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Home My WebLink AboutProject Completion Affidavit - College St and Sunnymede Ave Traffic Calming Proj No 117-113 - Selge Construction1316 COUNTY-Crry BUII,DrNG 227 W. JEFFERSON Bow,F,VARD SOUTH BENI). INDIANA 4660 1 - 1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAY BOARD OF PUBLICMOV t, June 12, 2018 Tom Lentz Selge Construction Co., Inc. 2833 S II"' Street Niles, MI 49120 1'110M574/235-9251 FAX 574/ 235-9171 RE: Project Completion Affidavit — College St. and Sunnymede Ave. Traffic Calming — ProjectNo. 117-113 Dear Mr. Lentz: The Board of Public Works, at its, meeting held on June 12, 2018, approved the Project Completion Affidavit for this project in the amount of $37,400. 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, C, Linda M. Martin, Clerk Enclosure C: 'Foy Villa, Engineering GARY A. Gtw'j, SUZANNA M. FRITZBI-Azo EuZABETH A. MARADIK JAMFs A, MUELUR THERESE J. DORAU CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME College St & Sunnvmede Ave Traffic Calming PROJECT NO 117-113 FINAL COST $37,400.00 CONTRACT SIGNED 12/12/201�7 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Install traffic calming devices at two (2) locations, all within the City of South Bend, IN, WITNESSETH: 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, Execute his 11 th daY of - way 201 e§gnaiu-re Tom Lentz, Project Manager Printed Name SeIge Construction Co., Inc. Company Name 2833 S. I 1th Street Company Address Niles, MI 49120 City, State, Zip WITNESSES& Before me, the undersigned Notary Public in and for said country and state, personally appeared Torn,Lentz , and acknowledged his/her signature to the above Project Completion Affi t e 1 day of ,,14a 201 8 Notary Signature My Commission Expires 07/25/2020 Vicki A. Priest 70177-417kp- "IR County of Residence 10,47JIMS I F PUBLIC (A My COMWSSION 7-25-2020 If the Contractor is a corporation, the following certificate will be executed. -11111FIfIlIM, 1. Vicki A. Priest certify that I am Secretary of the Corporation executing this release; that Tom Lentz who signed this release on behalf of the: contractor was then P-rn-i imr-+ Manager of said Corporation; that said release was duly signed for and on behalf of said Corp, ation'by Authority,pf its governing body, and is within the scope of corporate powers: X Secretary's Signature' Corporate Seal Vicki A. Priest Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for -fin pproval and we recommend to the Board of Public Works that it be ordained so. a -A Date: Construcfion tiager BOARD OF PUBLIC WORKS APPROVAL Date: Gary A, Gilot, President Suzarma M, Fritzberg, Member Eliza i5th'A Maradik, Member Therese JI. trorau,'Member James A. Mueller, Member irlda M. Martin, Clerk Final Waiver of Lien State of Indiana, as WHEREAS, the undersigned Selge Construction Co., Inc. has been heretofore employed by the City of South Bend, IN to furnish certain material and labor, to wit: College Street & Sunnymede Avenue Traffic Calming Project No 1.17-113 for the real estate owned by the Cites South Bend located in South Bend, IN County of St. Joseph, State of Indiana., Now Therefore, Know Ye, That the undersigned, for and in consideration of Three Thousand Six Hundred Porte Six Dollars and Fifty Cents ($3,646.50), 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 real estate. TO AND FOR SAID AMOUNT, an account of any and all labor material, or both furnished for or incorporated into said real estate by the undersigned up to this date, and we further certify that the consideration moving to the undersigned for executing this Final Waiver of Lien has been mutually given and accepted as final payment to or on account of the said project for said real estate. Signed, sealed and delivered this 1 l th day of Mae, 2018 a� Signed Tom Lentz, Oioject eager Personally appeared before me this 1 Ith day of May, 2018, Tom Lentz, who, being duly sworn on oath, says: That he is Project Manager of the Selge Construction Co., Inc. and that he hereby acknowledges the execution of the foregoing ri trument for and a behalf of said Selge Construction Co. Inc. y p M Commission expires: 07/25/20217� � Q. Notary Public TAR PUBLIC �. 031 rev COMMISSQN 00 EXPIRES 5 2f3eu srr'.r�� BOARD OF PUBIAC WORKS AGENDA ITEM RE, VIEW RE QUEST FORM Date .05/18/2018 . . ..... . Department Engineering Name Toy Villa Division/Bureau DPW BPW Date 06/12/2018 Phone Extension 5933 Legal El 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 F LJ Agreement El Professional Services F] Bid Opening R Quote Opening F-1 Change Order No. Ease/Encroach. Other: Company or Vendor Name New Vendor MBEANBE Contractor MBE/WBE Contractor Requested Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Amount of ❑ F.Ar,•4 P 1% ITO E] Req. to Advertise E] Title Sheet I PAI 1 M Selge Construction Co., Inc. El Yes 0 No El If Yes, Approved Iby MBE [:1 VVBE ❑ No H Yes Name of Company Martell mm College Avenue & SunnVmede Avenue Traffic Calming 117-113 M 251 .0608.431.42.96 $37,400,00 Project Closeout U Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.) Increase $ Decrease $ Previous Amount $ Current Percent of Change: % New Amount $ Total Percent of Change: % Dispersal After Approval Copy Original El El F-1 F-1 El El