HomeMy WebLinkAboutChange Order No 1-PCA - Main and Jefferson Earthwork Project No 119-022 - Hardman Construction Inc1316 COUNTY -CITY BUILDING
;
227 W. JEFFERSON BOULEVARD"
SOIITH BEND_ INDIANA 46601-1930
I865
CITY OF SOUTH BEND
PETE BUTTIGIEG, MAYOR
September 24, 2019
Marty Gamble
Hardman Construction, Inc.
242 South Brye Road
Ludington, MI 49431
PHONE 574/235-9251
FAx 574/235-9171
RE: Change Order No. 1 (Final)/Project Completion Affidavit - Main and Jefferson
Earthwork — Project No. 119-022
Dear Mr. Gamble:
The Board of Public Works, at its meeting held on September 24, 2019, approved the Final
Change Order for this project, for a decrease of $9,750. The new Contract sum is $255,250.
In addition, the Project Completion Affidavit for this project was approved in the amount of
$255,250.
Copies of the Change Order and Project Completion Affidavit are 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
Enclosures
GARY A. GILOT GENEVIEVE E. MILLER ELIZABETH A. MARADIK LAURA L. O'SULLIVAN THERESE J. DORAU
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE: 8/28/2019
PROJECT NO: 119-022
PROJECT NAME: Main and Jefferson Earthwork
CONTRACT DATE: 4/9/2019
CHANGE ORDER NO: 1.1 Final
SUBJECT OF CHANGE ORDER: PCR #1-Adjustment to Final Quantities.
All items completed substantially as planned.
See attached Comparison of Estimate for overruns and underruns.
The original contract sum
Net change by previously authorized change orders
The contract sum prior to this change order
By this Change Order, the project amount is
The new contract sum including this change order
This Change Order represents a total change of
Total change for entire project
Original contracted completion date/time
Extension of date/time by previous change orders
Date/time extensiop by this change order
New completion d to/time In 14
Co tractor Signature
Printed Name and Title
Hardman Construction„ Inc,
Company Name
242 South BrVe Road
Address
Ludin ton, MI 49431
City, State, Zip
$
265,000.00
$
0.00
$
265,000.00
Increased
X Decreased
$
9,750.00
$
255,250.00
-3.68 %
-3.68 %
6/5/2019
0 days
6/5/2019
REC M LIAENDQ
FOR
P 8DVAL
CONSTR
ON MANAGER
CITY OF SOUTH BEND
BOARD OF PUBLI W KS
Approved Date: *200
Gary A. Gilot, President
Genevie a E. Miller, M tuber
Elizabeth A. I+gara ik, Member
h The e J. Dor,g" rnier
...,
k6'Su�lliva,
Laure
CITY OF SOUTH BEND, INDIANA . "r
BOARD OF PUBLIC WORKS
PROJECT COMPLETION AFFIDAVIT " Igo
PROJECT NAME Main and Jefferson Earthwork
PROJECT NO 119-022 FINAL COST $255,250.00
CONTRACT SIGNED 4/9/2019 MAINTENANCE AGREEMENT ENDS
Perform earthwork retention using a Soldier Pile and Lagging Earth Retention System. This
system shall be permanently left in place and used by the General Contractor to form the
PROJECT DESCRIPTION concrete foundation.
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 contra t„ and that the contractor perfrmed the work within the scope of the Specifications and Standards of the City
of South en which were a pa of the o Contract.
Exec d th` d 201 0 Hardman Construction, Inc.
Company Name
�w
Printed Name
242 South Brye Road
Company Address
Ludin ton, MI 49431
City, State, Zip
WITNESSESS:
Before me, the undersigned Notary Public in and for said country and state, personally appeared
(gip and acknowledged his/her signature to the above Project Completion Affidavit on
the " day of IeHl�.
Notary Signature My Commission Expires
Printed Name County of Residence
If the Contractor is a
rporation, the following certificate will be executed,
, certify that I am Secretary of the Corporation executing this release; that
who signed this release on behalf of the contractor was then
o aporporation; that said release was duly signed for and on behalf of said
of its e � go''ing b ,; d is within the scope of corporate powers:
�S6cretary's Signature
Corporate Seal
Printed NameZ
DEPARTMENT OF PUBLIC WORKS APPROVAL
This project is acceptable fdr i approval and we recommend to the Board of Public Works that it be ordained so.
Date: e
Construction ger r
BOARD OF PUBLIC WORKS APPROVAL Date„ l �f
Ga. A. Gilot, President Gen ieve E. Miller.tentber Elizabeth . ar dik Member
ember u a O'Sullivan, rKber (_,Ur#M. Martin Clerk
AFFIDAVIT AND WAIVER OF LIEN
State ofdarart'a, +bounty of
_...� T /
M� e-" 1 being duly sworn that he/she is the t,
(Name of Officer) %(Title)
of having contracted with ) u
(Subcontractor/Supplier)
(Contractor)
to furnish certain materials and/or labor as follows: _
(Description)
fora project known as
p J , . .� E_actio�h.
(Name of Project)
located at
and owned by
(f (Owner)
and does hereby further state on the behalf of the aforementioned subcontractor/supplier:
(PARTIAL WAIVER) that there is due from the Contractor the sum of
Dollars
❑ receipt of which is hereby acknowledged; or
L� the payment of which has 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;
WAIVER) that the final balance due from the contractor is the suin of
❑ 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 -described property and improvements thereon an account of labor or material ortt
"',famished b the undersigned
thereto, subject to limitations or conditions expressed herein, if any; and further certified that x her party has any claim or right to a
lien on account of any work performed or material furnished to the undersigned for sa" proj t, and itltin t." scop f is Affidavit
and Waiver of Lien.
y
(F) STATE OF 1NDIANA (Authorized presentative)
)
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 Lien.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the dayof
200� 19
Notary Public Signature
My Commission Expires: ,m
Residin in
g Zn�5;" County, �° �„ � , r,� � _ _ Notary Public Namner''
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 9/13/2019 Department Public Works
Name Toy Villa /�%..........................._.....w�w..�.-��...........�...,,.�,,,�.......A...�.�...�.�.........�_
Division/Bureau Engineering
BPW Date 09/24/2019......�......._._._..........................................................._�..................�_________.u_. Phone Extension .�...5920.�_�.�.�...�w .
I, IIIIIIIIIIIIIIIIIIIIIIIIIIIIIWIIWW�Wi.NqM NNFlW�d ' P I"NM�IV(�l %1%N�PIA�IdYF "WWWWP I'WWM�MP IlM DMi mmlmlmmmmmmmmmllllllllllllllll�t
................ .......................,.,
Required Prior to Submittal to Board
... _ .._ _ .. ........ _..�..............
Legal Attorney Name:
Controller Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing El
Check the
LJ Agreement
❑ Professional Services
E] Bid Opening
E] Quote Opening
0 Change Order No. _
EJ Ease/Encroach.
�7 Other:
)ropriate Item Type—_!3eguired for All Submissions
❑ Contract [❑ Proposal
E] Resolution
❑ Bid Award ❑ Req. to Advertise
El Quote Award
® C/O & PCA No.1 Final ❑ PCA
❑ Traffic Control:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of
Reauu fired Information
Hardman Construction, Inc.
Addendum
❑ Title Sheet
Main and Jefferson Earthwork
_..._._........... .... ....... .... ....
...... ... .....
119-022
RWDA TIF
324.1050.460.42.01
$255,250.00
Proiect Closeout
❑ Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment„ E-Verify, Iran, etc.
egyufirer j , m mge Orders Ong
Increase $
Decrease $
I After