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Home My WebLink AboutProject Completion Affidavit - Unity Gardens Learning Center Site Improvement Project No 117-050R - Ritschard Bros' 1316 COUNTY -CITY BUILDING �� j PHONE 574/ 23$-92$1 227 W. JEFFERSON BOULEVARD �' PEACE FAX $74/ 235-91 % 1 SOUTH BEND. INDIANA 46601-1 930 w Y CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARDU LIC WORKS September 24, 2019 Rachelle Dolniak Ritschard Bros., Inc. 1204 W. Sample Street South Bend, IN 46619 RE: Project Completion Affidavit — Unity Gardens Learning Center Site Improvements — Project No. 117-05OR Dear Ms. Dolniak: 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 $73,541.85. 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 ��ykv� fAl Nk-gh CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT" e� PROJECT NAME Unit Gardens Learning Center Site Im rovements PROJECT NO 117-05OR FINAL COST $73,541.85 CONTRACT SIGNED 2/26/2019 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Installation of sanitary lateral and water service at the Unitv Gardens site, 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. ecuted this _28th d of August 201 9 Ritschard Bros., Inc. Company Name ignature 1204 W. Sam le St. Rachelle L. Dolma' Company Address Printed Name South Bend„ IN 46619 City, State, Zip WITNESSESS:" Before me, the undersigned Notary Public in and for said cor1t_*st sally appeared Rachelle L. Dolniak ,and cknowledged his/her signatur t� . above Proja ,ompletion Affidavit on the 28 t day t . 1� tr'' 201 9 Notaryignature My Corrnisaor �G „" 8/25 Printed Name County of Rolain Fozo y �a�aI� ^��St Joseph If the Contractor is a corporatl th M allowing ce oMe will be executed,� l . �.. ald Ritscl° m-w erttf that I am Secretary of the Corporation executing this release; that L ,_r who signed this release on behalf of the contractor was then Pr i nt of -aid rporation; that said release was duly signed for and on behalf of said Corpo do y A Ph, ri y o i g ern'i bo , ar is within the scope of corporate powers: Corporate Seal Donald Ritschard, Jr,. Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for ,t al approval and we recommend to the Board of Public Works that it be ordained so. t. • Date Construo ° nagerl Y Gary A. Gilot, resident BOARD OF PUBLIC WORKS APPROVAL Genevieve E. Miller, Member Dater rv-t� / al t � ElEaEbtfi A. Nfarddik, Member J-PorTu, Member JAura L. O'Sullivan„ Member Lwnda M. Martin. Clerk Final Waiver of Lien State of Indiana, County of St. Joseph SS: Rachelle L. Dolniak _ being duly sworn that he/she is the president (Name of Officer) (Title) of Ritschard Bros., Inc. having contracted with City of South Bend (Contractor) (Owner) to furnish certain materials and/or labor as follows; Earthwork and Site Utilities (Description) for aproject:know as l txit (Iar darts Learnin Center Improvements (Name of Project) located at —3.7-QL— raat B1yd Bend, IN and owned by ity of South Bend (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 aclatowledged; or ❑ 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; (FINAL WAIVER) that the final balance due from the contractor is the sum of Tive Thousand Four Hundred Fift -2i ht and 34/100 5,45t3.34 ❑ receipt ofwhich 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 Ownor ofsaid premises, any and all liens or claims whatsoever on the above -described ,property and improvements thereon an account of labor or material or both, flrrnished b the undersigned thereto, subject to limitations or couditions oapressed herein, if any; and further certified that no other party has awry claim or right to a lien on account of any work performed or material furnished to the underLed r said project„ and within the scope of this Affidavit and Waiver ofLien. Ritschard Bros., Inc. BY �) (Atttitorized �eprosentative) STATE OF MDIANA ) SS: ST. JOS131"H COi:1NTY Ilefore me, the undersigned, a Notary Public, in and for sold County and State, personally appeared Rae lle L. Dolniak and aclatowledged the execution of the foregoing Affidavit and Waiver of"Lien. IN WITNESS WHEREOF, I have hereunto subscribed, my name andaffixed my offacl al .i the 2 th day of —August _ tltt 19 X N e01 � i� , �✓', N Public Signature My Commission Expires: 918 25 " 4 Robin Fozo Residing in S.t_._h county, "Marne OF ' rr110111000 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 09/04/201.9 Name Tea. _.�..' ��..........�........ � Public Works — Eng. ...... . BPW Date 09/24/ 019 PhRNMRNone Extension 5920 _..__. ITIT...c� uired Prior to Submittal ._...__._.... ___W ma.. bmittal to Board BPW Attorney ❑ Attorney Name Dept. Attorney FAttorney Name Purchasing ❑ Check the Appropriate Item Type Professional Services Agreement Contract Open Market Contract ❑ Amendment/Addendum Bid Opening ❑ Bid Award Quote Opening Quote Award E] Proposal Opening [ C/O & PCA No. Chg. Order, No. El Traffic Control Other: All Submissions ❑ Proposal n Special Purchase, QPA E Req. to Advertise ❑ Reject Bids/Quotes ® PCA El Resolution Ease./Encroach ❑ Title Sheet Company or Vendor Name Ritschard Bros., Inc. ❑ Yes 0 If Yes Approved b Purchasing New Vendor p y ® No MBE/WBE Contractor ❑ WBE Completed E-Verify Form Attached ❑❑ Nos Protect Name Unity Gardens Learnin Center Si w to Improvements Project Number 117-05OR Funding Source R WDA TIF Account No. _—.........mw� 324-1050-460-42.01 _..........._.......................................va Amount $73,541.85 ..._ �..w.... Terms of Contract --� � __ ._ ......_—........M Project Closeout Purpose/Description _...... _ For Chang Orders....0' ....._m ... mount of ❑ increase $ _.------ - .......�.. nY_ ❑ Decrease ($ ) Previous Amount $ ..,..Increase. ...... ............ �.�.........�.�.�.�.........- % Current Percent of Change: Decrease ( % New Amount .�..............�...._... Increase Total Percent of Change: Decrease (m % Time Extension Amount: New Completion Date: