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Home My WebLink AboutProject Completion Affidavit - Century Center Convention Hall A-B New Entry Project No 115-017A - Brown & Brownf 4xy( ! 1316 COUNTY -CITY BUILDING Ff G J PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD FAX 574/ 235-9171 SOUTH BEND_ INDIANA 46601-1 830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARDU LIC WORKS September 24, 2019 Eric Brown Brown & Brown General Contractors, Inc. 124 S. Elkhart St. Wakarusa, IN 46573 RE: Project Completion Affidavit — Century Center Convention Hall A-B New Entry — Project No. 115-017A Dear Mr. Brown: The Board of Public Works, at its meeting held on September 24, 2019, approved the Project Completion Affidavit for this project in the amount of $96,325. 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 0 N N i Zz Cr � U- U os J w ZjJrLL 0 J >- LLLLIi E a �Fy0Z JZ cc i m� ao 20 i �r�dbk UYN MJ„� CITY'' OF SOUTH BEND, INDIANA x,µ BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT:ry PROJECT NAME Ce�ntur r Center Convention Hall A-B New Entry PROJECT NO 115-017A FINAL COST $96,325.00 -...._ .._. m�.__.........�.w�,.__. CONTRACT SIGNED 1002018 _ MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Addmcr,new entry to convention hall. WITNESSETH: _. _......_ .. .. _ _._..... _.... _ u. _...._._......... 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. EX( d di day of Set 201 9 General Contractors, Inc. _.. Brown &Brown Gene mm_ ww�� Company Name �µ Signa tpr'e' 124 S Elkhart St. Eric Brown Company Address Printed Name Wakarsa IN, 45'S'73 City, State, Zip WITNSSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Eric Brown , and acknowledged his/her signature to the above Project Completion Affidavit on the 9th day of Set , 2019 Notary Sign ture My Commission Expires Bradley A. Romine Printed Name County of Residence 2/12/2027 Marshall Co.. Indiana If the Contractor is a corporation, the following certificate will be executed. I. Hannah M. Aitken certify that I am Secretary of the Corporation executing this release; that Eric Brown who signed this release on behalf of the contractor was then President of said Corporation; that said release was duly signed for and on behalf of said Co ration by Authority o its go erntng body, and is within the scope of corporate powers: Secretary s &gnature _ .. Corporate Seal Hannah M. Aitken Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL project p approval and we recommend to the Board of Public Works that it be ordained so. This ro'ect is Date: acceptable a or a ro Constructio Hager - BOARD OF PUBLIC WORKS APPROVAL Date: , cm j" eV Gary A. Gs""lot, President Genevieve E Millen, Memb Elizabeth A. Maradik, Member h rase .. , orauu e��.�,-....,..m. ra. O Sullivan, Member M da M. Martin, Clerk r" � Final Waiver of Lien Stoic of Indiana, County of Elkhart Co. SS: Eric Brown President being duly sworn that he/she is the (Name, of Officer) . ..... of Brown & Brown General Contractors, Ing, (Title) I'Lavin contracted with Cit oL..§qujt end, IN (Contractor) y (Owner) to f=ish certain materials and/or labor as follows; Addj11q_neA ntrytoconventionhall (t)",cr(pdon) for a projca itnowu as Century Center Convention Hall A-B New Entry (Name of Project) located at South Bend, IN and owned by City of South Bend, IN and does hereby hirtbor state on fire, behalfaf the aforementioned subcontractor/suppliar„ (PARTIAL WAIV1311) that there is doe from the Contractor the sum of --'8'6v--e —nTh o —us dii`d'fiVe-1Tu—n d —re d—s I Me f'rff rfd-O W1,010-- Dollars 7 5160 C1 receipt of which is hereby nolmowledged; or the PaYntent of which has been proinised as the sole consideration for this Affidavit mid Final Waiver of Lien, which 13 given solol)t with, respect to said amount, and which, waiver sball be, effective, only upon, receipt of Payment thereof by the undersigned; (FINAL WAIVER) that the final balance dtw Itom the contractor is the sum of Four thousaj��ndred sixteen and oo/1 00 B.00 13 receipt ofwhich is hereby acknowledged; or N the, payment of which has been promised as tile sole consideration foribils Affidavit and Final Waiver of Lien which shall become offiective only upon receipt of such payinent THMIFORE, the undersigned waives said releases luilo the Owner ofsaid promises, any and all liens or claims whilboaver on the above -described property, and imPrOvdMeAts thereon On account Of labor ormaterial or both, ftunishod b tbo undersigned thorolo, subject to limitations or conditions exprossed herein, if any; and flulber eartified, that no other party has any claim, or right to u lien on account of any work performed or material furnished to Cite undersigned for said pr 'cot, and the soo a of This A111davIl and Waiver of Llen� P Brown & Brown General Contractors, Inc. ............ By STATE OFINDIANA (Authorkzed Representative) SS: ST. JOSEPH COUNI'V Before me, the unrlarsigned, a Notary Public, in and for said County and Slate, personally appeared ,- Eric Brown mid acknowledged tire execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my narno and affibed nay offtilil, seal on the 9th day of 200 .3019 '�Z4No t;w—�y V bpi o—A R n a t t it �o My Commission Expires: 2/12/2027 Residing in Marshall county, Indiana Bradle �� A. Rom ine Notary Public Nettie BRADLEY ALLEN ROMINE NOTARY PUBLIC SEAL MARSHALL COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12,2027 COMMISSION NUMBER NP0718569 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 09/12/2019 Department Public Works Name Toy Villa Division/Bureau Engineering BPW Date 09/24/2019 Phone Extension 5920 i^i^emu A,mirr�aauuu w w luau mmimwn°,lomuuuuuuuuuuuuuuummmmmmmm upromnwn .,,,., ,.,�. ._......�.__ .......�p ._.�. w ....�..m..,.,.�._....._...........................�..�.. .................. I e�ui.redmm_Prior to Submittal to Board ..................._...... _...._.._.................._.. Legal Attorney Name: Controller El 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 ElCheck the LJ Agreement F-1 Professional Services Bid Opening 0 Quote Opening ❑ Change Order No.. Ease/Encroach, F-1 Other: Company or Vendor Name �ropriate Item Tie �] Contract Resolution El Bid Award D Quote Award ElC/O &PCANo. _ ❑ Traffic Control: 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 Increase Decrease Previous Amount $ Current Percent of Change, % New Amount $ Total Percent of Change: % Copy Original ❑ ❑ ❑ ❑ ❑ for All Submissions I Proposal ❑ Req. to Advertise wired Information Brown & Brown General Contractors, Inc. Proiect Closeout Addendum ❑ Title Sheet ❑ Required Contractor's Certification Forms Attached (Non - Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc. ,cgtred For n e Orders ONy._........ Dispersal After Approval