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Home My WebLink AboutProject Completion Affidavit - Gemini at Washington-Colfax Apartments Masonry & Stair Repairs Div A Project No 118-080B - Bokon Masonry1316 COUNTY -CITY BUILDING f7. PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD FAx 574/ 235-9171 SOI ITH BEND. 1NDIANA 46601-1 93O u r � x �86 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARDU LC WORKS September 24, 2019 Ryan Bokon Bokon Masonry, Inc. 56571 Pear Road South Bend, IN 46619 RE: Project Completion Affidavit — Gemini at Washington -Colfax Apartments Masonry and Stair Repairs, Division A — Project No. 118-080B Dear Mr. Bokon: 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 $237,713. 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. G1LOT GENEVIEVE E. MILLER ELIZABETH A. MAR ADIK LAURA L. O'SULLIVAN THERESE J. DORAU st,0c ut d� Cv5 CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS p, PROJECT COMPLETION AFFIDAVIT tAwo " PROJECT NAME Gemini at Wash in ton -Colfax Apartments Mason and Stair Repair Division A PROJECT NO 118-080B FINAL COST $237,713.00 CONTRACT SIGNED 10/23/2018 _ MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Re air a various mason areas at the Gemini A artments. 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 above y above Contract. Exec 0 d th of d w41Ahich were a pad of ' yt - , 201 . Bokon Masonry, Inc. Company Name Sig Iture 56571 Pear Road mpany Address Pr4nted Name Nio, , Si WITNESSES& Be me, the nd rsigned N r frr IT 0A and day of 201 VA rinted ANGIELA4 M. BESERRA, Notary Public A Resident of St. County, IN Commission N6.663712 th Bend„ IN 46619 , State, Zip ,sonally appeared cl Completion Affidavit on c)?— A If th, Contract is acorporation, the following certificate will be executed. ........... certify that I am Secretary of the Corporation executing this release; that co fed 4 ......... .. 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 Cor=,orafion bylhlor'V of its governing body, and is within the scope of corporate powers: Secreta "s Signature Corporate Seal Printed Name atu re My Commission Expires County of Residence DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable o ° final approvaland we recommend to the Board of Public Works that it be ordained so. Date: Constructic nager BOARD OF PUBLIC WORKS APPROVAL Date: w.� ,ary A. Gilot, rresident Geneyfqve E. Miller, Me jber 00ibM A. Maradik, Member u, Member � lxaurL. O'S@Iiva , em" aer \ . - i da M. Martin, Clerk INSURANCE LIFE • HOME • CAR - BUSINESS BOND NUMBER: 66280424 MAINTENANCE BOND KNOW ALL BY THESE PRESENTS, that we, BOKON MASONRY INC 56571 PEAR RD, SOUTH BEND, IN 46619 (hereinafter called the Principal), as Principal, and Auto -Owners Insurance Company, a corporation organized and existing under the laws of the State of Michigan and duly authorized to transact business in the State of Michigan (hereinafter called the Surety), are held and firmly bound unto CITY OF SOUTH BEND 227 W JEFFERSON BLVD SOUTH BEND IN 46601 (hereinafter called the Obligee), in the full and just sum of 10% of attached contract price ( ) lawful money of the United States of America, to be paid to the said Obligee to which payment well and truly be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that WHEREAS, the Principal has entered into a contract with the said Obligee, dated the 23rd day of October , 2018 for MASONRY AND STAIR REPAIR AT GEMINI AT WASH I NGTON-COLFAX APARTMENTS which contract is herein referred to and made a part of as fully and to the same extent as if the same were entirely written herein and WHEREAS, said contract has been completed, and was approved on the 18th day of July , 2019 , NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal shall guarantee that the work will be free of any defective materials or workmanship which become apparent during the period of twelve months following completion of the contract, then this obligation shall be void, otherwise to remain in full force and effect, provided, however, any additional warranty or guarantee, whether expressed or implied, is extended by the Principal or Manufacturer only, and the Surety assumes no liability