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Home My WebLink AboutChange Order No 1 & PCA - Notre Dame Ave. Accessible Pedestrian Signals Proj No. 119-090 - Michiana Contracting, Inc.1316 COUNTY -CITY BUILDING �� ra�� " PRONE 574/ 235-9251 227 W. JEFFERSON BOULEVARD 4 ��' �j FAX 574/ 235-9171 SOIITHBEND. INDIANA46601-1930 �� r v CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS February 11, 2020 Mr. Scott Kirkpatrick Michiana Contracting, Inc. 7843 Lilac Rd. Plymouth, IN 46563 RE: Change Order No. 1 (Final)/Project Completion Affidavit - Notre Dame Ave. Accessible Pedestrian Signals —Project No. 119-090 Dear Mr. Kirkpatrick: The Board of Public Works, at its meeting held on February 11, 2020, approved the Final Change Order for this project, for a decrease of $1,137.50. The new Contract amount is $15,200. In addition, the Project Completion Affidavit for this project was approved in the amount of $15,200. 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 i DEPARTMENT OF PUBLIC WORKS�tin PROJECT CHANGE ORDER ly DATE: 12/1 8/2019 PROJECT NO: 119-090 PROJECT NAME: Notre Dame Ave, APS CONTRACT DATE: 10/' /2019 CHANGE ORDER NO: j __ Fined 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 $ 16337.50 Net change by previously authorized change orders $ 0.00 The contract sum prior to this change order $ 16,337.50 By this Change Order, the project amount is Increased 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 Scott •. d «�Min - * and Title lichiana Contractin , lnc Company Name 763 Lilac Road Address FAN mouth IN 46563 City, State, Zip Decreased $ 1 137.50 $ 15 200,00 -6.t6 % -6.96 % 11/22/2019 0.11/22/2019 r EOR AEMQYAL / CITY OF SOUTH BEND BOARD OF PUBLIC 1i0 IS Approved Date:m,i'o Gary A. olot, president V. TW-" ember ......................... Elizabeth A. Maradik, Member CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT; PROJECT NAME Notre Dame Ave. APS PROJECT NO 119-090 FINAL COST $15 200.00 CONTRACT SIGNED 10/8,12019 MAINTENANCE AGREEMENT ENDS Installation of APS (Accessible Pedestrian Signals) system at the intersection of Angela Blvd, PROJECT DESCRIPTION and Notre Dame Ave„ 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 17th d of January , 20X 20 Michiana Contracting, Inc Company Name Sibnature 7843 Lilac Road Scott Kirkpatrick Company Address Printed Name Plymouth, IN 46563 City, State, Zip WITNESSES: Before me, the undersigned Notary Public in and for said country and state, personally appeared Scott Kirkpatrick _ and acknowledged his/her signature to the above Project Completion Affidavit on the 17t d7 of an gnu, 20�C 20 ANDREA JAE FISHER _ .. Notary Public - Seal of Indiana Nry i nat M Commission Expires "�: " Stata Mar 27 2022 (�. g Y P ��f,�� y mission Expiresa M Com ✓ �:mr�mrdV�mg,�ii�� 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 Kirkpatrick who signed this release on behalf of the contractor was then ftPresident of said Corporation; that said release was duly signed for and on behalf of said n ;Authority of its governing body, and Is within the scope of corporate powers: Sacretary's Signature Corporate Seal Lisa Botto Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acc=,Approval and we recommend to the Board of Public Works that it be ordained so. Date, Zv Construotlo Wpager BOARD OF PUBLICWORKS APPROVAL Date: Gay A. Gllot resident -30 111 V• ��emb er Elizabeth A Maradlk; Member a R• o� bm r -Unda M. Martin, Clerk Final Waiver of Lien State oflndiana, County of Marshall mm SS: Scott Kirkpatrick being duly sworn that he/she is the President (Name ofOfllner) (Title) of Michiana Contracting, Inc. having contracted with Department of Public Works (Contractor) (Owner) to furnish certain materials and/or labor as follows; Accessible Pedestrian Signals (Dasorrlpdoa) for a project Imown as Notre Dame Ave. APS (Name ofprojeco City of South Bend India located et �, aan�..�„�_....��_....�.. ,. and owned by 9LtY of South Bend Indiana and does hex+eby hurther state on the behalf of the aforementioned subconttactor/supplier: (PARTIAL WAIVER) that there is due from the Contractor the awn of Dollars �fS ) ❑ rcoelpt 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 amounk and which waiver shall be effective only upon recelpt of payment thereof by the undersigned; (FINAL WAIVHM that the final balance due from the contractor Is the suns of Fifteen Thousand Two Hundred Dollars _ _ g f S 2tlil.l 0 ❑ receipt of which is hereby acknowledged; or ® thopayment of whicb has been promised as the sole consideration fbrtbis Affidavit and Final Waiver of Lien which shall bcoome effeohve oniyupon receipt of such payment. THBREFORE,, tho undersigned valves and Wesses unto the owner of sold promises, any and all items or claims whatsoever on the obovawdascribed property and improvements thereon on account of labor or ,material orbotb, Arrnished b the undersigned thereto, subject to limitations or conditions expressed havolo, if any; and f mhar certified that no other party has any claim orri t to n lies on account of any wo is performed or material tUrnlshed to the undersigned for saWanzew,this the scope oftbia , efidavit and Waiver ofLien Michiana Contractin Inc. I3y (Firm) e,pr>esentative) STATE OF INDIANA ) SS: 929M$XXV�W Marshall ) Before me, the undersigned, a Notary Public, In and for said County and. Slate, ,person lly appeared n Scott f�tr trl k and acknowledged the execution oftho foregoing Affidavit and Waiver of Lien. IN WITNESS WHMOF,1 have hereunto subscribed my name and at'lixed sly offi hd a Ion the tha day of January 7SQtDC 2020 / �,... • otary I'tr lie Sign My Commission Expires; �"�� )� � ,� Residing in Marshall_ County, Nndlana Notaulr Public Name ANDREA JAE FISHER Notary Public - Seal State of Indiana Marshalt County My Commission Expires Mar 27, 2022 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date Name 01/28/2020 Department Engineering BPW Date 2/11/2020 Phone Extension 5920 �._...._ ._ ... IT _,�,uired Prior to Submittal to Board BPW Attorney ❑ Attorney Name Villa Dept. Attorney 11 Attorney Name Purchasing c heck the Ap o ?riat Item T rcel�c�rw i El Professional Services Agreement Contract Open Market Contract Amendment/Addendum Bid Opening [ Bid Award ❑ Quote Opening Quote Award ❑ Proposal Opening ® C/O & PCA No. 1 final ❑ Chg. Order, No. ❑ Traffic Control EJ.2t—her--..--. Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract N! g§e/Descn�Li( Amount of ❑ Previous Amount Current Percent of Change New Amount Total Percent of Change: Time Extension Amount: New Completion Date: Information All Submissions H Proposal El Special Purchase, QPA Req. to Advertise ❑ Reject Bids/Quotes PCA Resolution Easew/Encroach Michiana Contractin Inca Yes If Yes, Approved by Purchasing ® No ❑ MBE Completed E-Verify Form Attached WBE Notre Dame Ave. APS 119-090 ....... ........ .. .....-._....�. _ Traffic Si nal Maintenance 251.0608.431.36.67 Prpiect Closeout For ChanChann Orders Increase $ 137 Decrease .50 $ 16,337.50 � WWWWWWWWW Increase % _ Decrease (6.96%) $ 15,200.00 Increase % (6.96% WW Decrease .. ) ❑ Title Sheet El Yes No