HomeMy WebLinkAboutProject Completion Affidavit - Three Twenty at the Cascade Composite Wall Panels Project No 118-074C - Construction Ahead Inc1316 COUNTY -CITY BUILDING
i i PHONE 574/ 235-9251
227 W. JEFFERSON BOULEVARD
�PFACK �� � FAX 574/ 235-9171
SOT Mi BEND. INDIANA 46601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD U LIC WORKS
September 24, 2019
Jerry Halbmaier
Construction Ahead, Inc.
1659 N Lancaster Road
South Elgin, IL 60177
RE: Project Completion Affidavit — Three Twenty at the Cascade Composite Wall Panels,
Division A — Project No. 118-074C
Dear Mr. Halbmaier:
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 $174,729.
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
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
PROJECT COMPLETION AFFIDAVIT
PROJECT NAME Three Twentv at the Cascade - Composite Wall Panels, Division A
PROJECT NO 118-074C FINAL COST $174,729.00
CONTRACT SIGNED 4/9/2019 MAINTENANCE AGREEMENT ENDS
PROJECT DESCRIPTION Install Nichiha wall panels at the Three Twen!y at the Cascade proiect.
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 co Tact, and that the contractor performed the work within the scope of the Specifications and Standards of the City
of South dwhich were p part of the above Contract.
Exec this day of ,- , 201 Construction Ahead, Inc.
Company Name
S tu� 1659 N. Lancaster Rd
r ® Company Address
Printed Name South Elgin, IL 60177
City, State, Zip
WITNESSESS:
Before me, h undersigned Notary Public in and for said country and state, personally appeared
C , and acknowledged his/her signature to the above Project Completion Affidavit on
the _._. .._. day of 201
Not nature My Commission Expires
J. Elliot Kowalski
Printed Name
County of Residence
6/7/2022
LaSalle
I is a corporationthe following certificate will be executed.
the Contractor r , erticertify that I am Secretary of the Corporation executing this release; t
t �� t r 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
C por its gov r i ody, and is within the scope of corporate powers:
Secretary's Signature
6 A I
Printed Name
Corporate Seal
DEPARTMENT OF PUBLIC WORKS APPROVAL
This project is acceptable forkfi I approval and we recommend to the Board of Public Works that it be ordained so,
Date:
Consl;ructio ager Q
BOARD OF PUBLIC WORKS APPROVAL Date: i`
Gary A. Gflof msident Genev ve E. Miller, M be EfizaUX A, daradik, Member
Therese orau, Member 1k, ura L. O'Sullivan,'Member b a M. Martin, Clerk
State oflndiana, County of
Final Waiver of Lien
St. Joseph
SS:
Jerry Halbmaier being duly sworn that he/she is the Presdient
(Name of Officer) (Title)
having contracted with
Of
Construction Ahead, Inc City of South Bend
_
(Contractor) (Owner)
to furnish certain materials and/or labor as follows: Exterior Nichiha Cladding Install
(Description)
for a project known as 320 @ the Cascade
(Name of Project)
located at 320 E Colfax Ave, South Bend IN, 46617
and owned by City of South Bend
(Ow r)
and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier:
(PARTIAL WAIVER) that there is due from the Contractor the aura of
Dollars
❑ receipt of which is hereby acknowledged; or
❑ the paymont of which has been promised as the sole considoratioa for this Affidavit and Final Waiver of Lien which is given
solely with respect to said amount, and winch waiver shall be of ctive only upon receipt of payment thereof by the
undersigned;
(F ) that the final balance due fyom the contractor is the sum of
Fourteerthousand, five -hundred eighteen dollars and 191100 ($14,518.19 )
❑ 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 shell
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 titereorn an account of labor or material or both, f3artnished b the undersigned
thoroto, subject to litnitations or conditions expressed herein, if any; mid further certi cd th no other party has any claim or right to a
land' Waiver of ofatany wont performed or material fltrrnished to the undersigned for sold o ct, and within the scope of this Affidavlt
Construction Ahead, Exteriors, Inc 13Y
(F�) uthorired Representative)
STATE OF iNDIANA )
) SS:
ST. JOSEPH COUNTY )
Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared
and acknowledged the execution ofthe foregoing Affidavit and Waiver of Lien.
iN WITNESS WHEREOF, f have hereunto subscribed my name and affixed my official seal on the day of
200
Notary Public Signature
My Commission Expires: 6/7/2022
IL LaSalleResiding in County, Notary Pubho Name
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 09/04/2019
Department Public
Name Toy Villa-:4 Works
BPW Date 09/24/2019 Phone Extension 5920
00000n000000000mmmmimmmNo... rrawmm� momomomomo�mmm�ueruoxommmimoirrv�ma�ra�n gram
d Prior to Submittal to Board
_.................... l �.__ ..� . �.............. .................... _....._.................
BPW Attorney [ Attorney Name
Dept. Attorney] Attorney Name
Purchasing E]
......... ....... _...... ...... ......... ...... _.
... _ Check the pp npri tIT Item Type ` / rgyh cl All Submissions
E] Professional Services Agreement [� Contract Proposal
El Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA
Bid Opening [:] Bid Award ❑ Req. to Advertise ❑ Title Sheet
EJ Quote Opening E] Quote Award Reject Bids/Quotes
E] Proposal Opening C/O & PCA No. ® PCA
Chg. Order, No. Traffic Control ❑ Resolution
Other: Ease./Encroach
Required u i red. Information
Company or Vendor Name Construction Ahead, Inc.
Yes If Yes, Approved _....0
New Vendor � pp d by Purchasing
No
MBE/WBE Contractor ❑ WBE Completed E-Verify Form Attached Yes
BE ❑ No
J p Panels Division A
Project Name 320 at the Cascade Composite Wall Panmmmm v....
Project Number 118-074C
Funding Source River East TIF _
Account No. 429-1050-460-42.02 mm
Amount $174,729.00
Terms of Contract
......... ..... _ .. .......w
Purpose/Description Prp'ect Clo qr utt
_..... mm._ .._.
For Ch �itg Orders Only
Amount of ❑ Increase $
❑ Decrease ($ ) w�
Previous Amount
$
_............._%....
Increase
Current Percent of Change:
Decrease
New Amount
$ .....................................�.�.�.�.................._...w_
Increase
°
/o
Total Percent of Change:
Decrease
Time Extension Amount:
New Completion Date: