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Home My WebLink AboutProject Completion Affidavit - FLIR Traffic Cameras Replacements Project No 118-006 - Pemberton Davis Electricy a E'Acf 1865 EM1wtj11111M Wof FRINKTAINE11 Mrw�l November 13, 2018 John Ferro Pemberton Davis Electric, Inc. 916 E. McKinley Avenue Mishawaka, IN 46545 PHONE 574/ 235-9251 FAx 574/235-9171 RE: Project Completion Affidavit — FLIR Traffic Camera Replacements —Project No. 118- 006 Dear Mr. Ferro: The Board of Public Works, at its meeting held on November 13, 2018, approved the Project Completion Affidavit for this project in the amount of $123,866.10. 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 GARY A. G1LOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU CITY OF SOUTH BEND, INDIANA��rr BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME FLIR Traffic Camera Replacements PROJECT NO 118-006 FINAL COST $123,866.10 CONTRACT SIGNED 2/13/2018 MAINTENANCE AGREEMENT ENDS Remove existing traffic cameras and install FUR vehicle video detection systems at three PROJECT DESCRIPTION intersections. 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. Execu d 1 s d D 201 Pemberton Davis Electric, Inc. Company Name gnature 916 E. McKinley Ave. Company Address Wv L'/<Printed Name Mishawaka, IN 46545 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared 9 , and acknowledged his/her signature to the above Project Completion Affidavit on the day of 0—d-16 F� _ , 2018 ca Notaryignature My Commission Expires �'u�,n¢" w, 1.,1-, Ii/.lfi'.^ � '9'Y1 '!i �"d10J690.flv y'r"`� N;�^P7tlR2YSYe�J:H ry 6� Printed Name County of Residence fo r s"',`A"," If the Contract r ia c poratds o �, the following certificate will be executed. , certify that I am Secretary of the Corporation executing this release; that r 0 who signed this release on behalf of the contractor was then of said Corporation; that said release was duly signed for and on behalf of said Corporation by AuI 'ty of " s governing body, and is within the scope of corporate powers: Secretary's Signature Corporate Seal Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL project is This p acceptable for, pprovaland we recommend to the Board of Public Works that it be ordained so. Date: Construction tt Eger BOARD OF PUBLIC WORK4 APPROVAL Date: Oil - Gary A. Gilot„ President zjuzanna V. Fri berg, Member Ellabd h A. Maradik, Member Therese J. um r,) er James A. Mueller, Member Linda M. Martin�CI rlc..,, MAINTENANCE BOND Bond No. 2621729 KNOW ALL BY THESE PRESENTS, That we Pemberton -Davis Electric, Inc. 916 E. McKinley Ave, Mishawaka, IN 46546 as Principal, and Great American Insurance Company, 301 E. 4th Street, Cincinnati, OH 45202 s as Surety, are held and firmly bound unto City of South Bend, Department of Public Works, 227 West Jefferson Blvd, Ste 1300 N, South Bend, IN 46601 as Obligee, in the penal sum of Twelve Thousnad Three Hundred Eight -Seven & 00/100 _-- ($ 12,387.00 to which payment well and truly to be made we do bind ourselves, our and each of our heirs, executors, administrators, successor and assigns jointly and severally, firmly by these presents. WHEREAS, the said Principal entered into a contract with the City of South Bend, Department of Public Works dated February 13, 2018 for FLIR Traffic Camera Replacements, Project No. 118-006 WHEREAS, said contract provides that the Principal will furnish a bond conditioned to guarantee for the period of three (3) year(s) after approval of the final estimate on said job, by the owner, against all defects in workmanship and material which may become apparent during said period, and WHEREAS, the said contract has been complete, and was approved on 2018 6th day of August NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH that, if the Principal shall indemnify the Obligee for all loss that the Obligec may sustain by reason of any defective materials or workmanship which become apparent during the period of three(3) year(s) from and after August 6 2018 then this obligation shall be void, otherwise to remain in full force and effect. SIGNED, SEALED AND DATED 22nd 000591 12100 day of August 2018 Pemberton -Davis Electric, Inc. (L.S.) (L.S.) PRINCIPALS) :Great mencan Insurance Company By Lyn tte Long Attorney- in -Fact GREAT AMERICAN INSURANCE COMPANY@ Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than ELEVEN No.0 20754 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREATAMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name Address Limit of Power DEBORAH NEICHTER LYNNETTE LONG ALL OF ALL JILL KEMP SHERYON QUINN LOUISVILLE, KENTUCKY $100,000,000 LEIGH MCARTHY THERESA PICKERRELL BARBARA DUNCAN AMY MEREDITH MARK A. GUIDRY