HomeMy WebLinkAboutProject Completion Affidavit - Ironwood Dr Sidewalk Edison Rd to SR 23 Project No 117-033A - Walsh & Kelly Inc227 W. JEFFERSON BOULEVARD
Dustin Hilary
Walsh & Kelly, Inc.
24358 SR 23
South Bend, IN 46614
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CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
December 11, 2018
PHONE 574/235-9251
FAx 574/235-9171
RE: Project Completion Affidavit — Ironwood Drive Sidewalk, Edison Rd. to SR 23 —
Project No. 117-033A
Dear Mr. Hilary:
The Board of Public Works, at its meeting held on December 11, 2018, approved the Project
Completion Affidavit for this project in the amount of $188,144.74.
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
PROJECT COMPLETION AFFIDAVIT" -
PROJECT NAME IRONWOOD DRIVE SIDEWALK„ EDISON ROAD TO S.R. 23
PROJECT NO 117-033A FINAL COST $188,144.74
CONTRACT SIGNED 12/21/2017 MAINTENANCE AGREEMENT ENDS
Install sidewalk improvements....................
according to the intent of the the plans and specifications at
PROJECT DESCRIPTION Ironwood Drive between Edison Road and S.R.23.
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 whicl ere a pail of the above Contract.
04
Executed t ' St d of Novein r . �, 201 8 Walsh & Kelly, Inc.
Company Name
E
Printed Name
24358 SR 23
Company Address
South Bend, IN 46614
City, State, Zip
WITNESSESS:
Before me, the undersigned Notary Public in and for said country and state, personally ap eared
an �- �°"w NotaryH��^'���1� PA� sta o ofGn�Va�ar,,b
9 9 1
tin I d acknowled ed his/her si nature to the above Project orr
the 1st of N 201
St. Joss, . -ounty
My commission Expires
Notary at' e My Commission Expires i�� June 05, 2022 '
Alisha Kxla=
Printed Name _ County of Residence St. Jose h
If the Contractor is a corporation, the following certificate will be executed.
I, J. Michael Schatun certify that I am Secretary of the Corporation executing this hbehalf relea�rse; that
Dustin who signed
is release on
Hilary of said Corporat onn; t atsaid release asduly signed for and
was �
Copp son uthorit goverr�mg body, and is within the scope of corporate powers.
SecZclliael
y"s Signature t
Corporate Spal rcr
J Schatim >
Printed Name
DEPARTMENT OF PUBLIC WORKS APPROVAL t
This project is acceptable f r f I approval and we recommend to the Board of Public Works that it be ord ihe'4i"
Date: l 0. 3 0° L
Constructio anger
BOARD OF PUBLIC WORKS APPROVAL Date„ A
Gary A. Gilot, President Suzanna M. Fritzberg, Member Elizabeth A. Maradik, Member
_..._.
Therese J. Do0 u, Meru, r James A. Mueller, Member
M. Martin,
Surety 0 +908.903.3485
202B Halls Mill Road, PO Box 1650 F + 908.903.3656
Whitehouse Station, NJ 08889.1650
Federal Insurance Company
Maintenance Bond BondNo.MNT 8245-58-81 Amount$18,814.47
Know All Men By These Presents,
That we,
Walsh & Kelly, Inc.
24358 State Road 23
South Bend, IN 46614
(hereinafter called the Principal), as Principal, and the FEDERAL INSURANCE COMPANY, a corporation duly organized
under the laws of the State of Indiana, (hereinunder called the Surety), as Surety, are held and firmly bound unto
City of South Bend, Indiana, Board of Public Works
227 West Jefferson Blvd.
South Bend, IN 46601
(hereinafter called the Obligee), in the amount of 4 /100 Eighteen Thousand Eight Hundred Fourteen Dollars and
for the payment of which we, the said Principal and the said Surety, bind ourselves, our heirs, Sealed with our seals
and dated this 30th day of October, 2018.
WHEREAS, the said Principal has entered into a contract dated December 21 , 2017
for: Ironwood Drive Sidewalk, Edison Road to S.R. 23, Project No.: 117-033A
And
WHEREAS, the said Principal is required to guarantee the Ironwood Drive Sidewalk, Edison Road to S.R. 23, Project No.: 117-033A
installed under said contract, against defects in materials or worlananship, which may develop during the
period October 30, 2018 to October 30, 2021 .
Form 1502-0075FED (Rev. 5/17)
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal shall faithfully carry out and
perform the said guarantee, and shall, on due notice, repair and make good at its own expense any and all defects in materials
or workmanship in the said work which may develop during the period October 30, 2018 to October 30, 2021
or shall pay over, or make good and reimburse to the said Obligee all loss and damage which said Obligee may sustain
by reason or default of said Principal so to do, then this obligation shall be null and void; otherwise shall remain in full
force and effect.
Walsh & Kelly,
By
South Bend Area
Insurance Company
By
Attorney -In -Fact
David M. Oliger
Form 15.02-007SM (Rev. SAD
CHUBB'
Power of Attorney
Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company
Know All by These Presents, That FEDERAL, INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC
INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Tia A. Boice, Terry R. Hurst, Brian T, Morton, David M. 011ger,
Robert M. Rutigliano, Christina Marie Schmitter, Tina N. Senefeld and Eric M, Wahlstrom of Indianapolis, Indiana -----------------------------------------
each as their true and lawful Attomey-in-Fact to execute under such designation in their names and to aMx their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory In the nature thereof (other than ball bonds) given or executed In the course of business, and any
instruments amending or altering the same, and consents to the modification or alteration ofany Instrument referred to in said bonds or obligations,
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these
presents and affixed their corporate seals on this 1911 day ofJanuary, 2017, „e"_ l'
Dawn M, Chloros, Assistant SeeCtetary Catherine A. MraM !"°Vlce President
STATE OF NEW JERSEY
County of Hunterdon
On this 1911 day of January, 2017 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE
COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M.
Chloros. being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL. INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC
INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by
authority of said Companies; and that she signed said Power of Attorney as Assistant Secretary of Bald Companies by like authority; and that she is acquainted with Catherine A.
Donahue, and knows him to be Vice President of said Companies; and that the signature of Catherine A. Donahue, subscribed to said Power of Attorney Is in the genuine
handwriting of Cathetin e;, and was thereto subscribed by authority ofsaid Companies and In deponent's presence.
Notarial Seal KATHERINE JVAR, A IR
NOTA�R"Y PUBLIC OF NEW JERSEY
r M No16686 Notary Public
PUB i.� + COmmISSIon Expirea J91' ' Resolutions adopted by f'Dtr@ctors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 201G:
"RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, recognizances, contracts and other wrluen commitments of the Company
entered Into In the ordlnaryeourseof business (each a'Wtitten Commitment");
(1) Each of the Chairman, the President and the Vice Presidents of the Company Is hereby authorized to execute any Written Commitment for and on behalf of the Company, under the
seal of the Company or otherwise.
(2) Each duly appointed attorney -in -fact of the Company is hereby authorized to execute any written Commitment for and on behalf of the Company, under the seal of the Company or
otherwise, to the extent that such action to authorized by the grant of powers provided for in such person's written appointment as such attorney -In -fact.
(3) Each of the Chairman, the President and the "cc Presidents of the Company is hereby authorized, for and on behalf of the Company, to appoint In writing any person the attorney -
In -fan or the Company with full power and authority to execute" for and on behalf orthe Company, under the seal of the Company or otherwise, such Written Commitments of the
Company as may be specified In such written appointment, which specification may be by general type or days of Written Commitments or by specification of one or more particular
Written Commitments.
(4) Each of the Chairman, the President and the Vice Presidents of the Company Is herebyauthorized,forandonbehalfoftheCompany,todelegateInwritingtoanyotheroflleerofthe
Company the authority to execute, for and on behair of the Company, under the Company's seal or otherwise, such Written Commitments of the Company as are specified In such
written delegation, which specification may be by general type or class of Written Commitments or by specification crone or more particular Written Commitments.
(S) The signature of any officer or other person executing any Written Commitment or appointment or deleption pursuant to this Resolution, end the seal of the Company, may be affixed by
facsimile on such Written Commitment or written appointment or delegation,
FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of officers, employees and other persons to act for and on behalf of
the Company, and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested."
1, Dawn M, Chloros, Assistant Secretary of FEDERAL. INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies') do hereby
certify that
(U the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect,
(11) the Companies are duly licensed and authorized to transact surety business in all 5o of the United States of America and the District of Columbia and are
authorized by the U,S. Treasury Department; further, Federal and Vigilant are licensed In the U.S. Virgin Islands, and Federal is licensed In Guam, Puerto Rico,
and each of the Provinces of Canada except Prince Edward Island; and
(III) the foregoing Power of Attomey is true, correct and In full force and effect.
