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Home My WebLink AboutProject Completion Affidavit - Small Drainage Design and Repair Div C Project No 118-063 - Walsh & Kelly1316 COUNTY -CITY BUILDING C� f ��^�� -? PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD rr %( FAX 574/ 235-9171 SOUTH BRND_ INDIANA 46601-1 830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS August 27, 2019 Dustin Hilary Walsh & Kelly, Inc. 24358 SR 23 South Bend, IN 46614 RE: Project Completion Affidavit — Small Drainage Design and Repair, Division C — Project No. 118-063 Dear Mr. Hilary: 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 $72,200. 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 OVEN CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVITa" PROJECT NAME Small Drainage Design and Repair DivC PROJECT NO 118-063 FINAL COST $72 200.00 _ �.. _._ .............. ._ CONTRACT SIGNED 12/20/2018 MAINTENANCE AGREEMENT ENDS Provide and install various stormwater drainage improvements along and near Hawbaker PROJECT DESCRIPTION Street, Olivia Circle, and Creekwater Lane including an pavement, curb, and sidewalk repair. ..._... .�..._.._._... � ......... WITNESSETH: The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. Executed ,A�of A'� �0 , nWalsh 8 Kelly, Inc. r Company Name X�24'358 SR 23 Hilary, VP_ of South Bend Area Company Address Printed Name South Bend„ IN 466�14 City, State„ Zip_ _.._ WITNESSES& Before me, the undersigned Notary Public 'said" ,Pountf and state, personally appeared Dustin WLaa and acknowledged h`s/hl�r sin$i� e""tag the �.bove Project Completion Affidavit on the 1st dad f At t9at 201 ��a,N ALISHA KRUEGER � Ffd� `' Mary Public, state of Indiana' �� Not gna'ture 7tnL; ap My griaaExpires SI]a Krueger My Commission Expires Printed Name �� r„emo�° 9une O5, 2022 �� St. Joseph If the Contractor is a corporation, the following certificate will be executed„ I, J. Michael Schaum certify that I am Secretary of the Corporation executing this release; that who signed this release on behalf of the contractor was then CorpVP f t Ar : e, - of said Corporation; that said release was duly signed for and on behalf of said a tnty f p erning body, and is within the scope of corporate powers: Secretary' Signature Corporate Seal J. Mi heel Scl-oun Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable fbr f"I approval and we recommend to the Board of Public Works that it be ordained so. Date: Construotion ger BOARD OF PUBLIC WORKS APPROVAL Date: dd U 7 Gary A. Gilot, President Genevieve E. Miller, Member Elizabeffi A.. Maradik, ember Therese J. orau„ Menler° Laura O'Sullivan, Member Liinda M. Martin, Clerk Co "° """1 I„„JB 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 Bond No. MNT8252-46-71 Amount $7,220.00 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 E COMPANY, a corporation duly organized under the laws of the State of Indiana, (hereinunder called the Surety),, as Surety, are held and firmly bound Canto 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 Seven Thousand Two Hundred Twenty Dollars and 00/100 ($7,220.00 ), for the payment of which we, the said Principal and the said Surety, bind ourselves, our heirs, Sealed with our seals and dated this 25th day of July, 2019. WHEREAS, the said Principal has entered into a contract dated December 20 , 2018 for: Small Drainage Design and Repair - Project No. 118-063 And WHEREAS, the said Principal is required to guarantee the Small Drainage Design and Repair - Project No. 118-063 installed under said contract, against defects in materials or workmanship, which may develop during the period July 25, 2019 to July 25, 2022 Form 15-02.0075FED (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, repairand make good at its own expense any and all defects in materials or workmanship in the said work which may develop during the period July 25, 2019 to July 25, 2022 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, I �p,� ;�, ;BY VP of ui h Bend r Federal Insurance Company .... G6 fvf 4 FOmt 15-02-00 SFED (Rev. S/17) 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 Lisa M. Becker, Tia A. Boice, Brian T. Morton, David M. Oliger, Kathryn R. Postma, Tina N. Senefeld and Eric M. Wahlstrom of Indianapolis, Indiana --- -- •----_-- --------- ----- ------------------------------------------ each as their trace and lawful Anorney-bi-Fact to exectne under such designation in their natrres and to affix Moir corporate seals to and deliver for and on their behalf as surety thereon or otherwise, twnds and undt akinp and other wrlitni p obligatory III the nature thereof (anther than hall bonds) given or executed br that course of huslness, and any Instruments aun riding or altering the . a ne, and conserus to the'rotodilicaaion or alteration of any Instrument preferred 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 12d, day ofluly, 2019. [khan 11. Chloros. A�sb4ant Secretary I Lem. A � P- STATE OF NEW JERSEY County of Hunterdon stephol Al Ilaney. Vice PI'l54dont On this 121 day of July, 2019, 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 swom, 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 said Companies by like authority; and that she is acquainted with Stephen M. Haney, and knows him to be Vice President of said Companies; and that the signature of Stephen M. Haney, subscribed to said Power of Attorney is in the genuine handwriting of Stephen M. Haney, and was thereto subscribed by authority of said Companies and in deponent's presence. Notarial Seal ROSE CURTIS yrMh* "w w NOTARY PUBLICOFNew JBt1iEY yN400 2z,2M2 flyVY, IAI ACi vgalT llullBC.... CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016: "RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, recognlzances, contracts and other written commitments ofthe Company entered into in the ordinary course of business (each a "Written 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 ofthe 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 ofthe Company or otherwise, to the extent that such anion is authorized by the grant of powers provided for in such person's written appointment as such attorney -In -fact. (3) 1416 of the Charlown, the Pre,stdtntt and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to appoint In writing any person the attorney- Infact of the f amaiaamy with Rail power and authority to execute, for and on behattof ibe Company, under the seal of the Company or otherwise, such Written Commitments ofthe Company as may be specified in such written appointment, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chalmnan, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to delegate in writing to any other officer ofthe Company the authority to execute, for and on behalf of the Company, under the Company's seal or otherwise, such Written Commitments ofthe Company as are specified In such written delegation, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments.. (5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and 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 ofany such power or authority otherwise validly granted or vested." I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies") do hereby certify that (i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect, (ii) the foregoing Power of Attorney is true, correct and in full force and effect. Given under my hand and seals of said Companies at Whitehouse Station, NJ, this ,July 25, 2019 naval M Chka'(F. A.vsistant Scrrcufl) IN THE EVENT YOU t� to a VFXIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT: telephone (,908)903-3493 Fax(9f )903.3 56 e-mail: surelvOchubbr+mna FED- VIG-PI (rev,.08-1@) Final Waiver of Lien Slate of Indiana, County of ...._._..�,.......em Stw __Os6 Jii .... SS: Dustin Hilaryu yW w .... M y mm being duly sworn that he/she is the South Bend AreaVicePresident (Name of Officer) (Title) Walsh & Kell Inc. m..m ... having contracted with._.... __.. _en of CiY of St out...h Bend _ ...�w�.......�.� _M (Contractor) (Owner) to furnish certain materials and/or labor as follows A �i alt wPa ing, COnCre 'e,wSewer and Landsc e t. (I:IcscrJirtion) for a projeot known as SmallYDraina Design &, Re aqr Div CrµProject# 118-063 (Name of Project) a ..._ ... located at Creekwater, Street, South Bend, IN 46628 and owned by City of South Bend, Indiana++tlttit,,, and doe hereby r state nbehalf s h y furthc tat o the ofthe aforementioned subcontractor/supplier. from the Contractor the sum of (PARTIAL WAIVER that Were is due .,, m .. , . w.....n. Dollars _ ...m.., ❑ 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 is g%vm solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; FINAL WAIVER) that the final balance due from the contractor Is the sum of 3,610 0 ❑ 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 effective only upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever on the above-doserlbed property and improvements thereon an account of labor• or material o. , ftunished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and Iivther ccrtifl at other° la s any claim or right to a lien on account of any work performed or materiel furnished to the undersigned for dd p Oct, .and the scope of this Affidavit and Waiver of Lien. _ Walsh & Kelly, Inc _...... (Authorized g�nsscn(aii�rre) STATE.. �..__.._._ OFINDIANA ) D tin Hilary, South Bend Area Vice President SS: ST. JOSEPH COUNTY Before me, the undersigned, a Notary Public, in and rr said County and State, personally appeared Dustin Hilary and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscrJbed my na� and affixedmy ofticisi ion Rl r� ,th day of UqUSt 200_ lary public SJgnat�u^e My commissionr.xpires: m June 7, 2023 Ammer Elizabeth Turin_ _.._ Realdingin Marshall County, _ Indiana W Notary Public Name AMY ELIZABETH TURPIN `rr;d Nctary Pub 1c, State of Indiana Marshall Cour:y Commission Expires Jung 7, 2023 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 08/13/2019 �w�......_ Name "I'o Villa Department Engineering BPW Date 08/27/2019 Phone Extension 5920 ��nwu�smmmmRm inn i��ou�ua� mnmmm�mrm � Renred Prior to Submittal to Board BPW Attorney Ej Attorney Name ��/��IT�ITITITITITITmmmuWWWWW ITITITITITITIT Dept. Attorney ❑ Attorney Name ._._. ��w�_...w�._... Purchasing Check the ,pEop ke Item IIT pe net uir �] Professional Services Agreement E] Contract Open Market Contract ❑ Amendment/Addendum EI Bid Opening ❑ Bid Award ❑ Quote Opening ❑ Quote Award ❑ Proposal Opening C/O & PCA No. El Chg. Order, No. E] 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 Or All Submissions F]Proposal Special Purchase, QPA Req. to Advertise ❑ Title Sheet ❑ Reject Bids/Quotes ® PCA �] Resolution Ease./Encroach Walsh & Kell , Inc. Yes If Yes, Approved by Purchasing ❑ No ❑MBE Completed E-Verify Form Attached No WBE Small Draina e Desi mmm.and Repair 118-063 UtilitExense/Contractual.S...e...r..... Service Fund 251.0608.431.42.96 "r iect Closeout ......� ww�w m..�,. _. ...... For Change Orders Only ...::....w.a � � ......._ _..... �..... �.._ .. ._...... Amount of ❑ Increa�............ se $ ❑ Decrease Previous Amount $._....�.. Increase /o Current Percent of Change: Decrease w %) New Amount $._.��_... ..................�.�_�_�.�..........ow_...........��...._......................._..... Increase .......................... . /o Total Percent of Change: Decrease /o Time Extension Amount: New Completion Date: