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HomeMy WebLinkAboutProject Completion Affidavit - 2017 Curb and Sidewalk Proj No 117-008 - Ziolkowski Construction Inc1316 COONTY-My BuiLDING 227 W, JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTvi BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS July 10, 2018 Bill Favors Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 1'11()Nr,, 574/235-9251 FAX 574/ 235-9171 RE: Project Completion Affidavit — 2017 Curb and Sidewalk, Divisions B, C, D, F & F — Project No. 117-008 Dear Mr. Favors: The Board of Public Works, at its meeting held on July 10, 2018, approved the Project Completion Affidavit for this project in the amount of $268,3 81. 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 GAT A. Ga,o'r SUZANNA M. FRITZBER(i ELIZABETH A. MARADIK JAMFs A. MUELLF'R TiiF,RESt,' J. DORAU CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME 2017 Curb and Sidewalk Div. B,,C, D,E & F PROJECT NO 117-008 FINAL COST $268,381,00 CONTRACT SIGNED 5/23/2017 MAINTENANCE AGREEMENT ENDS Removal and replacement of concrete sidewalk, concrete curb, ADA compliant concrete curb PROJECT DESCRIPTION ramps, and concrete approaches. 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 I of South Bend which were a part of the above Contract, Executed this 19th day of June .201 8 ZiolkowsId Construction, Inc. !��J �c -1 Company Name /Signature 4050 Ralph Jones Drive Bill Favors President & CFO Company Address Printed Name South Bend, IN 46628 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Bill Favors -. and acknowledged his/her signature to the above Project Completion Affidavit on the 19th dall i f Jrrne 2018 LYNN D VINiN:G Sea[ March 6, 202 Notary Public.. State of Indiana Notary S My Commission Exp�ires ri MY commission Expires mar 6,2o2s Lynn D. Vining IM] Printed Name County of Residence Elkhart If the Contractor is a corporation, the following certificate will be executed. 1, Charles Lewis certify that I am Secretary of the Corporation executing this release; that Bill Favors who signed this release on behalf of the contraopmewthoo President & CFO of said Corporation; that said release was duly signed jo?'% $0 . V id its governing body, and is within the scope of corporate powers. «4 -I 0 Secretary's Signature 0 V AC -Iry porid Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL 1. This project is acceptable for final approval and we recommend to the Board of Public Works that M Construction Manager BOARD OF PUBLIC WORKS APPROVAL Date: AA IIJAA,,-- Gary A. Gilot,'Pfeside!nt , Suzan e(W Fr'6156& Meo6er Ehab 66 A Maradilc, We­-M-er Maintenance Bond Bond'285055066-M KNOW ALL BY THESE PRESENTS, That we, Ziolkowski Construction, Inc. 4050 Ralph Jones DrLive, South Bend, Indiana 46628 as Principal, and I lberty Mutual Insurannp Company; 175 a rkel'ey Street: Boston, Massachusetts 02116 a corporation organized under the laws of the State of Massachusetts and duly authorized to do business in the State of Indiana - , as Surety, are held and firmly bound unto City of South Bend 227 W. Jefferson Street; South Bend, Indiana 46601 as Obligee, in the penal sum of Twenty Six Thousand Eight Hundred Thirty Thirty Eight& 10/100 ----- ($ 26,838.10 to which payment well and truly to be made we do bind ourselves, our and each of our heirs, executors, adn-Linistrator's, successors, and assigns jointly and severally, firmly by these presents. WHEREAS, the said Principal entered into a Contract with the City of South Bend dated for 2017 Curb and Sidewalk Constructions, Divisions B-F, Project No. 117-008 WHEREAS, said Contract has been completed, and was approved on day of June , 2018 1 5th May 23, 2017 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That if the Principal shall guarantee that the work will be free of any defective materials or workmanship which became apparent during the period of -Thre.e3 .. - yeaT(s) following completion of the Contract then this obligation shall be void, otherwise to remain in full force and effect, provided however, any additional warranty or guarantee whether expressed or implied is extended by the Principal or Manufacturer only, and the Surety assumes no, liability for such a guarantee. Signed and scaled this 20th — day of June ) 2018 Ziolkowsk! Construction, Inc. Bill Favors, President (Seal) (Seal) (Seal) Liberty Mutual Insurance ;omp C 40y CN. By A Adrienne C. Stevensorf Attorney -in -Fact STATE OF ILLINOIS COUNTY OF COOK T, C.R. Hernandez , 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 LIBERTY MUTUAL INSURANCE COMPANY for the uses and purposed therein set forth. Given under my hand and notarial seal at y office in the City of Chicago in said County, this 20t" day of .Tune A.D. 2018 Notary P C f H'ERfJAN©EZ Offical Seal Notaryf'ublle State of Illincis fvly Commission Expires Jun fi, 2020 ' 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. 7963880 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 Casually Insurance Company is a corporation duly organized under the laws of the Slate of New Hampshire, that. Liberty Mutual. Insurance Company is a corporation duly. organized. under the taws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the:.'Companies'j, pursuantto and.by authority herein set forth, does hereby name, constitute and appoint, . Katherine J. Forett• John K. Johnson; Adrienne C. Stevenson; Triniy Garcia; C. R. Hernandez• Gabriel Jac uez; Arny B. Wickett all of the city of CHICAGO ; slate of IL ... each individually if there be .more than one named, its truo and lawful attorney -in -fact to make, execute, seal, acknowledge and. deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds; recognizances and other. surety obligations, In pursuance of these presents and shall . be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own jproper persons. IN WITNESS WHEREOF, this Power of Attarney.ilas been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 1 ath day of December 2017 The Ohio Casualty Insurance Company n Liberty Mutual Insurance Company to 0) Gs )9i 9 West rnerican Insurance Company N y Ss�yl1`„l {�\a � y 7.n3�•• "f it g ..� +' David M. Carey Assistant Secretary. STATE OF PENNSYLVANIA ss sic «� COUNTY OF MONTGOMERY —o m On this 141h day of December 2017, before me personally appeared David M. Carey, who acknowledged himself 10 be the Assistant .Secretary of Liberty Mutual Insurance M I-- L) (D .Company, The Ohio .Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes �.,Q) p therein contained by signing on behalf.af. the corporations by himself as a duly authorized officer. W > IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. PA&� COMMONWEALTf1 Or' PENNSYLVAN1A / a O` Nralanal Seal +, Teresa Pasteila, Notary Public BY of Upper MerionTwp., Montgomery counly Teresa Pastella, Notary Public d - �. aY�V��i�G -. My Commission Expires March 26, 2021 --- .M O0.QTd#! p1Jk'ti :.: Mambo Pennsylvania Assodahoa of Notaries _ - .. - . _ ._ C This Power of Attorney Is.made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casually Insurance Company, Liberty. Mutual W o F; Insurance Company, and West American In Company which resolutions are now in full force and effect reading as follows: ;F ` M ARTICLE IV— OFFICERS- Section 12. Power ofAttorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject C) O C tm ,�, to such lim€talion 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 make, execute, seal,:+. O = acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject.fo the limitations set forth in. their respective � E powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments. and to. attach thereto the seal of.the Corporation. When so executed, such instruments shall.be as binding as if signed:by the President and attested to by the Secretary. Any power.or authority granted to any representative or atlomey-in-fact under a, the provisions of this 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. et M c ARTICLE XIII — 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, s 04 �? d and subject to such limitations as the.chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to actin behalf of.the Company to make, execute, - M O seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.' Such attorneys -in -fact subject to the.limitalions set forth in their G Z Q. respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and 10 attach thereto the seat of the Company. When so executed such instruments shall be as binding as if signed by president and attested by the secretary. O Certificate of Designation —The President of the Company; acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in- ~ fact as may be necessary to act on bottalf of.lhe Company.to make, execute, seal, acknowledge and deliver as. surety any. and all undertakings; bonds, recognizances and other surely: obligations, Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of 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 affixed 1, Renee C. Llewellyn, the. undersigned, Assistant. Secretary, The Ohlo Casually Insurance Company, Liberty:: Mutual Insurance. Company, and West American Insurance .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 full force and effect and has not been revoked. IN.TE$TIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 20 day of June 2018 - " c c By l919 n ,- )12 19J1 <, s i Renee C. Llewe ssistant Secretary c3 226 of 250 Lms 12873 022017 Final Waiver of Lien State of Indiana $ County of St Joseph Sg; Bill Favors being duly atwoM that helsliS Is the Presldent & CFO (Name ofofficer) (Title) of Ziolkowski Construction, Inc. having contracted with City of South Bend (Contractor) (Owner) to furnish certain materials and/or labor its follows: curb and Sidewalk (Description) for a project known as 2017 Curb and Sidewalk Div. B, C, D, E & F (Name of Project) located at South Bend, Indiana �.",. and owned by City of South Bend (owner) and does heraby further state on the behalf of the aforernentioned subcontractor/supplier: (PARTIAL WA1lrVBR) that there is dire from the Contractor the aura of DORRIS i� receipt ofwvhlch is hereby acltrrowledged; or the payinent of which has been promised as the sole consideration for this Affidavit and Final Waiver of Llenwhlch is ,given solely with respect to said umount, and which wwuivrrr shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance clue fr' n the contractor Is the sure of Twentv Elaht ThousandSeven Hundred TwentyFour and 690t70 ( 28.72469 E] receipt ofw~tbioli is hereby acknowledged; or thepayanent of which has been promised as the sole consideration for tlrls Affidavit and Final Waiver of Lien which shall become effective onlyuponreucipt ofsuoh payment. Tl' BREFC9RE, the undersigned wwalves and releases unto the Owner of sold premises, any and all liens or claims whatsoever on the above-desarlbed propezty ,and improvements thereon an accowt: of labor or material or both, f rmished b the undersigned thereto, subject to limitations or conditions expressed herein, If any; and further certified thatrro other party has any claim or right to a Bert on accolant of any work performed or material fturnished to the undersigned for saidprraject, and within the scope of this Aftldavlt said Waiver ofLlem Ziolkowski Construction, Inc, By ' 4Favurs president &CFO - (Firm) (Atnthorizeci Ap-presuntative) STATF Dlr !! DJAANA ) SS: ST, JOSEPH COUNTY ) before me, the tandersfgtred, a Notary Pablio, in and for said County and Slate, personally appeared � BillFavors and acicraowledged the execution oftho foregoing Affidavit and Waiver ofLion, IN WITN1 SS WIRRE ?F, x have hereunto subscribed jay name and. affixed my official seal ore the 19tn day of June, 2018 µ_ NOtarty!'tmbllfff_ My Commission Bxpfres: March 6, 2025 Lynn D. Vining Residing in Elkhart County, Indioana l+Tatary.FENotary LYN'N D VINING Public5eata't C'U State of Pndlanaotn7 sslsa�n s>zpdrest�tar d, 2025 BOARD OF PUBLIC WORT S AGENDA ITEM REVIEW BEQUEST FORM Date 06/2212018 Department Public Works Name Toy Villa Division/Bureau Engineering BPW Date 07/10/2018 Phone Extension 5920 9peAired Prior to,Sobmittalto Board Legal ❑ Attorney Name: Controller ❑ Controller review is required for all Contracts $5,0010.00 or more and greater than one year in length per the City Purchasing Policy Purchasing El LJ Agreement El Professional Services F-1 Bid Opening R Quote Opening F] Change Order No. El Ease/Encroach. F] Other: LJ Contract R Resolution n Bid Award El Quote Award ❑C/O & PCA No ❑ Traffic Control: Company or Vendor Name, New Vendor MBE/WBE Contractor MBE/WBE Contractor Requested Project Name Project Number lure 0 =10-1 I 0 Req. to Advertise Ziolkowski Construction, Inc. FAT5MT g 0 , q F1 Title Sheet El Yes El No El If Yes, Approved by Purchasing [:] ABER WBE 0 No El Yes Name of Company 2017 Curb and Sidewalk, Divisions B, C, D, E & F 117-008 Funding Source MVH Account No. 202.0619A31.31.06 Amount $ 268,381.00 Terms of Contract Purpose/Description Project Closeout E:1 Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-VerifV, Ira- etc N 0 Amount of El increase $ El Decrease $ Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original F-1 R El F-1 El El