for such a guarantee. SIGNED AND SEALED this 4th day of . September , 2019 By Witness By ritness By Z�f BORON MASONRY INC Principal Title Auto -Owners Insurance Company 29296 (12-18) DATE AND ATTACH TO ORIGINAL BOND AUTO -OWNERS INSURANCE COMPANY LANSING, MICHIGAN 66280424 POWER OF ATTORNEY NO. KNOW ALL MEN BY THESE PRESENTS: That the AUTO -OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN, a Michigan Corporation, having its principal office at Lansing, County of Eaton, State of Michigan, adopted the following Resolution by the directors of the Company on January 27, 1971, to wit: "RESOLVED, That the President or any Vice President or Secretary or Assistant Secretary of the Company shall have the power and authority to appoint Attorneys -in -fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity, and other writings obligatory in the nature thereof. Signatures of officers and seal of Company imprinted on such powers of attorney by facsimile shall have same force and effect as if manually affixed. Said officers may at any time remove and revoke the authority of any such appointee." Does hereby constitute and appoint REBEKKAH E GROSHANS its true and lawful attorneys) -in -fact, to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and the execution of such instrument(s) shall be as binding upon the AUTO -OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office. IN WITNESS WHEREOF, the AUTO -OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN, has caused this to be signed by its authorized officer this 1 st day of August, 2016 A,X� IvXA,�� Denise Williams Senior Vice President STATE OF MICHIGAN} COUNTY OF EATON f 55. e.M�f"N, ZAA On this 1st day of August, 2016 before me personally came Denise Williams, tome known, who being duly sworn, did depose and rc,w�w� say that they are Denise Williams, Senior Vice President of AUTO -OWNERS INSURANCE COMPANY, the corporation described in andwhich executed the above instrument, that P h y know the seal of said corporation, that the Seal, and that they received said instrument on behalf of the corporation by authority of their office pursuant � oinstrument saRe Resolution of the Board of Ar ..� Directors of said corporation. �"'r� w My commission expires March 10, 2022 Susan E. Theisen Notary Public STATE OF MICHIGAN 1ss. COUNTY OF EATON J I, the undersigned First Vice President, Secretary and General Counsel of AUTO -OWNERS INSURANCE COMPANY, do hereby certify that the authority to issue a power of attorney as outlined in the above board of directors resolution remains in full force and effect as written and has not been revoked and the resolution as set forth is now in force. Signed and sealed at Lansing, Michigan. Dated this 4th day of September 2019ya r" CORPORATE '; SEAL r "" William F. Woodbury, First Vice Pr ident, Secretary and General Counsel 2940 (10-17) Print Date: Print Time: Final Waiver of Lien State of Indiana, County of St,^mT_Q_sep_„ _. _ SS: being duly sworn that he/she is the President (Name of Officer) (Title) of B o k o (Contractor)" a s oy Inc. having contracted with 1 Cite S,0 t, e n d (Owner) to furnish certain materials and/or labor as follows: _QnX., __A t.a ice' . ^ a r t n t s (Doscrlptlon) for a project known as as ? , al—F—a��n. ten -Colfax &pa wtments (Name of Project) located at 617 �e��t ?�ashin.tcsn_ Stst•eotSouth Brt�d IN 466Q1 and owned by 5D1It]_Ben�1 H 1 aP noun ien... no, _... _..__.. _...w_ (Owner) and does hereby further state on the behalf ofthe aforementioned subcontractor/suppUer. (PARTIAL WAIVER) that there is due from the Contractor the sum of Dollars —_ ) ❑ receipt of which is hereby aclatowledged; or ❑ the payment of which lies been promised as ahe sole consideration for this Affidavit and Phial "Waiver of Lien which is given solely wills respect to said aniount, and which waiver shall be effective only uport receipt of payment thereof' by the undersigned; (FINAL WAIVER) that the final balance due from the contractor is the sum of Th i r..t. . ..th. . la. —. i..Vr h3l,n . ,cents _m. o—. ❑ 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 beconic effective only upaolt receipt ofsuch payrsiottt. I'TIEREFORE$ the undersigned waives and releases )into the Owner of said promises, any and all liens or claims whatsoever on tho above -described property and improvements thereon an account of labor or material or both, fisrnishod b the undersigned thereto, subject to litu itations or conditions oxpressed hereia, if any; and further certified that no other party has any claim or right to a lies), on account of any work performed or materialfurnished to the undersigned for said project, and within the scope of this Affidavit and '' alver of'Llem MAM ___ _ =)n „"' , ANGELA M. E(E � _ STATE OF INDIANA �� Notary Public SEAL A Resident of St. Joseph County, IN ST. JOSEPH COUNTY Commission No. 66371 Before me, the undersigna ic,IYly I and acknowledged the execution of )Jt(Wl"1 nMS F Jhave hereunto subscribed my nar� and2I)0 .. appeared '. %. my offiic'ial seal on e. y n Expires: „~ o u µ natnn . g M Commission p' b Z �':? Residing in w .t Quist (/l _.... _��.__ yr _ __� ( Notary Fu lie rime day of BOKOMAS-01 ROOM A��`a►' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/4/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER The Healy Group, Inc. 17535 Generations Drive South Bend, IN 46635 271-6000 243-3214 INSURED Bokon Masonry Inc. 56571 Pear Rd South Bend, IN 46619-9801 COVERAGES CERTIFICATE NUMBER: INSURER A: Hastings Mutual Ins. Co. INSURER B ; INSURER C . ........ INSURER D : INSURER E INSURER F : REVISION NUMBER: 14176wwwww_ .......... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR _ TYPE OF INSURANCE ADOL S9%BR POLICY NUMBER _ POLICY EFF POLICY EXP - ._....ww.. � LIMITS _ A X COMMERCIAL GENERAL LIABILITY EACH'OCCURRENCE $ 1,000,000' CLAIMS -MADE X OCCUR X CPP9874827 8/17/2019 8/17/2020 WDAMAGE TO RENTED 100,006 SE n $ ..... MED EXP (Any one erson) $ mm 5,000 PERSONAL & ADV INJURY $ 1,000,000 L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY vT 0 LOC 2,000,000 t�u PRODUCTS - COMP/OP AGO $ OTHER $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _. .. 506,066 X ANY AUTO ACV9874840 8/17/2019 8/17/2020 BODILYINJURYPer erson $ OWNED SCHEDULED """. """"' AUTOS ONLY AUTOS BODILY_IN,I_ URY (Per accident! $ App AUTOS OPER�Y AMAGE Port __. 1J ONLY Of accil eAl A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS -MADE ULC9874849 8/17/2019 8/17/2020 AGGREGATE-_, _ 1,000,000 --- . DIED RETENTION $ A WORKERS COMPENSATION OTH AND EMPLOYERS' ANY Y❑ WC 9874841 8/17/2019 6I17/2020 — PROPRIETOR/PARTNER/EXECUTIVE HR EXCLUDED? 1ERI'M �) N / A CEA SOO,OOO .F,1, E,L. DISEASE EMPLOYEE $ If es, describe under DESCRIPTION OF OPERATIONS below _.__a... E,L DISEASE -POLICY LIMIT ....._.. 500,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of 'South Bend Is listed as Additional Insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of South Bend THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 125 South Lafayette Blvd, Suite 100 South Bend, IN 46601 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 09/04/2019 Name I o Villa Department: Engineering BPW Date 09/24/2019 Phone Extension 5920 vivimimuwmu�wiw� �u®ir�nmram�v wi�w�mir�mnn�!�n!r�m� ..._..... �..�.. Required Prior to Submittal to Board BPW Attorney Attorney Name Dept. Attorney Attorney Name Purchasing El Check the ;Atn)1`0' 7riate Item Tvpe -- ❑ Professional Services Agreement ❑ Contract Open Market Contract ❑ Amendment/Addendum E] Bid Opening ❑ Bid Award [] Quote Opening E Quote Award ❑ Proposal Opening [:1 C/O & PCA No, F Chg. Order, No. Traffic Control Other: Information Company or Vendor Name Bokon Masonry, Inc. New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description All Submissions L j Proposal ❑ Special Purchase, QPA F-1 Req. to Advertise ❑ Title Sheet ❑ Reject Bids/Quotes ® PCA Resolution Ease./Encroach U Yes U If Yes, Approved by Purchasing ® No ❑ WBE Completed E-Verify Form Attached ❑❑ Nos Gemini Wit hinjon-wColfax Masonry and Stair Repairs 118-080B West asliitj ton 1 Ifw �.._ ....._.. ,. 422-1050-460-42.02 $237,713.00 Protect Closeout For Chic mOrders Only wmw Amount of Increase $ ❑ Decrease ($ Previous Amount $ Increase % Current Percent of Change: Decrease ( % New Amount $ Increase Total Percent of Change: Decrease % Time Extension Amount: New Completion Date: