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Home My WebLink AboutPCA - VPA Restroom Remodeling Proj No. 118-043R - Michiana Contracting, Inc.1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD �� 1" A K SO] JTH BFND_ INDIANA 46601-1 930 r` `tit 94 ._w.. 144r CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARDU LIC WORKS December 19, 2019 Mr. Scott Kirkpatrick Michiana Contracting, Inc. 7843 Lilac Rd. PO Box 929 Plymouth, IN 46563 PHONE 574/235-9251 FAx 574/235-9171 RE: Project Completion Affidavit — VPA Restroom Remodeling — Project No. 118- 043R Dear Mr. Kirkpatrick: The Board of Public Works, at its meeting held on December 19, 2019, approved the Project Completion Affidavit for this project in the amount of $529,308.82. 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 �nra a ep aq v, CITY OF SOUTH BEND, INDIANA, BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT d " PROJECT NAME VPA Restroom Remodeling PROJECT NO 118-043R FINAL COST $529,308.82 CONTRACT SIGNED 1/22/2019 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Renovate 11 VPA Park restroom facilities 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. Execu ed this 27th day ofNovember , 2019 Michiana C ntractin Inc. Company Name Signature 7843 Lilac Rd. PO Box 929 W Company Address Printed Name Plymouth, IN 46563 City, State, Zip WITNESSES& Before me, the undersigned Notary Public in and for said country and state, Scott it atrick and acknowledged his/her signature to the above Pr ect Comp1A fjlp� ltSbfiR the t ay of No c j r 2019 Notary Public - Seal State of Indiana �' Marshall County lit ry Signature My Commission Expires to sio es Mar 27, 2022 Andrea Fisher Printed Name County of Residence Marshall If the Contractor is a corporation, the following certificate will be executed. I Lisa Botto certify that I am Secretary of the Corporation executing this release; that Scott it patri.c' who signed this release on behalf of the contractor was then President of said Corporation; that said release was duly signed for and on behalf of said ratdor by Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Corporate Seal Lisa Botto Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for, fin approval and we recommend to the Board of Public Works that it be ordained so. Date: Construction ger BOARD OF PUBLIC WORKS APPROVAL Date: l" e, o!0I 4ary—IkAlot, President Genevi ft E, Mifleru ljz4aeWth A. Maradik, Member "Member A ura O'Sull'ivari—Member � ClAda M. Martin, Final Waiver of Lien State ofhAana, County of --MaLShaLL-- SS: tt -X�irk )a trick L_ being duly sworn that he/she is the President (Name of Officer)- (Title) Of having contracted with City of South Bend (Contractor) (Owner) to furnish certain materials and/or labor as follows-, Renovate 11 VPA Park Restroom Facilities ......... . . (Description) for a project known as located at and owned by VPA Restroom Remodeling (Name of Project) .-S-QjLth. Bend IN QiLLoLf 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 D receipt of which is hereby acknowledged; or El the payment of which has been promised as the sole consideration for this Affidavit and Final "Via alver 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 0,320.53 El receipt ofwhich is hereby acknowledged; or XEI the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become efreadve only upon re celpi of such paymant. THEREFORE, the undersigned waives and releases unto the Owner of said promises, any and all liens or claims whatsoever on the above -described property and improvements thereon an account of labor of 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 lion on account of any work performed or material furnished to the undersigned for said project, and wlthl the scope of this Affidavit and Waiver of'Llen. By (Firm) Author] d suntativa) STATE OF INDIANA Marshiill SS: X"AX,)U&- hCOUNTY Deforame, the undersigned, a Notary Public, hi and for said County and State, personally ppeared Andrea Fisher and aoIcnowledged the execution of the foregoing Affidavit and Waiver of Lim, . . . . ..... IN ATrNESS WHEREOF, I have hereunto subscribed name and affixed iriyofffic on y of Nox�-- X19 2019, 1 P blic Signature My Commission Expires: March 27. 2022 Andrea . hor e — ?A I Residingin County, F3, I , 4 9MVIEA JAE FISHER Notary Public - Seal State of Indiana Marshall County My Commission Ex$)ires Mar 27, 2022 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 12/10/2019 Department Name .................Ty Villa Enineerin _o.................................... BPW Date 1 Z • I q . % ok Phone Extension 5920 Run Required Prior to Submittal to Board BPW Attorney ❑ Attorney Name Dept. Attorney 0 Attorney Name Purchasing [: Check the A p p tit Item ] , E] Professional Services Agreement ❑ Contract [� Open Market Contract ❑ Amendment/Addendum ❑ Bid Opening ❑ Bid Award ❑ Quote Opening F] 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 Vclal`w-All Submissions Information H Proposal E] Special Purchase, QPA Req. to Advertise ❑ Reject Bids/Quotes ® PCA F-1 Resolution Ease./Encroach ❑ Title Sheet Michiana Cantr�acti�, Inc.:....._...... ❑, Yes If Yes, Approved by Purchasing No ❑ MBE Completed E-Verify Form Attached Yes ❑ WBE F-1 No VPA Restroom Remodeli�ag, 118-043R __-------- ................... .._........ �.. 471.113 8.452.42.01 Parks Bond I ................................ $529,308.82 Proiect Closeout For Change Orders Qnly Amount of Increase $ .. wwwwwwww . ......:......... .....mm .. Decrease ($ ) Previous Amount $ Increase % IT�ITmmmm mmmITIT�� ._. ....................... ..................... Current Percent of Change: Decrease Q %) New Amount $ Increase % .._ Total Percent of Change: Decrease ........... ( %) Time Extension Amount: New Completion Date: . ...................... ..-..-._........................... ..............