HomeMy WebLinkAboutProject Completion Affidavit - Wastewater Treatment Plant Riverbank Stabilization, Phase 2 - EFM Excavating, Inc.1316 COUNTY —CITY BUILDING
PHONE 574/ 235-9251
227 W. JEFFERSON BOULEVARD �'s
'� � `� FAX 574/ 235-9171
SOIJTH BEND_ INDIANA46601-1930
x �
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARDOF PUBLIC WORKS
November 12, 2019
Mr. Edward Mackowicz
EFM Excavating, Inc.
20932 West. 1st. C Road
Walkerton, IN 46574
RE: Project Completion Affidavit — Wastewater Treatment Plant Riverbank Stabilization,
Phase 2
Dear Mr. Mackowicz:
The Board of Public Works, at its meeting held on November 12, 2109, approved the Project
Completion Affidavit for this project in the amount of $99,650.
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
4' 4-n �.
CITY OF SOUTH BEND, ANA
BOARD OF PUBLIC IDS
PROJECT COMPLETION AFFIDAVIT ,
M '
PROJECT asteater Treatment Plant Riverbank Stabilization - Phase 2
PROJECT NO. n/a FINAL $99,650.00
COST
CONTRACT
SIGNED
PROJECT
DESCRIPTION
10/09/2018 MAINTENANCE AGREEMENT Not
ENDS Aplicable
Construction of St. Joseph Riverbank Stabilization, install well graded stone,
veg,�itation, trees and shrubs. Remove rubble, dead trees, and shrubs.
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 were a part of the above Contract.
Executed this,, a rlty of +✓° C7', 20—Z-F.
EFM Excavating, Inc,
Si n�tt�e� _ _ N _...
Company Name
her 0 3 aic- 20932 West lst C Road
Printed Name Company Address
Walkerton, Indiana 46574
City/State/Zip
WITNESS
Before ine, me um ersigned Notary Public in and for said country and state, personally appeared
r'1 acknowledged his/her signature to the above Project orm�ple "
on the day of 201�_. R03 '61 AV sajldx3 uolsslWWOO AN
`
eue Ipul to MIS
y Iaatatl
' tve, M Commission Expires <
Ott°y �ttu� � ea �I_.._.�
Priatt1 Name County of Residence
If the Contractor is a corporation, the following certificate will be executed.
1, m _ _.. _ , certify that I am Secretary of the Corporation executing this release; that
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 Corporation by Authority of its governing body, and is within the scope of corporate powers:
Secretary's Signature
Corporate Seal
Printed Name
DEPARTMENT OF PUBLIC WORKS APPROVAL
This project is acceptable for final approval and we recommend to the Board of Public Works that it be
ordained so.
Date: //- O4-2019
Construction Manager
BO RD OF PUBLIC S APPROVAL Date:
Gary A. Gilot, President Genevieve E. Miller. Member
Elizabeth A. Maradik, Member Therese J. Dorau, Member
ra O'Sullivan;"1" einber
"" .�inrlau M. Martin, Clerk
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date November 4 2019
Department
Name Jacob M. Klosinski Engineerm^ / Utilities
BPW Date November 12 2019 Phone Extension Ext. 9496
wwwmeme ommmmmm�o morvr�ummiNpmrau�urereamrnp!nip m=m M
Required Prior to Submittal to Board
BPW Attorney ® Attorney Name Clara McDaniels
Dept. Attorney ❑ Attorney Name
�_............����.............................�..........._....w _.
PurchasingEl
Check the Appropriate Item Type
Professional Services Agreement QJ Contract
E] Open Market Contract
El Amendment/Addendum
❑ Bid Opening
[] Bid Award
F Quote Opening
El Quote Award
Proposal Opening
C/O & PCA No.
El Chg. Order, No.
Traffic Control
Other:
R..._Information
Information
._........................_...................
All Submissions
Proposal
LJ Special Purchase, QPA
E] Req. to Advertise
Reject Bids/Quotes
PCA
❑ Resolution
Ease./Encroach
❑ Title Sheei
Company or Vendor Name EFM Exc,avatin, Inc ....._._
New Vendor -0—WT1 If Yes, Approved by Purchasing
® No
MBE/WBE Contractor ❑ MBE Completed E-Verify Form Attached Nos
Project Name Wastewater Treatment Plant Riverbank Stabilization - Phase 2
.
...
.................. ____.mw�. _�........�w ........
Project Number
Funding Source Utilities, Wastewater, Other Equipment.
Account No. 641-0630-793-36-05
$99,__....................................m
650
Amount 00
Terms of Contract Lump Sum Not to Excee
d
Purpose/Description The Division of EngineeringEpgineering and Utilities requests approval of the Project
ComL)Ietior A1'llday.it fo.r tl e sttb'ect rca"ett_...EFM Excavating com2leted
work. Final Project Cost $99 650.00.. Project Completion Affidavit attach(
For Cltartc Orders trl_:_.
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