HomeMy WebLinkAboutProject Completion Affidavit - Studebaker Museum Rooftop Unit Replacement Proj No 117-081 - BC Mechanical Inc1316 COUNTY-C'ITY MniJAW,
227 WJEFFFIASON Boui-iwARD
SOUTH 131M). INIMANA46601-1830
CITY OF SOUTH BEND PFTt� Buntow), MAYOR
BOARD OF PUBLIC WORKS
September 25, 2018
Mike Fields
B.C. Mechanical, Inc.
882 Anderson Road
Niles, MI. 49120
1'110Ni-- 574/235-9251
FAX 574/ 235-9171
RE: Project Completion Affidavit — Studebaker Museum Rooftop Unit Replacements —
Project No. 117-081
Dear Mr, Fields:
The Board of Public Works, at its meeting held on September 25, 2018, approved the Project
Completion Affidavit for this project in the amount of $162,298.
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-
9,251.
Sincerely,
Linda M. Mat -tin, Clerk
Enclosure
GARY A. Ga,o'r SUZANNA M. FR1TZ13L,'iw ELIZAI*'A's-i A. MARADIK JAWs A. Murii.js:l� TjiRt'w J. DORALJ
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
PROJECT COMPLETION AFFIDAVIT
PROJECT NAME -Studebaker Museum Rooftop Unit Replacements
PROJECT NO 117-081 FINAL COST $162,298.00
CONTRACT SIGNED 12112/2017 MAINTENANCE AGREEMENT ENDS
PROJECT DESCRIPTION Replace four RTUs on the Studebaker roof, Test and balance eciuiDment,
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 tinder 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 the abov Contract.
Executed this day of
201 Y B.C. Mechanical, Inc.
Company Name
Signature 882 Anderson Rd.
M , k,— e Company Address
Printed Narne Niles, Ml, 49120
City, State, Zip
WITNESSESS:
ife � 'Jh undersigned Notary Public in and for said country and state, personally appeared
'tI and acknowiedged his/her signature to the above Project Completion Affidavit on
201
the
d
Notar Signature My Commission Expires
Printed Name County of Residence 0
If the iAintra r is a c9rporatio the following certificate will be executed,
1, „ wad certify that I am Secretary of the Corporation executing this release; that
U � KJ, fl p'), X who signed this release on behalf of the contractor was then
k, of said Corporation; that said release was duly signed for and on behalf of said
Cor oration by Authority of its governing body, and is within the scope of corporate powers:
Secretary's Signature Corperate Seal
t-lo(,-t.
Printed Narne
DEPARTMENT or PUBLIC WORKS APPROVAL
This project is acceptable 'T0 f fi t approval and we recommend to the Board of Public Works that it be ordained so,
7
,, ",A Z- , Date: 0�
ConstrUCtiO nager
BARD OF PUBC W LIORKS APPROVAL Date:
Al O. dw,
- —
Gary A. Gilot, President
Suzann@ M. Ffftzbe-rg, Miiber E FEa6e5 A. 'Maradik, Member
Therese J. D(brau, Member James A. Mueller, Member '--Lid M. Martin, Clerk
FULL CONDITIONAL WAIVER
(Undci- the Constructim Len Act of 1980)
I/Nvc liave a contract with: City of South Bend
to provide Ial)or and material for the finprovernents to the
propert), described as: Studebaker Museum Rooftop Replacement
and JjCj.-C[))7 �vaiN7C my/our construction lien.
Tliis waiver is conditional on actual payment of: $16,229.80
B.C. Mechanical, Inc.
882 Anderson Rd
Niles, MI 120
269-6�4 533
41)
3
13 Y:
(Signature of claimant)
,ell
Date:
BOARD OF PUBLIC WORKS
AGENDA ITEM RE VIEW REQUEST FORM
Date 09/11/2018 Department Public Works
Name Toy Villa,�� Division/Bureau Engineering
.7
BPW Date 09/25/2018 Phone Extension 5920
Required Prior to Submittal to Board
Legal F-1 Attorney Name:
Controller ❑ Controller review is required for all Contracts $5,000.00, or more and
greater than one year in length per the City Purchasing Policy
E] Agreement Amendment
LJ Contract Ll Proposal Ll Addendum
F_1' Professional Services
F-1 Resolution
F-1 Bid Opening
0 Bid Award F] Req. to Advertise El Title Sheet
F-1 Quote Opening
El Quote Award
[:] Change Order No.
F-1 C/O & PCA No. PCA
El Ease/Encroach.
F-1 Traffic Control:
F-1 Other:
Company or Vendor Name
New Vendor
MBENVBE Contractor
MBE/' VBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of El increase
F-1 Decrease
Previous Amount $
Current Percent of Change
New Amount
Total Percent of Change:
B. C. Mechanical, Inc.
[J Yes Z No [:] If Yes, Apprq\T.d.....by Purchasing
E:1 MBE [:1 WBE
F-1 No El Yes Name of Company
Studebaker Museum Rooftop, Unit Replacements
117-081
Liability Insurance Fund
226.0417.672.39.01
$162,29&00
Proiect Closeout
F-1I, Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non-Debarmient, E-Verify, Iran, etc.
Copy Original
F] Kara Boyles, City Engineer
F-1 Patrick Slebonick, Studebaker National Museum
❑ El