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Home My WebLink AboutProject Completion Affidavit - Angela Bridge Lighting Project No 116-111 - Martell Electric LLC1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOI JTn BEND. INDIANA 46601-1830 April 9, 2019 Jennifer Martell Martell Electric, LLC 4601 Cleveland Road South Bend, IN 46628 PHONE 574/ 235-9251 FAx 574/ 235-9171 RE: Project Completion Affidavit — Angela Bridge Lighting — Project No. 116-111 Dear Ms. Martell: The Board of Public Works, at its meeting held on April 9, 2019, approved the Project Completion Affidavit for this project in the amount of $51,996.69. 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. GILOT GENEVIEVE E. MILLER ELIZABETH A. MARADIK LAURA L. O'SULLIVAN THERESE J. DoRAu Si CITY OF SOUTH BEND, INDIANA�.,W'7'. BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT" PROJECT NAME Angela Bride Li htin PROJECT NO 116-111 FINAL COST $51,996.69 CONTRACT SIGNED 8/28/2018 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Add liahtina on the Angela Blvd bridae. 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. Execut 't is day, f 201 Martell Electric LLC " Company Name &goal Are 4601 Cleveland Road ITC III I %� IQ A 1, A V1 Company Address Printed Name South Bend, IN 46628 City, State, Zip WITNESSES& Before me, the uraderss ned Notary Public in and for said country and state, personally appeared it and acknowledged his/her signature to the above Project Completion Affidavit on the . 11 day of , 20 Notary Signature My Commission Expires Printed Name County of Residence 6" If the Contractor is a corporation, the following certificate will be executed. I. certify that I am Secretary of the Corporation executing this release; that 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 Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL Corporate Seal This project is acceptable for r approval and we recommend to the Board of Public Works that it be ordained so. Date: Construction ger BOARD OF PUBLIC WORKS APPROVAL tl 'Gary A. Gild ", President fAtre�Qve "% k, p-j #4nber Therese J. borau, Member Laura O'Sullivan, Member Date: o Elizabeth A. Maradik, Member inda M. Martin, Clerk AFFIDAVIT AND WAIVER OF LIEN -01 Final ❑ Partial 0 Payment to Follow STATE OF: Indiana COUNTY OF: St. Joseph ,Jennifer Martell being duly sworn, deposes and says that she makes this affidavit for and in behalf of MARTELL ELECTRIC, LLC which, having entered into an agreement with City of 4t wli 13end Dept of Public Works ("Contractor") for the construction of Angela Bridge Lighting on the premises of the owner located at Angela Steet states that, upon receipt of payment by Martell Electric from Contractor in the amount of Fifty one thousand nine hundred ninety six & 69/100 Dollars, (the "Payment"), which payment has been promised by Contractor and is anticipated by Martell Electric, all material and subcontract, due and payable, will have been paid and all labor paid in full to the date of this affidavit EXCEPT for: CONTRACT RETENTION Effective upon receipt by Martell Electric of the Payment, Martell Electric does waive and release unto the owner of said premises, any and all lien, right of lien or claim of whatsoever kind of character on the above -described building and real estate under the Statutes of the State of Indiana relating to Mechanic's liens, on account of any and all labor, material, or both, furnished for or incorporated into said building by the undersigned, up to this date. Subscribed and sworn to before me, on this 6th day of March, 2019 Notary Public My commission expires: 2/28/2023 MARTELL ELECTRIC, LLC (hdl^'�'y k14 BY (4i�rrecl Jennifer Martell (Printed Name) President (Title) ��✓ �, Y641Wd dq '�r� JpwTm yN.,uq � j pgpW A NA (w a dmd (� ��j r.sr, &P N,viy P,01fib. aN fr✓ gas Ya;,�i vi 4 �+ urE i �YPH 41k ✓r 1� �',IiDP� IA trir "9"'s �Y i � Y (IP � Ft6Q BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 03/27/2019 Name Toy Villa Department Engineering BPW Date 04/09/2019 Phone Extension 5920 ..... _.......... -- ... -_.... _ .._ Required Prior to Submittal to Board Legal ❑ Attorney Name Controller ❑ Controller review is required for all Contracts $5,000.00 or more anc greater than one year in length per the City Purchasing Policy Purchasing ❑ Michael Schmidt ................ Check the H Agreement [l Professional Services E] Bid Opening ❑ Quote Opening Change Order No. _ F Ease/Encroach. Other: Nmpriate Item Typeww— Contract [:] Resolution Bid Award R Quote Award ❑ C/O &PCANo. _ [:] Traffic Control for All Submissions ] Proposal [l Addendum ❑ Req. to Advertise ❑ Title Sheet ired Information Company or Vendor Name Martell Electric, LLC New Vendor ❑' Yes ❑ No ❑ If Yes, Approved by Purchasing MBE/WBE Contractor ❑ MBE ❑ WBE MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company Project Name Angela Bridge Liahtinc Project Number 116-111 Funding Source COIT Account No. 404.0602.431.31.06 Amount $-.._w_.69 _ ._.... . 51,996.69 Terms of Contract Purpose/Description Project Closeout ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment., E-Verif , Iran, etc. Required For Chanute Orders Qnj Amount of ❑l inEl cease ._..case $ Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original' ❑ ❑ ❑ ❑ Dispersal AftermmApproval -._. _..