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Home My WebLink AboutChange Order No 2-PCA - 100 Wayne Street Plaza and Streetscape Project No 116-047R - Premium Concrete Services Inc1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SO[ ITH BEND. INDIANA 46601-1830 PEACE 1865 SOUTHCITY OF BEND PETE BUTTIGIEG, MAYI BOARD /PUBLIC WORKS January 22, 2019 Becky Yeakey Premium Concrete Services, Inc. 712 Richmond Street Elkhart, IN 46516 PHONE 574/235-9251 FAx 574/235-9171 RE: Change Order No. 2 (Final)/Project Completion Affidavit - 100 Wayne Street Plaza and Streetscape —Project No. 116-047R Dear Ms. Yeakey: The Board of Public Works, at its meeting held on January 22, 2019, approved the Final Change Order for this project, for an increase of $10,558. The revised contract sum is $267,518. In addition, the Project Completion Affidavit for this project was approved in the amount of $267,518. Copies of the Change Order and Project Completion Affidavit are enclosed for your records. If you have any further questions regarding this matter, please call this office at (574) 235-925 L Sincerely, W., w Linda M. Martin, Clerk Enclosures GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK LAURA O'SULLIVAN THERESE J.. DORAU CITY OF SOUTH BEND, INDIANA�„ DEPARTMENT OF PUBLIC WORKS PROJECT CHANGE ORDER DATE: 9/7/2018 PROJECT NO: 116-047R ........................... PROJECT NAME: 100 Wayne Street Plaza and Streetscape CONTRACT DATE: 12/12/2017 CHANGE ORDER NO: 2 Final SUBJECT OF CHANGE ORDER: PCR #2-Additional Work Outside of Original Scope. 1-Over Excavate & Fill Lower Sidewalk = $2,025; 2-Furnish & Install Gravel in Planters = $772.50; 3-Adjust Casting = $350. PCR #3-Adjustment to Final Quantities $7,385.50 . All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns, The original contract sum Net change by previously authorized change orders The contract sum prior to this change order By this Change Order, the project amount is The new contract sum including this change order This Change Order represents a total change of Total change for entire project Original contracted completion date/time Extension of date/time by previous change orders Date/time extension by this change order New completion date/time CONTRACTOR � ACTOR; . ontrac r la e : Printed Name and Title Premium Concrete Services, Inc. Company Name 712 Richmond Street Address Elkhart, IN 46516 City, State, Zip $ 224,110.00 $ 32 850.00 $ 256,960.00 X Increased Decreased $ 10,558.00 $ 267„518.00 4.11 % 19.37 % 5/4/2018 ........... 43 days _WW _ ........ 0 days 6/16/2018 C P CONST ON MANAGER CITY OF SOUTH BEND BOARD OF PUBLIC WORKS Approved Dale: K,�' Gary A. G116t„ President Suzanna M. Fritzberg, Member Eliza befh A. Maradik, Member They° se J. P6rau, Member e A: uellef-,M Y NrP d CITY OF SOUTH BEND, INDIANA of BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVITS PROJECT NAME 100 Wayne Street Plaza and Streetsca e PROJECT NO 116-047R FINAL COST $267,518.00 CONTRACT SIGNED 12/12/2017 MAINTENANCE AGREEMENT ENDS ................. Construct the plaza and streetscape improvements along Wayne Street and Michigan Street, at PROJECT DESCRIPTION the Northwest corner of the facilit at 100 Wa ne Street. .._.... 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. 19 Premium; Concrete Services, Inc. Company Name - WITNESSESS: Before methe undersigned Notary Public in and for said country and stall LcJG�I `IAIC/ and acknowledged his/her signature to the above the day ofJ/1NUAk\,I ,201CL—. Ng ary Signature My Commission Expire Printed Name County of Residence 712 Richmond Street Company Address Elkhart IN 46516 JANEE M TOWNER !, personally apWAW PUBLIC Project Completion SlEftit on ELKHART COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12, 2026 r C tMMISSION NO.710399 If the Contractor is a corporation, the following certificate will be executed. I, C , certify that I am Secretary of the Corporation executing this release; that 1-3 -. i" who signed this release on behalf of the contractor was then r' ""'" c . " of said Corporation; that said release was duly signed for and on behalf of said Corporation b hority of its governing body, and is within the scope of corporate powers: w d"r ry's Signature Corporate Seal M Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptabl fo fs I approval and we recommend to the Board of Public Works that it be ordained so. Date: Constr°ucti eager BOARD OF PUBLIC WORKS APPROVAL Date:„s 114 'A Gary A. Gi President S'uz r na M. Fritzberg, Member . xzabeth A.,,M radik„ Member rese J, 06raLi, giber Linda M. Martin, Clerk N...T..) MAINTENANCE BOND Bond NoMNT2156817 KNOW ALL MEN BY THESE PRESENTS: That, Premium Concrete Services, tic., 712 Richmond St, Elkhart, IN46516 as Principal, and Old Republic Insurance Company a corporation organized under the laws of the State of Wisconsin and authorized to do a surety business in the State of,lnd'ana as Surety, are held and firmly bound unto the Ci!y of South Bond Board of Public Works as obligee inthe sum of Twenty-si&� ind_SgygnllundtcdFiftv.oncAnj$QLLQg__ ($26,751.80 ), lawful nioncy ofthe United States of America, for the paytnent of which sutra well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents: SEALED with our seals and dated this 4th day of January 2019 WHEREAS, on the 12th day of December 2017 the said principal as contractor, entered into a contract for: 100 Wayne Street Plaza and Streetscape for the sum of Two Hundred Ninety-nine Thousand Six Hundred Thirty-five And NW 100 ($299,635.00 1; and, WHEREAS, tinder the terms of the specifications for said work, the said principal is required to give a bond in the amount of Thousand Seven Hundred Fifty-one And 80/100 ($$26,751.80 ), to protect the obligee against the result of faulty materials or workmanshio for a Period ofThree (Uear(s) frorn and after the date of the completion and acceptance of same, namely, until -9/7/2021 Now, THEREFORE, if the said principal shall for as period ofjtEe Qycar from and after the date of the completion and acceptance of same by said obligee replace any and all defects arising in said work whether resulting from defective materials or defective workmanship, their the above obligation to be void; otherwise to remain in full force and effect. Premium-CpncretpServicAt, [pc By (,A � ZP7 Old ReEblic Insurance C2�mpny Surety /Jennifer L. Kasznia Altorney-in- act ORSC 22518 (4-93) *OLD R EPUBLICI ** * ...o....M ....._................... ... . ....... .. ........ .—.......— —............—.-- --------- -- ................ 't POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania stock insurance corporation, does make, constitute and appoint: NICOLE L BICKNELL, MEGAN E RIESENBERG, MARK EDWARD WOBBE, BARBARA E PEARSON, JENNIFER L KASZNIA, SANDRA L JUNK, WILLIAM J CERNEY, III, WESLEY MANTOOTH, THERESA BURNS, JORDAN SCHEIBER, CHERYL E. ALKIRE, OF SOUTH BEND, IN its true and lawful Attorney(s)-in-Fact, with full power and authority, not exceeding $50,000,000, for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations In the nature thereof , (olherthan uif',4rnsuranee workers compensation, bunds gkwrauiteeing payment of be refit , asbestos abatement contract bonds, waste rnanage. 1TWnt boards hazardous waster rerneatratron bonds or black Nng bonds), as follows: ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED FOUR MILLION DOLLARS($4,000,000)----- ----------- --------- FOR ANY SINGLE OBLIGATION. and to bind OLD REPUBLIC INSURANCE COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This document is not valid unless printed on colored background and is multi -colored. This appointment is made under and by authority of the board of directors at a meeting held on March 14, 2014. This Power of Attorney is signed and seated by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC INSURANCE COMPANY on March 14, 2014. RESOLVED FURTHER, that the chairman, president or any vice president of the Company's surety division, in conjunction with the secretary or any assistant secretary of the Company, be and hereby are authorized and directed to execute and deliver, to such persons as such officers of the Company may deem appropriate, Powers of Attorney in the form presented to and attached to the minutes of this meeting, authorizing such persons to execute and deliver and affix the seat of the Company to bonds„ undertakings, reoo nizances, and suret shi obligations of all kinds, other than bafN bonds, bank depository bonds, mortgage defdcicncy bonds, nrortgage guaranty onds" gLwrantees o ins�Vi nenl paper and note guaranty bonds. The said officers may revoke any Power of Attorney previously granted to any such person. The authority of any Power of Attorney granted by any such officer of the Company as aforesaid shall not exceed fifty million dollars ($50,000,000,00), except (a) bonds required to be filed as open penalty bonds, and (b) bonds filed with any court or governmental authority requiring an unlimited penalty in bonds filed in that court. RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (i) when signed by the chairman, president or any vice president of the Company's surety division and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (0) when signed by a duly authorized Attorney -in -Fact and sealed with the seal of the Company (if a seal be required). RESOLVED FURTHER, that the signature of any officer designated above, and the seal of the Company, may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, OLD REPUBLIC INSURANCE COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be affixed this 11TH day of JUNE. 2 018 OLD REPUBLIC INSURANCE COMPANY dSEAL � ° `+,.,r...,� STATE OF WISCONSIN. COUNTY OF WAUKESHA - SS """" °"""� Vice President On this _ E 11TH_ day of _µµµµµNE JU, 2018 _ _ personally came before me, ALAN PAVLIC and JANE CHERNEY . w, to me known to be the individuals and officers of the OLD REPUBLIC INSURANCE COMPANY who executed the above instrument, and they each acknowledged the execution of the same; and being by me duly sworn, did severally depose and say; that they are said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said organization. �ea4 LUC Notary +u�t' My commission ex 9 / 28 ires; g�'2 p / 1B CERTIFICATE (Expiration of notary commission does not invalidate this instrument) I, the undersigned, assistant secretary of the OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force. 45-5314"„, g y_. ......_ day of.M, M,�+erwa�r Signed d sealed at the City of Brookfield, I this "SEAL r � �c �"aey.NN.w�wMw•",*�S�' '�'rewr lualN rw�'` _ ten. 22851-13 11006-R(5...10) Final Waiver of Lien State of Indiana, County of E LK H A?Z�_ SS: being duly sworn that he/she is the �'(mllme� of off/icer) (Title) of having contracted with E0 T aw (Contractor) (Owner) to furnish certain materials and/or labor as follows: a 0, (Description) for a project known as 715 7 C6 i) (Name of Project) located at So u and owned by (Owner) and does hereby further state, on the behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there, is due from the Contractor the sum of Dollars ❑ receipt of which is hereby acknowledged; or El the Payment of which lies been promised as the sole consideration for this Affidavit said Final Waiver ofLien which Is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; 10 that th final balance due f ,�,INA� WAT 'III that th, final due frog the contractor o the contractor Is th sum of q V, ❑ receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become offbotive only upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said promises, any and all liens or claims whatsoever on the above -described property and improvements thereon an account of labor or material or both, Airnishod b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other party has any claim or right to a lion on account of any work performed or material ftunished to the undersigned fo aid pr et, and within the scope 'r is Affidavit and Waiver of Lien. 4�' BY )KI I - "(, :�' __ , E -1 -c-L-E C (Fim) (Atta is epresentative) STATE OF INDIANA Ss. E LK K COUNTY %Belore me, the undersigned, a Notary Public, In and for said County and State, personally appeared CAKE and acknowledged the execution of the foregoing Affidavit and Waiver of Lion. IN WITNESS 4ryTkIl REOF, I have hereunto subscribed my name and affixed my official seal on the L day of tary Public Signature k �ru' t" My Commission Expires: IAN fQC�QAP N ROP Residing in Lqqt A P_ T- County, 1) 1 A Notary PublOftip ELKHART COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12.2026 COMMISSION NO. 710399 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 1 �Department Public ame Toy Villa " � D vs onureau Eng ineering NWorks �...__ g g BPW Date 01/22/2019 Phone Extension 5920 iarrnimim�mmr�nnn �iom�ommimoouo�mio� ui �.............. ......................................_.........y�r�rra�mrmn ��, Rtquired wPrior to�Sabmittal to Board Legal ❑ 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 El .Check the L JI Agreement El Professional Services El Bid Opening ❑ Quote Opening [l Change Order No. El Ease/Encroach. F-B Other: rooriate Item T oe Requ El Contract Resolution El Bid Award El Quote Award ® C/O & PCA No.2 Final ❑ 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 �m or All Submissions .._.........W�..�� j Proposal ❑ Req. to Advertise ired Information Proiect Closeout ❑ PCA Addendum ❑ Title Sheet ❑ Required Contractor's Certification Forms Attached (Non - Collusion Non -Discrimination„ Non -Debarment, E-Verify, Iran, etc. wired For Change, Orders Only Amount of 0' 00 Increase $ Decrease ............ ............... dw.. Previous Amount $ 256,960.00 Current Percent of Change: 4.11 �.��.��.....�.�.� �........... ..�-�__...........�...._................................� ..........................��........w wr ��.............................................................�... New Amount $ 267,518.00 Total Percent of Chano: 19.37% ....... _ _ .�......__. ___ .... A,. ............... ___ ....... ........ Disoersal After Aooroval Copy Original ❑ ❑ El 0