HomeMy WebLinkAboutProject Completion Affidavit - Century Center Upgrades and Renovations Project No 118-104AR - R Yoder Construction1316 COUNTY -CITY BUILDING ^.tl;
�? PHONE 574/ 235-9251
E hA0,:
227 W.JEFFERSON BOULEVARD
FAX 574/235-9171
SOUTH BEND. INDIANA 46601-1 930 "
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARDLIC WORKS
September 24, 2019
Randall Yoder
R. Yoder Construction, Inc.
27453 CR 150
Nappanee, IN 46550
RE: Project Completion Affidavit — Century Center Upgrades and Renovations — Project
No. 118-104AR
Dear Mr. Yoder:
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 $104,180.
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
.;eau
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
PROJECT COMPLETION AFFIDAVIT �
PROJECT NAME Century Center Upgrades & Renovations
PROJECT NO 118-104AR FINAL COST $104,180.00
CONTRACT SIGNED 4/23/2019 MAINTENANCE AGREEMENT ENDS
PROJECT DESCRIPTION Renovate interior offices/areas at Century Center
_............................................... ...... ........... ...._
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 wr a pa of th above Contract.
E d ted th` � o 2012 R Yoder Construction, Inc.
Company Name _._.M...
Signature 27453 CR 150
Izo Company Address
Printed Name Nappanee, IN 46550
City, State, Zip
WITNESSES&
Before me the and rsi ,pored Notary Public in and for said country and state, personally appeared
1, and acknowledged his/her signature to the above Project Completion Affidavit on
�.t. day of
s 1
e. y Si gnatu re My Commission Expires ®- �)
Printed Name
County of Residence
If the Contractor i, a corporation, the following certificate will be executed.
I, Isc±& f, L certify that I am Secretary of the Corporation executing this release; that
who s' ontmactor was then
Corporation b Authon , f of said Corporate ; that said �1 gA��� gAVL60ned for an on behalf of said
y ty its cavernin9 body, and is within t e scope of q�b
{ State of Indiana b
et
My Commission Expires Nov 20, 2020
Sec ary"s Signature
Corporate Seal
Printed Name
DEPARTMENT OF PUBLIC WORKS APPROVAL
This project is aooeptabl f fi I approval and we recommend to the Board of Public Works that it be ordained so.
Date: °i 4 • L 9
Construotpo anger
BOARD OF PUBLIC WORKS APPROVAL Date:6 T
d'qttor",
A&L11-1
Gary A. Gilot, President Genevigve E. Miller, Meat r .� EI abe h X. Mar�adik, Memb
rau, Member 'aura O'Sullivan, Member L"1a M. Martin, Clerk
www. RYODERCONSTRUCTION. COM
TEL: 574.773.3502 - FAx: 574.773.4941
R. "ODER CONSTRUCTION., INC,11
27453 CR 150 - PO Box 69 - NAPPANEE, INDIANA 46550
AFFIDAVIT AND WAIVER OF LIEN
X FINAL PARTIAL PAYMENT TO FOLLOW
On this date of August 27 , 20J_9 _in the State of Indiana, County of Elkhart
Estabtuhed1978 W^^^^ W
Jason Yoder being duly sworn states that he is President of
(Name of officer) (Title)
R. Yoder Construction, Inc. having contracted with City of South Bend to furnish certain
(Owner)
materials and/or labor for a project known as Century Center Upgrades located at 120 S Dr, Martin Luther King Jr. Blvd, South Bend, IN 46601
and owned by City of South Bend For the total amount of contract including extras is $ 104,180.00 of which
R. Yoder Construction, Inc. has received payment of $ 98 971.00 prior to this payment.
And does hereby further state on behalf of R. Yoder Construction, Inc.:.
(PARTIAL WAIVER) that there is due from owner the sum of
Dollars ($ ) .
( ) receipt of which is hereby acknowledged; or
( ) the payment of which has been promised as the sole consideration of this Affidavit of Partial Waiver of Lien which is given
solely with respect to said amount, and which waiver shall be effective only upon receipt of such payment.
(FINAL WAIVER) that the final balance due from the owner the sum of
Five thousand two hundred nine dollars and no cents Dollars ($ 5,209.00 ) .
( ) receipt of which is hereby acknowledged; or
(X) the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall
become effective only upon receipt of such payment.
THEREFORE, the undersigned waives and releases unto Owner of said premises any and all lien or claim whatsoever on the above
described property and improvements thereon the 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 to any work performed or material furnished to the undersigned project, and within the scope of this affidavit and waiver.
R. Yoder Construction Inc. By /n�a
President
(Firm) (Au zed' Repr) (Title)
WITNESS MY HAND AND NOTARIAL SEAL, this 27th day of Au uSt 2019
05-23-2027
(Notary Public) (My Commission Expires)
Annette Wiseman ANNETT AISEMAN
Notary Ptutft, Sp tO « Indiana
(Printed name) Elkhart County_
Corllmtssion # NP�7 Ct4 S
N MyOe 7Plac
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 09/13/2019
Department Public
Name Tom_ Works
BPW 019 Phone Extension Date 09/24/2 n 5920
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lcu�rd Prior to Submittal to Board
BPW Attorney Attorney Name
Dept. Attorney Attorney Name
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