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Home My WebLink AboutProject Completion Affidavit - Gemini at Washington-Colfax Apts Masonry & Stair Repair Project No 118-080B - Pauls Welding1316 COUNTY —CITY BUILDING C a PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD 4i 1 FAx 574/ 235-9171 SOIJTABEND. INDIANA46601-193O CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS August 27, 2019 Kyle Miller Paul's Welding, Inc. 7930 West 1000 North Nappanee, IN 46550 RE: Project Completion Affidavit — Gemini at Washington -Colfax Apartments Masonry and Stair Repair — Project No. 118-080B Dear Mr. Miller: 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 $186,439. 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 CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME -Gemini at Washington -Colfax Apartments Mason !y and Stair Repair PROJECT NO 118-0806 (Division B) FINAL COST $186,439.00 CONTRACT SIGNED 10/23/2018 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Replacement of fire stairs at the Gemini at Washinaton/Colfax Apartments 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. Exec ed this day of 14 201 Paul's Welding, Inc. Company Name Signature 7930 West 1000 North _1(me Company Address Prinked Name Nappanee, IN 46550 City, State, Zip WITNESSESS: fore me, Ltheundersigned Notary Public in and for said country and state, personally appeared C -elL. .. , and acknowledged his/her signature to the above Project Completion Affidavit on t ay of A-� 201_1 d :,A < Notary Signature 0 My Commission Expires Let&.tl C`1410ej/1�11 Printed Name 11) County of Residence If the Contractor is a corporation, the following certificate will be executed. 1, certify that I am Secretary of the Corporation executing this release; that — r.4 Li I i fe r— who signed this release on behalf of the contractor was then pet"i Ln�,4 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: KENDRA GINGERICH Secretary's Signature Notary Public HiCorporate Seal tle'r SILAL State of Indiana Printed Name My Commission Expires February 15, 20215 DEPARTMENT OF PUBLIC WORKS APPROVAL - This project is acceptable for ?i a pproval and we recommend to the Board of Public Works that it be ordained so. Date: Construction ger BOARD OF PUBLIC WORKS APPROVAL Date: L d,) L) C) -vqc b fl_ Gary A. Gil 4, President Genevieve E. Miller, Member Eriz—abeth A. Maradik, Member Laura L. O'Sullivan, Member .. . ...... . -Lin a M. Martin, Clerk' Final Waiver of Lien State of Indiana, County of SS: w � e, 1. being duly sworn that he/she is the Imam( ( " ' (Name of Officer) �" (Title) ` " of tit City of South Bend having contracted with y (Contractor) (Owner) to furnish certain materials and/or labor as follows;: for a project known as located at and owned by (Name ofProjeot) t I fah- City of South Bend (owner) and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there is due from the Contractor the sum of Dollars fi ❑ 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 Lion which is given solely with respect to said amount, and which waiver sball, be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVM that the final balance due Rom the contractor is the sum of ❑ receipt ofwhich is hereby aclmowledged; or ® the payment of which has been promised as tide solo consideration for this Affidavit and Final Waiver of LIen which sball become effective only uponroceipt ofauch payment THBREFORE, file undersigned waives and releases unto the Owner of said promises, any and all liens or claims whatsoever, on the above-descrlbed property and improvements thereon an account of labor or material or botb, tltruished 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 it lien on amount of any work perferrned or material t4mished to the undersigned for said pro eot, and within the scope ofthis Affidavit mid Waiver of Llera r gk (Firm) J) (Authorized Ropresentative) STATE OF INDIANA SS: ST. JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared and acknowledged the execution of the foregoing Affidavit and Waiver of Lion. Ji IN WITNE S WHEREOF, I have herounto subscribed my name and mixed my official seal on the � day of Notary Public Signature My Commission R�pfms: r :: a Residhtg in � ��(,��' county, rJj,i` iio Name KEWEPA GINGERICH Notary Public SEAL State of Indiana My Commission Expires February 15, 2025 ............... . BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 8/08/20 9 7 Name "I'o Villa Department„ Engineering ._..._....._...._ w w w... _ — .......... BPW Date 8/27/2019 Phone Extension 5920 flu�ummmmommmmmmmon'Mo owmmmmmwnmmnMrnmmr;m wmmmmmuammmmmwwmmmwwwmmw ,.... im��im vv ' to Submittal to ..._......._w_ R utr Pnor .......� Board ....... ._.......... BPW Attorney Attorney Name Dept. Attorney Attorney Name Purchasing ❑I ............ .... C. Check the ,ADDronriat - Item Tvne ..- LJ Professional Services Agreement ❑ Contract Open Market Contract El Amendment/Addendum [� Bid Opening E] Bid Award ❑ Quote Opening ❑ Quote Award EJ 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 Paul's Wel ❑] Yes❑ 15-1,1 No Information Inc. lbr All Submissions El Proposal Fj Special Purchase, QPA ❑ Req. to Advertise ❑ Title Sheet ❑ Reject Bids/Quotes PCA Resolution Ease./Encroach If Yes, Approved by Purchasing MBE Completed E-Verify Form Attached Nos WBE Gemini at Washington -Colfax Apartments Masonry and Stair Repair 118-080B West Washington TIF �..._ ............. -------- .. _ ............_.w._ ............... 422.1050.460.42.02 ....... ..._._ .. ... _— Project_ Closeout For ClInp Orders Onlyy ,w m.... .._ ___...... Amount of Increase $ Decrease ($ ) Previous Amount $ Increase �.�.�.�.�.�.�.�.�.�.............................. ��-.............._..�.�_..... �-_.�_��m.�....._................... 0 Current Percent of Change: Decrease ( /o New Amount Increase % Total Percent of Change: Decrease Time Extension Amount: New Completion Date: