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Home My WebLink AboutProject Completion Affidavit - Three Twenty at the Cascade Site Utilities Div B Project No 118-074D - Ritschard Brosolu Tit 1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD uaa A SOIJTH BEND_ INDIANA 46601-1 830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS August 27, 2019 Rachelle Dolniak Ritschard Bros., Inc. 1204 W. Sample Street South Bend, IN 46619 PHONE 574/235-9251 FAx 574/235-9171 RE: Project Completion Affidavit — Three Twenty at the Cascade -Site Utilities, Division B —Project No. 118-074D Dear Ms. Dolniak: 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 $53,487. 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 A CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME Three Twenty at the Cascade - Site Utilities Division B) PROJECT NO 118-074D FINAL COST $53,487.00 CONTRACT SIGNED 12/20/2018 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Installtion of sanitary sewer line and connection to Citv sewer, 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. txecuted this 5th T of August 2019 Ritschard Bros., Inc. I "I Company Name 8ignature 1204 W. Sample St. -Rachelle L, Dolniak Company Address Printed Name South Bend, IN 46619 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Rachelle L. Dolniak dacknowledged his/her signature to the above Project Completion Affidavit on the 5 Y of Au Zt ,2019 11111/, /// Z�lu Nok are My Commission Expires \Ap,RD Robin v\ F()oz TA Printed Name County of Residence St.:-:Jo8eph If the Contractor is a corpora e following certificate will be executed. J—, Donald Ritscb ar�Txl. ce fy that I am Secretary of the Corporation �644nq �Ilg Rachola-e L �O no who signed this, release on behalf of the r-was4 eat f said orporation; that said release was duly signed' are Y, by ion y f is �oveWrny, is within the scope of corporate powers: Corvat,` -0 it g d d is, Corporate Seal Donald Ritschard, Jr. Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable fry at approval and we recommend to the Board of Public Works that it be ordained so. Date: Construction ger BOARD OF PUBLIC WORKS APPROVAL Date: Gary A. Gilot, President 10zMT0=?J=,TJr; in Genevieve E. Miller, Member Laura L. O'Sullivan, Member Eftaboth A. Maradik, Member 'CWda M. Martin, Clerk Final Waiver of Lien State oflndiana, County of St , Joseph SS: Rachelle L. Dolniak being duly sworn that he/she is the President (Name of Officer) (Title) of Ritschard Bros., Inc. having contracted with City of South Bend (Contractor) (Owner) to furnish certain materials and/or labor as follows; Earthwork and Site._Utilities �.� (Description) for a project known as _Thr. ., e Cascade — Site Utilities ('Division B) (Name ofProject) located at �0 E. Colfax ._„venue and owned by City of South Bend (Owner) and does hereby fia Cher state on the behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there is due from the Contractor the aura of Dollars Cl receipt of which is hereby aelaxowledged; or ❑ the payment of which ]was been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given 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 �i Sim Hundred Sevent —four and 35/100 ❑ receipt ofwhich is hereby acknowledged; or ® thepaymeut of which has been promised as the solo consideration forthis Affidavit and Final Waiver of Lien which shall become effective only upon, receipt of such payment. WHEREFORE, 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, furnished 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 perfomned or material furnished to the winder i ed for said project, and within the scope of this Affidavit and Waiver of Lien Ritschard Bros., Inc. By ) M (Authorized Representative) STATE OF INDIANA ) SS: ST. JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared ilac 1..1.e L. Dolniak and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed ray name and mixed my o sea n the day of Au ust 200 19 c� "" otaryPublic Signa My Commission Expires; 9 1 2 5 t""."Z. .Robin Fozo Residingin St. e Co�ty, ana Notart' Public Nam e 1 OF MO BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date8/08/2019.........._._..........................�.�.�.�............ _. Department Public Name Tov Villa Works BPW Date 8/27/2019 Phone Extension 5920 _..__.� _.......... _— ................. ._.......... ......... .. required Prior to Submittal to Board BPW Attorney Attorney Name Dept. Attorney F Attorney Name Purchasing ❑ Check the A °o )ri�ate Item Ty a ldc"mta F] Professional Services Agreement [:] Contract n''' Open Market Contract ❑ Amendment/Addendum 0 Bid Opening ❑ Bid Award Quote Opening ❑ Quote Award ❑ Proposal Opening ❑ C/O & PCA No. EJ 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 LAB )r All Submissions Information H Proposal El Special Purchase, QPA Req. to Advertise [� Reject Bids/Quotes ® PCA ❑ Resolution Ease./Encroach Ritschard Bros., Inc. nYes❑ If Yes, Approved by Purchasing No [� MBE Completed E-Verify Form Attached ❑ WBE 320 at the Cascade — Site Utilities, Division B 74D, Div. B RiverEast...T.I.F.................�...._._..... �... ,,,,,,....._�... �.�...�.�.�.�.�...�.�........_...�_.... 429.1050.460.42.02............. �Y __... ......................�.�.�.�. $53,487.00................�.��—�� ....... Prc ie t - o§gout. ❑ Title Sheet ❑ Yes ❑ No — _ ......_ .... ._. ..� ww. __vvvvvv _.— ..m. ..... For C]tie Orders�aly m.. Amount of Increase $ [� Decrease — .��... Previous Amount $ Current Percent of Change: New Amount Increase _% Decrease ( % Increase % Total Percent of Change: Decrease (mmmmm mmm w% Time Extension Amount: New Completion Date: