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Home My WebLink AboutChange order No 1 - PCA - 2019 Curb & Sidewalk Construction, Division 2 Proj No 119-004 - Premium Concrete Services, Inc.i CITY OF • BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS November 26, 2019 Mr. Max Yeakey Premium Concrete Services, Inc. 712 Richmond Elkhart, IN 46516 PHONE 574/235-9251 FAX 574/235-9171 RE: Change Order No. 1 (Final)/Project Completion Affidavit — 2019 Curb & Sidewalk Construction, Division 2 — Project No. 119-004 Dear Mr. Yeakey: The Board of Public Works, at its meeting held on November 26, 2019, approved the Final Change Order for this project, for a decrease of $3,015.10. The new Contract sum is $39,108.90. In addition, the Project Completion Affidavit for this project was approved in the amount of $39,108.90. Copies of the Change Order and Project Completion Affidavit are 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 Enclosures GARY A. GILOT GENEVIEVE E. MILLER ELIZABETH A. MARADIK LAURA L. O'SULLIVAN THERESE J. DORAU CITY OF SOUTH BEND, INDIANA ' DEPARTMENT OF PUBLIC WORKS PROJECT CHANGE ORDER DATE: 10/18/2019 PROJECT NO: 119-004 PROJECT NAME: 2019 Curb & Sidewalk Div.D2 CONTRACT DATE: 5/28/2019 CHANGE ORDER NO: 1 Final SUBJECT OF CHANGE ORDER: PCR #1-Adjustment to Final Quantities and Damages. All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns.. The original contract sum Net change by previously authorized change orders The contract sum prior to this change order By this Change Order, the project amount is The new contract sum including this change order This Change Order represents a total change of Total change for entire project Original contracted completion date/time Extension of date/time by previous change orders Date/time extension by this change order New completion date/time CONTRACTOR 6;ac gnature ,Pa Printed Name and Title Premium Concrete Services, Inc. Company Name 712 Richmond Address Elkhart, IN 46516 City, State, Zip Increased FXDecreased 11/15/2019 0 days 0 days 11/15/2019 42,124.00 0.00 42.124.00 $ 3,015.10 $ 39,108.90 -7.16 % -7.16 % . :o. r r • , I�iMmwliliou��ul Eiar*PON CITY OF SOUTH BEND BOARD OF PUBLIC, WORKS Approved Date; l' z Ga A. Gilot "'President 9 Genevieve EWaradik, ember Elizabeth A.Member TherJ. Dorau, Memb r? I J ( Laura O'SulllivaCi, M tuber - CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME 2019 Curb & Sidewalk Div.D2 PROJECT NO 119-004 FINAL COST $39,108.90 CONTRACT SIGNED 5/28/2019 MAINTENANCE AGREEMENT ENDS Remove and replace concrete sidewalk, concrete curb, ADA compliant curb ramps, and PROJECT DESCRIPTION concrete approaches as a part of the 2019 Curb and Sidewalk Program, 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 thl day of�1�,y 201 Premium Concrete Services, Inc. Company Name nature 712 Richmond _........ ....... Company Address Printed Name Elkhart, IN 46516 City, State, Zip WITNESSES: Before rne, I'�""IAXl E theUndersigned andNotary acknowl acknowledgedic his/and herh s heror said country sign signature to he and abovestate, personally appeared Pi . da.vit on the day of 1 kVCmlbEfe, , 201�. JANEEMTOWNER NOTARY PUBLIC Nota Signature My Commission Expire yaEAL 1�CE f �N EXPIRES FEEPU 1,_b Printed Name County of Residence l ISION N4�,i"1t�;1I I If the Cot tractor is corporation, the following certificate will be executed. certify that I am Secretary of the Corporation executing this release; that XQ C° ,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 y Authority of its governing body, and is within the scope of corporate powers: S t ry`s tgnature Corporate Seal M 'A Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This projects acceptable f r I approval and we recommend to the Board of Public Works that it be ordained so. Date; C7 • Z Z • lC) Construe ' Manager . q .. BOARD OF PUBLIC WORKS APPROVAL Date: l t o)Lo f / /itl-1 d,,�U- ) — w - UL,W(-- Gary A. Gtlott, resident , Genevii^e E. Miller, M;jb'pf Eliza eth A. Maradik, Member Therese J. Dorau, Member / Xbura O'Sullivan, Me rz' `---dkd'a. M. Martin, Clerk * * *1 MAINTENANCEBOND Bond No MNT2420233 KNOW ALL MEN BY THESE PRESENTS: That, Premium Concrete Services, Inc., 712 Richmond St, Elkhart, IN 46516 as Principal, and Old Republic Insurance Company a corporation organized under the laws of the State of Wisconsin and authorized to do a surety business in the State of Indiana as Surety, are held and firmly bound unto the City of South Mad Board of Public Works as obligee in the sum of Three Th9wind NineHmndred ($3,910.89 ), lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents: SEALED with our seals and dated this 1 Ith day of November ;2019 WHEREAS, on the 28th day of May 2019 , the said principal as contractor, entered into a contract for: 2019 Curb and Sidewalk Construction; Project No. 119-004 for the sum of Forty-two Thousand One Hundred Twenty-four And No/100 ($42,124.00 ); and, WHEREAS, under the terms of the specifications for said work, the said principal is required to give a bond in the amount of Three Thousand Nine Hundred Ten. And 89/1.00 _......... .., ($$3,910.89 ), to protect the obligee against the result of faulty materials or wozkinanshin for a period ofThree Mear(s) from and after the date of the completion and acceptance of same, namely, until 11/15/2022 Now, THEREFORE, if the said principal shall for a period of Three (3year from and after the date of the completion and acceptance of same by said obligee replace any and all defects arising in said work whether resulting from defective materials or defective workmanship, then the above obligation to be void; otherwise to remain in full force and effect. Premium Concrete Services, Inc. By Principal Ol�ublic Insurance Company By winifer L.mKasznia Attorney -ill -Tact: ORSC 22518 (4-93) * OLD REPUBLIC INSURANCE COMPANY ** * .......� ....... _. �....�.�. �.. POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania stock insurance corporation, does make, constitute and appoint: NICOLE L BICKNELL, MEGAN E RIESENBERG, MARK EDWARD WOBBE, BARBARA E PEARSON, JENNIFER L KASZNIA, SANDRA L JUNK, WILLIAM J CERNEY, III, WESLEY MANTOOTH, THERESA BURNS, JORDAN SCHEIBER, CHERYL E. ALKIRE, OF SOUTH BEND, IN its true and lawful Attorneys) -in -Fact, with full power and authority, not exceeding $50,000,000, for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof, (other than self-4rosurance workers compensation boinids guaraicnte6ing payment of Ibeneliiks, asbestos abaternent contract bonds, waste imanage.. rrnent bounds, hazardous unvras&e rerned�atGorn bounds or li lack lung bonds), as follows: ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED FOUR MILLION DOLLARS($4,000,000)------ ---------- ------- FOR ANY SINGLE OBLIGATION. and to bind OLD REPUBLIC INSURANCE COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This document is not valid unless printed on colored background and is multi -colored. This appointment is made under and by authority of the board of directors at a meeting held on March 14, 2014. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC INSURANCE COMPANY on March 14, 2014. RESOLVED FURTHER, that the chairman, president or any vice president of the Company's surety division, in conjunction with the secretary or any assistant secretary of the Company, be and hereby are authorized and directed to execute and deliver, to such persons as such officers of the Company may deem appropriate, Powers of Attorney in the form presented to and attached to the minutes of this meeting, authorizing such persons to execute and deliver and affix the seal of the Company to bonds„ undertakings, reco nizances, and suret shi obltgalions of all kinds, other t�hmi ball bands hank dreposltory ponds, mortgage de(iclemy^ bonds, mortgage quaran O onds„ guarantee�s o fns a0mernt tmper and nate guaranty bonds, The said officers may revoke any Power of Attorney previously granted to any such person. The authority of any Power of Attorney granted by any such officer of the Company as aforesaid shall not exceed fifty million dollars ($50,000,000.00), except (a) bonds required to be filed as open penalty bonds, and (b) bonds filed with any court or governmental authority requiring an