MARGIE M, LOWRY SANDRA L, FUSINETTI This Power ofAttomey revokes all previous powers issued on behalf of the attomey(s)-in-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 27TH day of JUNE 2017 Attest GREAT AMERICAN INSURANCE COMPANY �� r5�rslr .. s° d1e4 Assistant Secrelary Divisional Senior Vice Presideni STATE OF OHIO, COUNTY OF HAMILTON - ss: DAVID C, KiTCHw (677-377-2405) On this 27TH day of JUNE 2017 , before me personally appeared DAVID C. KITCHIN, to me known, being duly swom, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company„ the Company described in and which executed the above instrument; that he knows the seal of"the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authoril�y r w a. a ,ji . r r This Power ofAttomey is granted by authority of the following resolutions adopted by the Board of Directors of GreatAmerican Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint om: or more Attorneys -in -Fact to exiceute on behalf of the Company as sureiyt any and all broads, undertaking's g's andr ontract„s of surx.tyship, or other wrill'en obligations in the nature thereof to prescribe their respective dulies and the J"t'"Rivelive limils of [hear aathoriO+; and ldr revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company maybe affixed by facsimile to any power qf attorney or a er^l ficaie of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligatton in the nature thereof such ,signature' and seal when so used tieing hereby adopted by the Company as the original signalure of srtch officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power ofAttomey and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this 44 day of y o� �ioreorm Assistant Secretary S1029AF (06/15) Final Waiver of Lien State oflndiana, County of 64 T L SS: -"I- t" ` " � being duly sworn that hafts. is the i^e3 i (Name of Officer) (Title) of g6kA 5 h `' having contracted with sty b (Contractor) (Owner) to furnish certain materials and/or labor as follows: �� + ✓� Ca-'p.. - I I for a project known as Es located at and owned by (Owner) and does hereby further state on the behalf of the aforementioned subcontractomisupplier: (PARTIAL WAIVER) that there is due from the Contractor the aura of Dollars ❑ receipt of which is hereby acknowledged; or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver ofLienwhich is given solely with respect to said amount, and which waiver sball be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due kom the contractor is the sum of ❑ receipt ofwhich is hereby acimowledged; or the payment of which has bean promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become of ootiveonlyuponreceiptofsuch payment THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever on the above -described property and Improvements thereon an account of labor or material or both, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and firrffier certified that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said projec% and within the scope of this Affidavit and Waiver of Llen. (firm) ( orired Representative) STATE OF INDIANA ) SS: ST. JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared w W � and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WkWl(EOF, I have hereunto subscribed my name and affixed my 0 1 ' seal on the rV day, of i3 ., " 20� 119 tore Not y blCc Slgn My Commission &pfres: ZIZ,ZG Z p Redding in I County, - 4 1CF11Y M HAIC'�AUGH �rd•ndr�p Notary Public 'St f lu'i' t AIM Joa Q.ornrnir,„p Ir ra ...- MY Cornnrission xs rr February 02, 2020 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 10/23/2018 Department Public Works Name Toy Villa Division/Bureau Engineering .... . ....... . BPW Date 11/13/2018 Phone Extension 5920 Rp1i:,.:Iujred Prior to Submittal to Board . ......... ... . .... . . ........... Legal E] 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 Purchasing 1:1 Agreement Amendment Professional Services E] Bid Opening F1 Quote Opening Change Order No. ❑ Ease/Encroach. F1 Other: LJ Contract Resolution Bid Award F] 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 Funding Source Account No. Amount Terms of Contract Purpose/Description ect Closeout Proposal LJ Addendum F-1 Req. to Advertise E] Title Sheet Z PCA n E:1 Required Contractor's Certification Forms Attached (Non- _.C.211,usion, No n-Discrim i nation, Non -Debarment, E-Verity,Iran, etc. Required For Chancie Orders OnIv Amount of Increase $ Decrease $ Previous Amount Current Percent of Change: % New Amount Total Percent of Chance: % Copy Original Roger Nawrot, Assistant City Engineer Derick Roberts, Director of Streets & Sewers - - - ------------- EJ Ed Gleckler, Manager Bureau of Traffic & Lighting