Given under my hand and seals ofsaid Companies at Whitehouse Station, N, this October 30, 201 H„
Dawn M. Chloros, Assistant Secretary
)1tiT}IEEVFtii'etl4pVhftSIIdTCNOTIFY LAOF'ACLAIM, VERIFY Tits AWHENTICrFYOFTHIS BOND ORNOTIFY USOFANY OTHERNim-TER, PI„EA FCONTACTUS,AT,
Form 15.10. 02259• U. GIEN CONSENT (rev. 12-16)
l
Final Waiver of Lien
State of Mana, County of St. Joseph
SS*
-Dustin Hilary being duly swom that he/she is the. South Bend Area Vice President
(Name of Officer) (IYtie)
of Walsh & Kelly, Inc.
having contracted with City of South Bend
(Contractor) (Owner)
to furnish certain, materials andlor labor as follows: —,— Asphalt, Concrete and Pavement Marking
(Description)
for a project Imown as # 117-033A: Ironwood Drive Sidewalk, Edison Road to State Road 23
(Name, ofilrojeot)
located at Ironwood Drive, Edison Road to State Road 23
and owned by City of South Bend
(Owner)
and does hereby fluther state on the behalf of the aforementioned subcontractor/supplier:
(PARTIAL WAIVER) that there is due from the Contractor the Sam of
Dollars
.-($-- - L�_�
0 receipt of which is hereby acknowledged; or
El the Payment of which has been promised as the sole consideration for this Affidavit and Mal Waiver offion which is given
Solely willi respect to said anionnt, and which 1volver shpil be cirertive only upon receipt orpsyraejIt thereof by the
undersigned;
(FINAL WAIVER) that the final balance due from the contractor is the am of
[I receipt ofthich is hereby admouiedged; or
21 the Payment of which has been promised as the solo consideration for this Affidavit and Final Waiver of Lien which Shall
become effective only upon receipt ofsuch payntont,
THEREFORE, the undersigned waives and releases unto the Ownor of said promises, any and all liens or claims whatsoever
on the above-describedpropexty and improventents thereon: anaccount of labor orma(arlat A thfbmishe-0the undersigned
thavelo, subject to limitations or conditions oxprossed1wr �Pl;and "bcrcerfife at o o6er has [lily claim or right to a
lien oil a0collat of any work perfomed ormatodal e�, ( 17d4oarsignedfor 1) OA an n tho scope ofibis Affidavit
and Walver of Lien. po
I Ole
Walsh& Kelly, ()RAT
Inc. Z'
(Firm) _J00 9,
0 thorized Replescntat vo)
STATE OF INMANA g
SS:
STI JOSEPH COUNTY Z'
N Dustin Hilary
x M
Before me, the undersigned, a Notary pil on and Slate personally appeared
and acknowledged the execution Of 1:110 forr,801119 A Abil r Or of Lien.
IN WITNESS *P,hod my name and affixed my Officseal on the 5th day of
November 200 18
WiOP�ubllc Signature
MyCommissinnExpires, June 07, 2023
Residingin ndiana county, Marshall
Amy Elizabeth Turpin
No, u 11'
RPIN
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 12/04/2018 Department Public Works
..w�wW _�.m...........__.........
Name Toy Villa Division/Bureau Engineering
BPW Date 12/11/2018 Phone Extension 5920
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uired Prior to Submittal to Board
LegalEl 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
uCheck the
LJ Agreement
❑ Professional Services
❑ Bid Opening
❑ Quote Opening
❑ Change Order No.
(� Ease/Encroach.
Other:
iropriate Item Type -
Contract
Resolution
El Bid Award
Quote Award
❑ C/O &PCANo.
El 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
Copy
Original
Required Information
Walsh „& Kelly, Inc.
for All Submissions
J Proposal
Req. to Advertise
. _. __�.�... .. El I If f
Yes No Yes, A
MBE WBE
�.�....._ .. ...._
[� No Yes Name of Company
Ironwood Sidewalks
..............
117-033A
LRSA - Mayor Moves
251.0608.431.42.96 ..............Y
$ 188,144.74
Proiect Closeout
Addendum
❑ Title Sheet
bar Purchasi
❑ Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, mE-Verify, Iran, etc.
wired For Change Orders Only ..