HomeMy WebLinkAboutChange Order No 1 & PCA - 2019 Community Crossings, Div.1, 2, 3, and 4 Proj No. 119-015 - Walsh & Kelly, Inc.1316 COUNTY -CITY BUILDING
PHONE 574/ 235-9251
227 W. JEFFERSON BOULEVARD
Pf, Ark."a
FAX 574/ 235-9171
SOI JTH BEND_ INDIANA 46601-1 930 ��
l
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARDOF PUBLIC WORKS
January 14, 2020
Mr. Dustin Hilary
Walsh & Kelly, Inc.
24358 State Road 23
South Bend, IN 46614
RE: Change Order No. 1 (Final)/Project Completion Affidavit for 2019 Community Crossings,
Div.1, 2, 3, and 4 —Project No. 119-015
Dear Mr. Hilary:
The Board of Public Works, at its meeting held on January 14, 2020, approved the Final Change
Order for this project, for a decrease of $30,093.62. The new Contract sum is $1,076,412.33.
In addition, the Project Completion Affidavit for this project was approved in the amount of
$1,076,412.33.
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 ELIZABETH A. MARADIK THERESE J. DORAU JORDAN V. GATHERS JOSEPH R. MOLNAR
CITY OF SOUTH BEND INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE: 12/2/2019
PROJECT NO: 119-015
2019 Community Crossing (Divl-Corby, Div2-Jefferson, Div3-
PROJECT NAME: Linden, Div4-Riverside
CONTRACT DATE: 6/11/2019
CHANGE ORDER NO: 1 Final
SUBJECT OF CHANGE ORDER: PCR #1-Adjustment to Final Quantities.
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 bar this change order
New completion g1a4�me
etbir Signature
in Hilary
South Bend Area Vice President,
Printed Name and Title
Walsh & Kelly, Inc.
Company Name
24358 SR 23
Address
South Bend,IN 46614
City, State, Zip
6
SEA
$
1,106,505.95
$
0.00
$
1,106,505.95
HIncreased
X Decreased $
30,093.62
$
1,076,412.33
-2.72 %
-2.72 %
9/30/2019
0 days
0 days
9/30/2019
RECOMMENDED FOR APPRQYAL
LL
CONSTRU,, MANAGER I" —
CITY OF SOUTH BEND
BOARD OF PUBLIC WORKS
Approved Date: l�/ -
A. Gilo ,President
ber
Elizabeth A. Maradik, Member
�uu var yA„q
CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS.
PROJECT COMPLETION AFFIDAVIT P`
PROJECT NAME 2019 Community Crossing Div1-Corti , Div2-Jefferson, Div3-Linden, Div4-Riverside)
PROJECT NO 119-015 FINAL COST $1,076,412.33
CONTRACT SIGNED 6/11/2019 MAINTENANCE AGREEMENT ENDS
Work to be performed shall include milling and resurfacing HMA surface pavement, pavement
PROJECT DESCRIPTION strip in, s and markings, and replacing cross ramps along these roadways.
_.W __...... ..-......... u
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, an hat the contractor performed the work within the scope of the Specifications and Standards of the City
of South Bend wnrere a part of the above Contract.
xecuted i� �- d F ��� 2019 _Walsh & Kelly, Inc.
„ Company Name
r91 24358 SR 23
rs Ill Z. Company Address
Printed Name South Bend„IN 46614
.....................
City, State, Zip
WITNESSES:.
Before tmethe undersigned Notary Public in and for said country and state, personally appeared
y and acknowledged his/her signature t tar oirs Go etion Affidavit on
v rsum OV91n"'Oft. �
^ALISHA KRwfE�[
the day o'f 201 9 I { r a
', Y Public, State of Ind3�=-�
Note y" � rtatuee L," Si rJi raieoii Cro fr'�u .ail.
A
g "�4 ., ssi�a pir s , a Jm°
Allsha Krueger
5, 2022
Printed Name County of Residence St. Joseph
If the Contractor is a corporation, the following certificate will be executed.
I, J. Michael Schaum certify that I am Secretary of the Corporation executing this release; that
Mtn Lujim who signed than release
rbehalf
lsi othe
contractor
wa �" tf lNl
l
of said Corporation° that said release was duy signed��
Corpo dhorit overning�body„ and is within the scope of corporate powers:
Secreta sjSiginature "
"
J. " to Sell
W vie" Schatun '
Printed Name
DEPARTMENT OF PUBLIC WORKS APPROVAL 1'
This project acceptable fit" f'al approval and we recommend to the Board of Public Works that it be orda}r 111, %
Date: JS
Constructio ages
BOAR
D P ILIC WORKS APPROVAL! Date:�� �o
f
Gary pv M f Ella e h A. Mara ik„ Member
Ga A. Gilot, President a
Therese J. D dyed, MerhberTo pil e I y9L4i...,' itrda M. Martin, Clerk
ww I,V ICIa a'Surety O + 908.903.3485
202B Halls Mill Road, PO Box 1650 F + 908.903.3656
Whitehouse Station, M 08889-1650
Federal Insurance Company
Maintenance Bond BondNo.MNT 8258-53-06 Amount$107,641.23
Rnow All Men By These Presents,
That we,
Walsh & Kelly, Inc.
24358 State Road 23
South Bend, IN 46614
(hereinafter called the Principal), as Principal, and the FEDERAL INSURANCE COMPANY, a corporation duly organized
under the laws of the State of Indiana, (hereinunder called the Surety), as Surety, are held and firmly bound unto
Board of Public Works, City of South Bend, Indiana
1316 City -County Building
South Bend, IN 46601
One Hundred Seven Thousand Six Hundred Forty One
(hereinafter called the Obligee), in the amount of Dollars and 23/100 ($107,641.23 ),
for the payment of which we, the said Principal and the said Surety, bind ourselves, our heirs, Sealed with our seals
and dated this 20th day of December, 2019.
WHEREAS, the said Principal has entered into a contract dated June 11 , 2019
for: 2019 Community Crossings (Divl-Corby, Div2-Jefferson, Div3-Linden, Div4-Riverside) - Project 119-015
And
20'19 Community Crossings (Div1-Corby, Div2-Jefferson, Div3-Linden, Div4-
WHEREAS, the said Principal is required to guarantee the tkiv+ersWe) - Project 119-015
installed under said contract, against defects in materials or worlananship, which may develop during the
period December 3, 2019 to December 3, 2022 ,
Form 15.02.0075FED Oleo 5/17)
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal shall faithfully carry out and
perform the said guarantee, and shall, on due notice, repair and make good at its own expense any and all defects in materials
or woknnanship in the said work which may develop during the period December 3, 2019 to December 3, 2022 .
or shall pay over, or make good and reimburse to the said Obligee all loss and damage which said Obligee may sustain
by reason or default of said Principal so to do, then this obligation shall be null and void; otherwise shall remain in full
force and effect.
Walsh & Kelly,
By
bawdbusdn Hilary, VP of South Bend Area *`
IAN
Federal Insurance Company
.By iV4411
Att6me 1n• ,act
Kathryn R. Postma
Form *02 0075RD (Rv. 5117)
CHUBBe
Power of Attorney
Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company
Westchester Fire Insurance Company I ACE American Insurance Company
Know All by These Presents, that FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, PACIFIC INDEMNITY
COMPANY, a Wisconsin corporation, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY corporations of the Commonwealth of
Pennsylvania, do each hereby constitute and appoint Kathryn R. Postma
Surety Bond Number. MNT8258-53-06
Obligee: Board of Public Works, City of South Bend, Indiana
each as their` true and tawful Attorney -in -Fact to execute under such designation In their names and to affix their corporate seals to and deliver for avid on their behalf as surety
tiaereott or otherwise, bonds and undertakings and other writings obligatory In tire stature thereof (other than ball bonds) given or executed In the course of business, and any
instruments amending or altering the same, and consents to the modification or alteration of any instrument' referred to in said bond's or obligations.
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY
and ACE AMERICAN INSURANCE COMPANY have each executed and attested these presents and affixed their corporate seals on this 1-t day of November, 2019.
Dawn M. Chloros, Assistant Secretary
(0 0 ID;
Yfraaa.a`�
STATE OF NEW JERSEY
County of Hunterdon
-... - --- -&X J&X-,
Stephen M. Haney, Vice President
,y1, c a e wauu
On this tat day of November, 2019, before me, a Notary Public of New Jersey, personally came Dawn M. Chloros and Stephen M. Haney, to me known to be Assistant Secretary and
Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY
and ACE AMERICAN INSURANCE COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros and Stephen M. Haney, being by me duly
sworn, severally and each for herself and himself did depose and say that they are Assistant Secretary and Vice President respectively, of FEDERAL INSURANCE COMPANY,
VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and know the
corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that their
signatures as such officers were duly affixed and subscribed by like authority.
Notarial Seal
K^THEMNE J. AoeAAR
NOTARY FuDuc or NEW JRR✓ y
f"tfOl lC
J a
No. 231606
Qaartsrtlp111 ttR*W.pry 16. 2024 FirMa Ra ,tc
CERTIFICATION
Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016;
WESTCHESTER FIRE INSURANCE COMPANY on December 11, 2006; and ACE AMERICAN INSURANCE COMPANY on March 20, 2009:
'RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, recognizances, contracts and other written commitments of the Company
entered Into In the ordinary course ofbuslness (each a'Written Commitment"):
(1) Each of the Chairman, the President and the Vice Presidents of the Company Is hereby authorized to execute any Written Commitment for and on behalf of the Company, under the
seal of the Company or otherwise.
(2) Each duly appointed attorney-in-factofthe Company is hereby authorized to execute any Wrl ften Commitment for and on behalf of the Company, under the seal ofthe Company or otherwise,
to the extent that such action Is authorized by the grant of powers provided for In such person.'s written appointment as such attorney -in -fact.
(3) Each of the Chalrmam, the Presldent and the Vice Prostdents of the CompanyIs hereby authorized,for and on behalf 'oftheCompany, toappoint Inwrlting any person rho onDenny-m-
faax of the Company with full power and authority to execute, for and onbohaif of tho C.omparwy, under the seal or the Comparty or otherwise„ such Written ComntRmvnn of the
Company as may be specified In such written appointment, which specification may be by general type or class of Written Commitments or by specification of one or more particular
Written Commitments.
(4) Each of the Chatroun, the President and the Vivo Presidents of the Company is herebyaathorlu4 for and on behalf of the Company„ to delegate in Writing to any other officer of the
Company the authority to execute, for and on behalf or the Compa ty, under the Company's seal or othorwive such Written Commkolonts of the Contpany as are specified in such
written delegation, which specification may be by general type or class of Written Commitment; or by specification alone ormom pardsular Written t aanno tmonts,
(5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, may be affixed by
facsimile on such Written Cmmmil anent or writtmsappofntment or delegation.
FORTUER RESOLVED, that the foregoing Resolution shall not be deemed to bean en.luxlvextammentof the powers and authority of officers, employees and other persons to act for and on behalf of the
Company, andsuch Resolution shall not limit or otherwise affect the oxvrtive of any such power or authority otherwise validly granted or vested!
I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE
COMPANY and ACE AMERICAN INSURANCE COMPANY (the "Companies") do hereby certify that
(1) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect,
(11) the foregoing Power of Attorney is true, correct and in full force and effect
Given tinder tray hand and se:of said Companies at Whitehouse Station, NJ, this December 20, 2019.
wewar
w
MLOUBC
a Dawn M. Chloros, Assistant Secretary
,k tetTtIE%VWff,'YOU WISn TO Vbit.I" TFMAU`niFN TICr Y OF,rniS BOND OR NOTIFY OS OF ANY OTBER
feleiahono 909E 3: 2i91 Feat "i09.903- 3656 o•znallaazure
r r:
C6roNne&FE1DAAG3 alwh l
" -
tTiw.'t1-19)
�
r
Final Waiver of Lien
State of Indiana, County of St. Jose SS:
Dustin Hilary being duly sworn that he/she Is the South Bend Area Vice President
(Name of Officer) (Title)
of mm Walsh & Kelly Inc. rn having contracted with mm City of South Bend, Indiana
(Contractor) (Owner)
to famish certain materials and/or labor as follows- oqc te and StripAiq
Asphalt Pavin
(Description)
for a project known as 2019 Comrwni!y m�r D4
(Name of Project)
located at Corby, Jefferson, Linden and Riverside throughout the City of out Bend
and owned by _qty of poi Lt!,j..pfrid, Indiana
(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 acknowledged; or
El 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 kom the contractor Is the sum of
. . . . ............. __ ------- ____ ........... . .....
E] receipt of which Is hereby acknowledged; or
El 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 Owner of said promises, any and all liens or claims whatsoever
on the above -described property and improvements thereon as account of labor or material or both, ftimished b the undersigned
(hereto, subject to limitations or conditions mpres ;and further certified Ilia" (leer party, , any claim orright to a
lien on account of any work performed or mate veraigned for said prKJicct and w119 io scope of this Affidavit
and Waiver of Lien >Y
Walsh & Kelly Inc POR,4
-----------
(Authorized Represcatative)
STATE OF INDIANA n Hilary, South Bend Area Vice President
SEAL
SS:
% ..... . ....
ST. JOSEPH COUNTY 00
Before me, the undersigned, a Notary I I I D*0(0 -ounty and State, personally appeared Dustin Hilar
A� IMMI ttoalver of Lion.
%pool'
and acknowledged the execution of the foregoing
IN WITNE'SS WITEREOF, I have 1wrounto subscribed my name and affixed my of I on the 1 8th day of
Decernber 200 19
�ohtry ublic, Signature
My Commission Expires: June 07, 2023
Ate Elizabeth furinu Staff Accountant
Residing to .,Marshiall County, _1pd1ana-_-__
44 fURMN
te of 46aoa
Saar;* ?, 2023
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 01/07/2020
Department
Name ...... _Toy Villa _ Engineeringµ„
BPW Date 01/14/2020 Phone Extension 5920
Required Prior to Submittal to Board
BPW Attorney ❑ Attorney Name
Dept. Attorney ❑ Attorney Name
Purchasing E] Michael Schmidt
Check theAI)propriate Item
LJ Professional Services Agreement Lj Contract
F Open Market Contract
El Amendment/Addendum
Fj Bid Opening
F-j Bid Award
Quote Opening
❑, Quote Award
E] Proposal Opening
® C/O & PCA No. 1 final
❑ 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
�r All Submissions
Proposal
Special Purchase, QPA
❑I, Req. to Advertise
Ej Reject Bids/Quotes
F-j PCA
Resolution
Ease./Encroach
❑ Title Sheet
Walsh & Kelly
[:] Yes[:] If Yes, Approved by Purchasing
Fj No
MBE Completed E-Verify Form Attached El No
WBE
2019 Community Crossings
119-015
.. _ ...._ _........... .......
Local Road.
and Bridge Grant
265.0608.431.36.10
Unit Price
Closeout
For Change Orders Oitl;
Amount of ❑ Increase $
Decrease 93 62
Previous Amount ® $ 1,106,505.950
..... ......... .........
Increase 0.0%
Current Percent of Change
New Amount
Total Percent of Change:
Time Extension Amount:
Decrease (2.72%
$ 1,076,412.33
Increase 0.3%
Decrease (2.72%
New Com letion Date:
.__......� ..._....... ...-.......................... ........................ .. .......