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Home My WebLink AboutProject Completion Affidavit - Bendix Theater Lift at Century Center Project No 118-036C - Brown & Brown1316 COUNTY -CITY BUILDING CJi PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD �'�'�-j FAX 574/ 235-9171 Srn JTH BFND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD F PUBLIC WORKS August 27, 2019 Eric Brown Brown & Brown General Contractors, Inc. 124 S. Elkhart St., PO Box 487 Wakarusa, IN 46573 RE: Project Completion Affidavit — Bendix Theater Lift at Century Center — Project No. 118-036C Dear Mr. Brown: The Board of Public Works, at its meeting held on August 27, 2019, approved the Project Completion Affidavit for this project in the amount of $82,679.58. 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 LO roo N M C') t U (D co N 9 �dQU)X a ZuJ�w �5Cl) aC O 7 J n m E t E ccU CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS " f PROJECT COMPLETION AFFIDAVIT PROJECT NAME Bendix Theater Lift at Century Center PROJECT NO 118-036C FINAL COST 82,679.58 CONTRACT SIGNED 2/1212019 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Install ADA com fiant lift in Bendix Theater at Centta Center WITNESSETH: _ �.Mm.�. 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. Executed k IT j ay of August 201 .�. Sign'atur Eric Brown .......... Printed Name Brown and Brown General Contractors, Inc Company..Name--.m._............ .......... 124 S Elkhart St. Company Address Wakarusa, IN.46573 y State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Eric Brown _ a and acknowledged his/her signature to the above Project Completion Affidavit on the 7th day of Au ust , 201 9 Notary Signature Todd A. Marek Printed Name My Commission Expires 4/3/2025 County of Residence Marshall Co., Indiana ..... > If the Contractor is a corporation, the following certificate will be executed. I, Hannah M. Aitken certify that I am Secretary of the Corporation executing this release; that b Eric Brown mm mITmmmm ..__ who signed this release on behalf of the contractor was then _ President _ of said Corporation; that said release was duly signed for and on behalf of said Cor ration by • uthority of its governing body, and is within the scope of corporate powers Seretarv's Signature Hannah M. Aitken Printed Name Corporate Seal DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for fM al approval and we recommend to the Board of Public Works that it be ordained so. ......_ Date: • 1 . 1' Construction e ' gr WARD OF PUBLIC WORKS APPROVAL Date: 0" �� . 6 ary A. GINot, President Genevieve E. Miller, Member Elizabeth A. taradik, Member Therese J, au, Me �ber�� Laura O'Sullivan, Im nda M. Martin, Final Waiver of Lien State of Indiana, County of Elkhart 5S: Eric Brown being duly sworn that President Officer) _... . ....,_.._�� (d�arnc ofOfflcer) .._,. (Title) of Brown & Brown General Contractors, Inch having contracted with City of South Bend, Indiana (Contractor) (Owner) ..._� to ihodsh certain materials andlor labor as follows; Install ADA compliant lift (Descriptlon) for a projectlorown as Bendix Theater Lift at Century Center (Name of Project), located at South Bend, IN and owned by City of South Bend, IN (Owner) and does hereby further state on tbo behalfofthc afore►sent.iorred subcontractorlsop liar; (PARTIAL WAIVBR) that there is due from the Contractor the sum of Doltars ( ) ❑ recoipt of which is hereby acknowledged; or ❑ the Payment of which has been. Promised as the sole consideration for this Affidavit and Final "Walver of Lioa whtelt is given solely with respect to said aneount, and which waiver shall be cffcctive only upon mtelpt ofpuynient thereof by the undersigned; P FINAL w at r tl'te sum of wAl" that tits final ba au (lie h°orrr� It ola rs our thousand one. hundred t trt our .. ❑ receipt of which is hereby acknowledged; or ® the payment of which leas been promised as trite sole consideration for this Affidavit and Final waiver of Lien which shall become offeodye only upon receipt of such payment. "l"l":llMl ORE, the undersigned waives mid releases unto the OwAar ofsaid premises, any and all lions or claims whal sever on tiro above -described property and Improvements thereon an account of labor or material or both, furnisbcd b the undersigned thorclo, subjectto limitations or conditions expressed hcrelu, if any; and, fhrthor certified that no other Marty has ally claim or right to a lien on account of any work performed or material iGbrnished to the undersipecl for sold project, and within the scope of this Aftidav3t and Waiver of Lien. Brown & Brown General Contractors, Inc. (I7hrn) (.Authorl lad Representotivo) STATE OF INDIANA SS: ST. JOSEPH COUNTY Y xcoution of the foregoing Affidavit County l yappealed _Eric Brown Before rue the undersigned, a rota public, In and for sold Iw.ount ' and State tersoaall trod acknowledged tiao a idavit and Waiver of Lion, IN Au ust name and affixed my offtoial seal on the 7th day of _ 010 . WITNESSll:Rl?t�l�, l have lrerermto subscribed my 20t1 Notary Pablio Signature My CommissionExpfros; 4/3/2025 Residing in Marshall County, Indiana Todd A. Marek _..---._.._ Notary Public Name Todd A Marek Notary Public SEAL Marshall County, State of Indiana My Commission Expires April 3, 2025 Commission Number: 698752 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 8/13/2019 Department Name Tov Villa �..� Engineering �....._-- �........................._�.�.�.�... BPW Date 8/27/2019 Phone Extension 5920 _..._. .........� �.. l.oguird Prior to Submittal to Board .._._.. .......... BPW Attorney Attorney Name Dept. Attorney E] Attorney Name Purchasing ❑ Check the Appropriate Item T ,� 1 �� r . _..-.:............................ww_ . Professional Services Agreement ]J Contract Open Market Contract Amendment/Addendum Bid Opening Bid Award ❑ Quote Opening Quote Award ❑ Proposal Opening C/O & PCA No. E] Chg. Order, No. ❑] Traffic Control Other: Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Information All Submissions Proposal (] Special Purchase, QPA ❑ Req. to Advertise E] Reject Bids/Quotes N PCA E] Resolution Ease./Encroach Brown & Brown General Contractors, Inc. Yes❑ If Yes Apmmmrovedb Purchasing ® No ❑ MBE Completed E-Verify Form Attached ❑ WBE Century Center Ben.......X...T.........�...._...._...........eater- ................Liftat C....�66 . ........ 118-036C Hotel... Motel ... Tax ... F.......................................................... �.,,,, _ _ and 7304.42010.000.0099 $82,679.58 P rc -qq closeout. ❑ Title Sheet ❑ Yes ❑ No Amount of ......_..w_ _ ....... For Chan -Orders Only_ _... �] Increase $.....� .. � � ------ --- Decrease $ )................................................. Previous Amount $ Current Percent of Change: New Amount Total Percent of Change:. Time Extension Amount: New Completion Date: Increase % Decrease ( % Increase % _ Decrease ( %