The URL can be used to link to this page

Home My WebLink AboutProject Completion Affidavit - Century Center Exterior Signage Project No 118-035B - Burkhart Sign Systems1316 COUNTY -CITY BUILDING I.J � �� tv i'1 PHONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD "ilk FAX 574/ 235-9171 SOI ITH BEND_ INDIANA 46601-1 830 �t CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARDU IC WORKS October 8, 2019 Charles Miller Burkhart Sign Systems 1247 Mishawaka Ave. South Bend, In 46615 RE: Project Completion Affidavit — Century Center Exterior Signage — Project No. 118- 035B Dear Mr. Miller: The Board of Public Works, at its meeting held on October 8, 2019, approved the Project Completion Affidavit for this project in the amount of $152,030. 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. G[LOT 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 xt- PROJECT NAME Century Center Site Signs PROJECT NO 118-035B FINAL COST $152,030.00 _ CONTRACT SIGNED 2/26/2019 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Remove 1 existing sign and install 2 new si ns 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 Ben which were a part of the above Contract,. P c s �q ""� day of 201 Burkhart Sign Systems 1 xeout Company Name Signature 1247 Mishawaka Ave AA �/� � �s_ � � �� Company Address Printed Name South Bend, IN 46615 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared . . .h and acknowledged his/her signature to the above Project Completion Affidavit on theo?544L day of J9A&A44d, 2019 _0ryggsgNrqarr�M No g" y SignatureExpires scion Ile r . . in y Comm. F�cpires . Printed Name S Qunty:of �sidence I, __„ _ ..... � " ��°l tk i `'ret ry of the Corporation executing If the Contractor is a corporation, the follovTm erti this release; that �__W . �`., OI+g this release on behalf of the contractor was then of sal& eA-1 that said release was duly signed for and on behalf of said Corporation by Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL Corporate Seal This project is acceptable for fp® a pproval and we recommend to the Board of Public Works that it be ordained so. Date: Construction Idager Gary A. Gifdi, President BOARD OF PUBLIC WORKS APPROVAL Date: v T Genevieve E. IVliiller, V1r4 gnber Elizabeth A. Maradik, Member Final Waiver of Lien State of Indiana, County of SS: being duly sworn that he/she is the (Name of Officer), (Title) of having contracted with (O'ontractor _ (Owner) to furnish certain materials and/or labor as follows; for a project known as located at and owned by 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 acknowledged; or ❑ the payment of which has been promised as the sole consideration fhr 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 ❑ receipt of which is hereby acknowledged; or ICJ the payment of which lies been, promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective only upon reoeipt 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 thereon an account of labor or material or both, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for saltl;proe6t,nd within the scope of this Affiidavlt. an Waiver of Lien. /'L'e' By l`h°tt (Authorized 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 aclatowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have horounto subscribed my name and affixed my official seal on the 45441- day of 200 O` ' OTA 9 Not Public Si iu°o My Commission Expires: ► t Y*'Y Comm. Expires Z : Janu4tY a, 202e ^ " Residing in county, - w "SEAL ` tart' Public Name f''"� OF-it~tO.''"w BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 9/30/2019 Name Tov Villa Department Public Works BPW Date 10/08/2019 Phone Extension 5920 .. ........................ Re PriortoSubmittal to Board BPW Attorney Attorney Name Dept. Attorney F-1 Attorney Name Purchasing (❑ Check the ADoroiniat Item I'voc — ❑ Professional Services Agreement Contract Open Market Contract p Amendment/Addendum E] Bid Opening � Bid Award 0 Quote Opening [ Quote Award ❑ Proposal Opening F� C/O & PCA No. Chg. Order, No. ❑ Traffic Control Other: Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description uired Information All Submissions --------------------- Proposal ❑ Special Purchase, QPA ❑ Req. to Advertise ❑ Title Sheet ❑ Reject Bids/Quotes ® PCA Resolution Ease./Encroach Burkhart Si wS sten s mm m ❑ Ycs[] If Yes, Approved by Purchasing ❑ No ❑ MBE Completed E-Verify Form Attached ❑❑ No � WBE .Centnry...Center Exterior Sign _................ m�,..........�.�...............�.�__ n. 118-035B Hotel Motel 73 04.42010.000.0099 $152,030.00 Project Closeout. __ ..... ...... ._....__ .._ For � l��t g Orders 0� Amount of ❑ Increase $�� ❑ Decrease ($ ) Previous Amount $ Increase % Current Percent of Change: Decrease ( mmmmmm New Amount $ _._....... Increase % Total Percent of Change: Decrease % Time Extension Amount: New Completion Date: