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Home My WebLink AboutProject Completion Affidavit - Charles Black Center Renovations Project No 116-073 - Gibson Lewis1316COUNTY-CITY BUILDING%fro 227 W. JEFFERSON BOULEVARD VEA E SOUTH BEND_ INDIANA 46601-1 Ran ✓F CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD F PUBLIC WORKS September 10, 2019 Robert Lingenfelter Gibson -Lewis LLC 1001 West I Ith Street Mishawaka, IN 46544 PHONE 574/235-9251 FAx 574/235-9171 RE: Project Completion Affidavit — Charles Black Center Renovations — Project No. 116- 073 Dear Mr. Lingenfelter: The Board of Public Works, at its meeting held on September 10, 2019, approved the Project Completion Affidavit for this project in the amount of $3,973,460. 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 PROJECT NAME PROJECT NO CONTRACT SIGNED PROJECT DESCRIPTION WITNESSETH: %0 M'f CITY OF SOUTH BEND, INDIANA +k-ySP � BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVITrw,r„. Charles Black Center Renovations 116-073 FINAL COST $3,973,460.00 9/26/2017 MAINTENANCE AGREEMENT ENDS Interior remodel along with an addition to the Charles Black Center. 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 u d is 22nd day of August 201 9 Signature Robert A. Lingenfelter, President Printed Name Gibson -Lewis LLC Company Name 1001 West 11 th Street Company Address Mishawaka, IN 46544 City, State, Zip WITNESSESS: Before me„ the undersigned Notary Public in and for said country and state, personally appeared Robert A. Lingenfelterr and acknowledged his/her signature to the above Project Completion Affidavit on the tad day of August 2019 Notary §Ignature My Commission Expires Elizabeth A. Biddle Printed Name July 10, 2024 County of Residence St. Joseph 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 Corporate Seal Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable r al approval and we recommend to the Board of Public Works that it be ordained so. Date: Ct.- Construct" nager — BOARD OF PUBLIC WORKS APPROVAL Date: 116 /4c IY'It Qu� Gary A. Gil; Rres ant 4auraL. 11�dler; `M bar El�abe hA. Maradik, Member to rase J. Dorau, Memb r llivan, rrwbe'1 4UnaM. Martin, Clerk " MAINTENANCE BOND Bond Number: 929641337M KNOW ALL MEN BY THESE PRESENTS, that we Gibson -Lewis, LLC as Principal, (the "Principal"), and The Continental Insurance Company a Co oration _duly organized under the laws of Pennsylvania as Surety, (the "Surety"), are held and firmly bound unto City of South Bend, Indiana - Board of Public Works as Obligee (the "Obligee"), in the penal sum of Three Hundred Ninety-seven Thousand Three Hundred Forty-six And No/100 Dollars 397,346.00 for the payment of which sum well and truly to be made, the Principal and the Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has by written agreement dated September 26 2017 entered into a contract (the "Contract') with the Obligee for.. Charles Black Center Renovations - Proiect No. 116-073 which contract is by reference made a part hereof. NOW, THEREFORE, the condition of this obligation is such that if the Principal shall remedy without cost to the Obligee any defect which may develop during a period of year(s) from the date of completion and acceptance of the work performed under the Contract provided such defects are caused by defective or inferior materials or workmanship, then this obligation shall be null and void; otherwise it shall be and remain in full force and effect. PROVIDED AND SUBJECT TO THE CONDITIONS PRECEDENT, that any claims must be presented in writing to The Continental Insurance Com an 151 N Franklin Street, Chica o, IL 60606 DATED as of this 23rd day of August 2019 Gibson -Lewis, LLC (Seal) Principal W T Al� I1L By: _ �, w- t1! Hodowaniec Name: Eo ert A. I,ingenfelter Title: President The Continental Insurance Company _(Seal) Scott „ Attorrie'y-In-Fact ACKNOWLEDGMENT OF SURETY STATE OF MICHIGAN ) COUNTY OF OAKLAND ) On this � _ day of - 2019, before me personally came Latrecia R. Scott who, being by Inc drily sworn, did depose and say that she is an Attorney -in -Fact of the bow lit t and knows the corporate seal thereof, that the seal affixed to said annexed ins'trLlnnent is such corporate seal, and was thereto affixed by authority of the Power of Attorney of said Company, of which a Certified Copy is hereto attached, and that she signed said instrument as an Attorney - in -Fact of said Company by like authority. Acknowledged and Sworn to before me on the date above written My Commission Expires Kathy DelGreco Notary Public, Oakland County, Michigan My Commission Expires: September 3, 2020 ota N116, � YY t� POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That The Continental Insurance Company, a Pennsylvania insurance company, is a duly organized and existing insurance company having its principal office in the City of Chicago, and State of Illinois, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Latrecia R. Scott , Individually of Southfield, Michigan , its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature — In Unlimited Amounts — Surety Bond Number: 929641337M Principal: Gibson -Lewis, LLC Obligee: City of South Bend, Indiana - Board of Public Works and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the insurance company and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Board of Directors of the insurance company. In Witness Whereof, The Continental Insurance Company has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 3rd day of June, 2015. ."' The Continental Insurance Company ...,�, Paul�°1�. Bruflat ice President State of South Dakota, County of Minnehaha, ss: On this 3rd day of June, 2015, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of The Continental Insurance Company, a Pennsylvania insurance company, described in and which executed the above instrument; that he knows the seal of said insurance company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said insurance company and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance company. �. EI H' � attrr�tta" r�tlat.tc � rx SOUT t 000WA My Commission Expires February 12, 2021 S. Etch ubl . Notary lrttblic CERTIFICATE I, D. Bult, Assistant Secretary of The Continental insurance Company, a Pennsylvania insurance company, do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance company printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance company this 23rd day of August 2019 The Continental Insurance Company goo w , D. Bult 7sistant ccrelary Rjmroa F6850-4-2012 ISA Form as 1-402 PREPARE IN DUPLICATE Orlpinal - Contractor Dupllcate - SubcontrectorlSuppller AFFIDAVIT AND WAIVER OF LIEN (X Final ❑ Partial ® Payment to Follow. State of Indiana, County of St. Joseph , SS Randall H. Rice _ being duly sworn states that he is the Asst. Secretary of (Name of Officer) (Title) Gibson -Lewis, LLC having contracted with City of So. Bend Brd of Pubiic Works to furnish certain (Subcontractor: Supplier) IContractorl materials and/or labor as follows General Construction for a project known as IDet�rhar?els Black Center Renovations located at _,,, South Bend, IN _ and owned by City of So. Bend Brd of Public Works IOwner) and does hereby further state on behalf of the aforementioned subcontractorlsupplier: G1�XIC�CAA�)6AItX?QbE�Kf XIIdX�CDCtY,�C�fldb(�DdD�ttilC9i�(�C9h��JIQDCDCfliXX _....�m_ _....m Dollars ($ [ ] reoeipt of which is hereby acknowledged; or l I the payment of which has been promised as the sole consideration of this Affidavit and Partial 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 One Hundred Ninety Eight Thousand Six Hundred Seventy Three Dollars and 00/100Dollars ($ 198,673.00 [ ] receipt of which is hereby acknowledged; or [X I the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above -described property and improvements thereon on account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on account of any work perf or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. Ild Gibson-Lewis LLC Asst. Secreta , _..�..__ .......-_.. �.. �.,�.,��...�....� By _�...-..__�...:.� __...�� ...... Title ry a 1 Firml lAuthorized Representative) WITNESS MY HAND AND NOTARIAL SEAL, this 31 st d of January 2019 3s...�_ (Notarypublic) My Commission Expires ... July 10, 2024 Printed Residing in _ . St. Jose h County 9 1974 INDIANA SUBCONTRACTORS ASSOCIATION, INCORPORATED Unauthorized Reproduction Prohibited Elizabeth A. Biddle ELIZABETH A. BIDDLE Notary Public, State of Indiana ;SEAL r :� St. Joseph County My Commission Expires NnI r July 10, 2024 10,87 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM ate Dame �`+��yVi la 1 � N�Department Enc ineenng mm BPW Date 09/10/2019 Phone Extension 5920 %WWWNI��iu,1iJdN�PUdAINiWWWN�IWNflflflf�lRiIG11VNN'OY�1%1'll�%Immmmmmmmlllllllllllllllllllllllllllllllllllllllllmlmllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll�ltl/0/iA�i� WMiMWIW'NMMONM'.��flIIMmMMWW V �' �iililWI�VIWWWWW g �:r�uiredwPriorto 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 E] Check the Agreement EJ Professional Services E] Bid Opening E] Quote Opening ❑I Change Order No. Ease/Encroach. ❑ Other: Grorate Item Type — ,lei 0 Contract 0 Resolution F] Bid Award Quote Award El C/O & PCA No. F] Traffic Control for All Submissions EProposal [ Adde ndum EJ Req. to Advertise ❑ Title Sheet ired Information Company or Vendor Name Gibson -Lewis 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 Charles Black Center Renovation ProjectNumber .................................................. __ �.....�.....�..m 116-073 Funding Source Park Bond Account No. 751.1101.4,�,� � ..................ww.......,w�____ �................................................��... 52.39.89 Amount $3, 0 973,460.0.............. ........................ .........._w.,.,.,.---- ,.............. �....................................... Terms of Contract Purpose/Description Project Closeout ❑ Required Contractor's Certification Form Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verif. Iran. etc. For Change Orders On Amount of ❑ Increase $ ❑ Decrease $ Previous Amount $ Current Percent of Change: % New Amount $ Total Percent of Change: %� Dispersal After Approval Copy Original El F-1 El F-1 ❑a 0