HomeMy WebLinkAboutProject Completion Affidavit - York Road Sewer Repairs Proj No 115-139R - C&E Excavating1316 COUNTY -CITY BUILMNO
227 W. JEFFILRSON BOULEVARD
SOUTi i BEND, INDIANA 46601-18 30
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLI'C WORKS
June 26, 2019
Thad Bessinger
C&E Excavating, Inc.
53767 CR 9 N
Elkhart, IN 46514
PHONc 574/235-925
FAX 574/ 235-9171
RE. Project Completion Affidavit — York Road Sewer Repairs — Project No. 115-
139R
Dear Mr. Bess,inger:
The Board of Public Works, at its meeting held on June 26, 2018, approved the Project
Completion Affidavit for this project in the amount of $68,338.%
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
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
sb �a7
PROJECT COMPLETION AFFIDAVIT
PROJECT NAME YORK ROAD SEWER REPAIRS (Div. A&B, & Alt.1)
PROJECT NO 115-139R FINAL COST $68,338,50
CONTRACT SIGNED 12/12/2017 MAINTENANCE AGREEMENT ENDS
PROJECT DESCRIPTION Repair damaged sewers, inlets and manholes near York Road and Crescent Oaks Subdivision.
WITNESSETH
The work under the above contract between the City of South (Bond 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 thi day of _ �-O _, 201 i? C & E Excavating, Inc.
Company Name
Signature 53767 CR9 N'
Company Address
Printed Name Elkhart, IN 46514
City, State„ Zip
WITNESSESS:
B fare, me, the undersigned Notary Public in and for said country and state, personally appeared
k�56tVrw4- , and acknowledged his/her signature to the above Project Completion Affidavit on
the t VI— day of 201 �y �/ ry �y / q ry
**v,AlYY1lPld/fA!/ JEFFRE9 L dONADIE,S
��d!'' t y Public. State of Indiana
Notary Signature My Commission Expires St. Jos®h Count
Commission N 709551
MYy Con i M n Expires
026
Printed Name County of Residence
If the C ntractor is a corporation, the following certificate will be executed.
I,Yi t tikwrU�lrcS certify that I am Secretary of the Corporation executing this release; that
I Q-A Bwho signed this release on 'behalf of the contractor was then
u of said Corporation; that said release was duly signed for and on behalf of said
orpora ion by thority of its governing body, and is within the scope of corporate powers:
Se reta s nature
� $ Corporate Seal
Printed Na e
DEPARTMENT OF PUBLIC WORKS APPROVAL
This project is acceptable for fin approval and we recommend to the Board of Public Works that it be ordained so.
Date: 's, - t 0 • I
Construction ° urger
BOARD OF PUBLIC WORKS APPROVAL Date: A')
Gary A. Gildt; President Suzanna M. Fritzberg, Member Eliza et A. Maradik, Member
Therese J. Dorau, Member Ja s A. Mueller, Member `::Ein a M. Martin, Clerk
AF EMC.
Employers Mutual Casualty Company
Bond No. S453986
MAINTENANCE BOND
KNOW ALL MEN BY THESE PRESENTS:
That C & E Excavating, Inc. of Elkhart, IN
as Principal, and EMPLOYERS MUTUAL CASUALTY COMPANY of Des Moines, Iowa as Surety,
are firmly bound unto City Of South Bend Board of Public_Works , (hereinafter called Obligee)
in the Penal Sum of Six Thousand Eight Hundred Thirty Four Dollars and 00/100 ($ 6,834.00 ) Dollars
lawful money of the United States of America, for the payment of which, well and truly to be made, the
Principal and Surety bind themselves, their and each of their heirs, executors, administrators, successors and
assigns, jointly and severally, firmly by these presents.
Whereas, the said Principal has completed a certain contract,
York Road Sewer Repairs (Div. A & B & Alt. 1 PN: 115-139R
in conformity with certain specifications; and submits
said contract for acceptance by the Obligee.
Whereas, a further condition of said contract is that the said principal should furnish a bond
of indemnity, guaranteeing to remedy any defects in workmanship or materials that may develop in said
work within a period of 3 years from the date of acceptance of the work under said
contract; and
Whereas, the said EMPLOYERS MUTUAL CASUALTY COMPANY of Des Moines, Iowa for
a valuable consideration, has agreed to join with said principal In such bond or guarantee, indemnifying
said Obligee, as aforesaid;
Now, therefore, the Condition of This Obligation is such, that if the said Principal does and
shall, at his own cost and expense, remedy any and all defects that may develop in said work, within the
period of 3 years from the date of acceptance of the work under said contract, by reason of
bad workmanship or poor material used in the construction of said work, then this obligation to be null and
void; otherwise to be and remain in full force and virtue in law.
Date of Formal Acceptance of Contract:
May 10, 2018
Bond Approved:
Signed and delivered this 15th Day of
May, 2018
C & E Excavating, Inc.
EMPLOYTRRS MUTUAL CASUALTY COMPANY
Suret T
w: SEAL racie Mouse Attorney -in -fact
7231 (03109)
AFEMC.
P.O. Box 712 • Des Moines, Iowa 50306-0712 INSURANCE
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
KNOW ALL MEN BY THESE PRESENTS, that:
1. Employers Mutual Casualty Company, an Iowa Corporation
2. EMCASCO Insurance Company, an Iowa Corporation
3. union Insurance Company of Providence, an Iowa Corporation
4. Illinois EMCASCO Insurance Company, an Iowa Corporation
Dakota Fire Insurance Company, a North Dakota Corporation
EMC Property & Casualty Company, an Iowa Corporation
Hamilton Mutual Insurance Company, an Iowa Corporation
hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint:
Tracle House
Its true and lawful attorney -in -fact, with full power and authority conferred to sign, seal, and execute the following Surety Bond:
Surety Bond Number: S453986
Principal : C & E Excavating, Inc.
Obligee City Of South Bend Board of Public W orks
and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all
of the acts of said attorney pursuant to the authority hereby given are hereby ratified and confirmed.
AUTHORITY FOR POWER OF ATTORNEY
This Power -of -Attorney Is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at the
first regularly scheduled meeting of each company duly called and held in 1999:
RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have
power and authority to (1) appoint attorneys -in -fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds
and undertakings, recognlzances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attorney -in -fact at any time
and revoke the power and authority given to him or her. Attorneys -in -fact shall have power and authority, subject to the terms and limitations of the power -of -attorney
issued to them, to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of
Indemnity and other writings obligatory in the nature thereof, and any such instrument executed by any such attorney -in -fact shall be fully and in all respects binding upon
the Company. Certification as to the validity of any power-of-atiomey authorized herein made by an officer of Employers Mutual Casualty Company shall be fully and in all
respects binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon
a certified copy of any power -of -attorney of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
IN WITNESS THEREOF, the Companies have caused these presents to be signed for each by their officers as shown, and the Corporate seals to be hereto affixed this
1s1rtav of Andl_ P017.
Seals
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.tKATHY LOM1M
Commission Number
My Commission apIres
"
October 10, 20119
4-ayA
Bruce G. Kelley, Chairman
of Companies 2, 3, 4, 5 & 6; President
of Company 1; Vice Chairman and
CEO of Company 7
Todd Strother
Vice President
On this 1st day of April, 2417 before me a Notary Public in and for the State of Iowa, personally
appeared Bruce 0, Kelley and Todd Strother, who, being by me duly sworn, did say that they
are, and are known to me to be the Chairman, President, Vice Chairman and CEO, and/or
Vice President, respectively, of each of the Companies above; that the seals affixed to this
instrument are the seals of said corporations; that said instrument was signed and sealed
on behalf of each of the Companies by authority of their respective Boards of Directors;
and that the said Bruce G. Kelley and Todd Strother, as such officers, acknowledged the
execution of said instrument to be their voluntary act and deed, and the voluntary act and
deed of each of the Companies.
My Commission Expires October 10, 2019.
CERTIFICATE
rl/I117
Notary P lic in and for the State Of Iowa
I, James D. Clough, Vice President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies, and
this Power of Attorney issued pursuant thereto on 1st day of April, 2017, are true and correct and are still in full force and effect.
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 15th day of May 2018
,,�_ x A/ Vice President
7853 (4-17) "For verification of the authenticity of the Power of Attorney you may can to loj i io-znou.
Firial Waiver of Lien
State o0uldiana, County of Elkhart
. . . ................. .
