separation — Phase V
114-062B
REDA TIE and 2012 Sewer
429,1050.460.31.02
$5,511,798.78
Approval of Completion Affidavit
[] Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verifv, Iran, etc.
Amount of El increase $
El Decrease $
Previous Amount $
Current Percent of Change
New Amount
Total Percent of Chanae:
Copy
Original
F-1
El
El
F-1
El
El