unlimited penalty in bonds filed in that court. RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (1) when signed by the chairman, president or any vice president of the Company's surety division and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (ii) when signed by a duly authorized Attorney -in -Fact and sealed with the seal of the Company (if a seal be required). RESOLVED FURTHER, that the signature of any officer designated above, and the seal of the Company, may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, OLD REPUBLIC INSURANCE COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be affixed this 11TH day of _ J1J E mIT„201,8, ...... a OLD REPUBLIC INSURANCE COMPANY nssasunr✓ a a SEAL u x *' STATE OF.. WISCONSIN, COUNTY OF WAUKESHA - SS Vice President — On thr, ALAN PAVLICand _ _ Jy of JtiJNEANE E CHERNEY _ to me known l own to be the individuals and of the OLD REPUBLIC INSURANCE COMPANY who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say; that they are said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said organization,. �ot�14� ° It Notary Public My commission expires. g / 2 £t / 18 CERTIFICATE (Expiration of notary commission does not invalidate this Instrument) I, the undersigned, assistant secretary of the OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in re now in force. A W' g % , Signed d sealed at the City of Brookfield, WI this day of e Power oAttorney,a 45-5314 � '" �wr a ne SEAL rr w �r ��M�ItlNIpNIIOGA. Final Waiver of Lien State of Indiana, County of 'el— A SS: being duly sworn that he/she is the �y P (Name of Officer) (Title) of t k ip w ` cllpwk" �l�aving contracted with to(Or U—t-H Bev (Contractor) (Owner) to furnish certain materials and/or labor as follows; for a project known as located at and owned by VL M and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier: (PAPTr4Y • INAivRR) that there is due from the Contractor the suns of Dollars $ ❑ 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 is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (Fl°l�"Al., WAl �/lll� that the final balanc due fCom the �otitractor is the sum of ,� - � _ j�_ ❑ xeceipt of which is hereby aclrnowledged; trx ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective onlyuponreceipt 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 said project, and within the scope of this Affidavit and Waiver ofLlen. (Firm)� By Uthor zed'lCepresentative) STATE OF INDIANA ) SS: ST, JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared .M&�& _Ak,�L and acknowledged the execution of tho foregoing Affidavit and Waiver of Lion. 1i F, I have hereunto subscribed my name and affixed my official seal on the day of T� 1N WITNESS WHEREOF, 200 1Q N Public Signature EE Ivly �tarnissioia �p (J Resi % in EAkoun , Notary Public Name ATE MY COMMISSION EXPIRES FEBRUARY 12, 20M COMMISSION NO.710M BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 11/19/2019 Name Toy Villa Department hn�� BPW Date 11/26/2019 Phone Extension 5920 Required Prior to Submittal to Board BPW Attorney ❑ Attorney Name Dept. Attorney ❑ Attorney Name Purchasing Check the ADDroDriate Item Tvne Professional Services Agreement LJ Contract E] Open Market Contract Amendment/Addendum ❑ Bid Opening [ Bid Award Quote Opening Quote Award Proposal Opening C/O & PCA No. I (final) Chg. Order, No. Traffic Control F Other: Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Pu se/Descri is Amount of Previous Amount All Submissions H Proposal ❑ Special Purchase, QPA Req. to Advertise Reject Bids/Quotes PCA ❑ Resolution Ease./Encroach Premium Concrete Services, Inc. ............. ........ . E] Yes[] If Yes, Approved by Purchasing Z No MBE Completed E-Verify Form Attached ❑ WBE 2019 Curb & Sidewalk Construction .......... 119-004 (Division D2) MVH ------------- 202.0619.431.31.06 Project Closeout For Chtt El Increase $ ..... ................ M Decrease $ 3,015.1 $ 42,124.00 Current Percent of Change: New Amount Total Percent of Change: Time Extension Amount: New Completion Date: Increase % Decrease 7.16%) $ 3. Increase % Decrease (7.16%) ❑ Title Sheet Yes [] No