Jennifer Burgess
baltip, (filly 8worii that It v/sho 1i tho Corporate Secretary
(Nail) 0 of OfF'r, acr—) .. . .......... ...... .. .....
of C & E E��ao.vating, Inc.
litiville, f'ontructoll With City of South Bend
ntractoy)
(owner.)
to furnish corta Ill inateriala and/or labor tis follows; sewer repairs
(Desv'ription)
f(),r A pk'(>Joct knuvn ors York Road Sewer Repairs - IDiv. A&B & Alt. 1
(NIM0 Of.projert)
located at York Road, South Bend, IN
and owned by City of South Bend
(owner)
land dons hor6by firthorstale on flit, bolialf oftiie sub conftlictor/supp] ion.
(PARUAL WAIV13R) that there is (file Bout the coluractor file suln of
M,01)t Of Which is lloreby nolwowledged; or
El thO My'nont Of NY1110h fifis NO)' Polulsed as tho solo coulidollama for this AffidAvRalld Final Waiver ofLion-Mlloh i, prjvou
sololy with).0spect to said amount, itud which 1valvor sb0l be effitaive, 0111Y "PORMceiPt of payviejit thereof by tile
undersigned;
(J"ZINAL WAIVER) that the fienj bjI,,jut;o title ft-oln tho ceI&Actor Is the Stall of
Sixty eight-thm-aan4-three hundred
E] reCe"Pt of Wbiell is hereby acknotyladped; or
the. payntent of whiolr has beou. prornbsed as file so) o cons idol -at ion lbr this Alli (Itwit ancl ri Mal Walvor of Lion Nyhioft rhuh
baconio Off-ectivc OlItY 11POR reccipt- of such payniont,
THER1,110RE, the ujtdrrqjfMU(j walwo and Manses unto the () wnoj� of.1gitl pr(anjjses, prty fund all Reins or clallim whatsoever
oil ateabove-dosoribed property and fimp,overnerds theroon tuL accorul t Of h1bul'Or Material or both, furnished b t1to undorsigned
thowto, subject to flukitatlom or co"didons axpressed horol ii, if ally*, and fbyljjor corlifled tbattit) Other Party bar, ally claim Of right tar
Pon on accowdof any vlogkperformod oryllaterial famishod to the undor,51pe'd f0rSHidr-PrQjCOf, and w1thly,11110 scope of this Affidavit
wid Waiver of LlaiL
C& E Excavating, Inc.
Frnl------ By
(i)
At ',�;d R4�r,-'
RTKYE OF INDLANA
SS:
8 7% J 0 SE, 131-1 COUNTY
DofOyalnO, tine notch( ignA allotorYPublic, In aftd forsaid County and State, Pel'S(Mally AplAured µ Jennifer Burgess
and acknowledged the execution Of tho fort-1.1ohig Affidavit and Walvel- Of Lj=
INWITHERS WM-RT',10j,',jjijrVO laarctnatta aalrsaritaetf frig lay ofrIcifli S,efff 0 t ore 110 Lath (lay of
May
200 2018
My comnlisgion Rxplros;
Rera i(ling ill _ St. Joseph Coorkty) ._Indiana
Notary l3aabtic i�ivatel . .....
jk Y PC,//,,
JEFFREY L BONADIES
Notary Public, State of Indiana
St. Joseph County
Commission # 7019661
1t)
I to o 4
My Commission expires
411111110N
January 21, 2026
BOARI) OF PUBLIC WORT
AGENDA ITEM REVIEW REQUEST FORM
Date
06/12/2018
Department
Public Works
Name
Toy Villa -�7
Division/Bureau
Engineering
BPW Date
06/26/2018
Phone Extension
5920
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 R
LJ Agreement Amendment
LJ
Contract LJ Proposal U Addendum,
F1 Professional) Services
El
Resolution
F-1 Bid Opening
F-1 Bid Award ❑ Req. to Advertise El Title Sheet
F-1 Quote Opening
F1 Quote Award
❑
Change Order No.
F-1 C/O & PCA No,. Z PCA
Ease/Encroach.
El Traffic Control:
F-1
Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of
El
C & E Excavating, Inc.
El Yes H No El If Yes, Approved by Purchasi
0 MBE 0 WBE
F-1 No El Yes Name of Company
York Road Sewer Repairs
115-139R
LRSA Capjtal Major Projects
251.0608.431.42.96
$68,338.50
Project Closeout
F-1 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: 0/0
Dispersal After Approval
Copy Original
F-1 Kara Boyles,, City Engineer
F-1 Roger Nawrot, Assistant City Engineer
0 Ron O'Connor