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Home My WebLink AboutPCA - Fire Station No. 9 – Project No. 116-012 - Ziolkowski Construction, Inc.1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA46601-1830 r� 186 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARDOF PUBLIC WORKS February 25, 2020 Mr. Robert A. Bash Ziolkowski Construction, Inc. 4050 Ralph Jones Dr. South Bend, IN 46628 PHONE 574/235-9251 FAX 574/235-9171 RE: Project Completion Affidavit — Fire Station No. 9 — Project No. 116-012 Dear Mr. Bash: The Board of Public Works, at its meeting held on February 25, 2020, approved the Project Completion Affidavit for this project in the amount of $3,681,702.50. 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 ELIZABETH A. MARADIK THERESE J. DORAU JORDAN V. GATHERS JOSEPH R. MOLNAR CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME Fire Station #9 ••M .. ........ PROJECT NO 116-012 FINAL COST $3 681,702.50 CONTRACT SIGNED 3/13/2018 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Construction of new Fire Station #9 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. Execrated this 19th day of v er_ 2019 Ziolkowski Construction, Inc. 4�a� - ;,�v2ld Company Name Signature 4050 Ralph Jones Drive — F r , P?xgkdernt & (70 Company Address Printed Name South Bend,, IN, 46628 City, State, Zip WITNESSES& Before me, the undersigned Notary Public in and for said country and state, personally appeared RJI Faye, and acknowledged his/her signature to the above Project C=Public- - the 19th w�@a of V :,#fiber „ 201 9 ININGltate of Indianallotary S��taa��° M Commission Ex firesounty 25y p �11� rrew� Marti, 2025 Printed �nt�ant ed Name County of Residence Elkhart If the Contractor is a corporation, the following certificate will be executed. 1, R4.,)bert A. Bils1 certify that I am Secretary of the Corporation executing this release; that Bill Favors who signed this release on behalf of the contractor was then President of said Corporation; that said release was duly signed for and on bqhalfof said Corporatio b Au ority of it ve ning body, and is within the scope of corporate powers: ' ", r Secretary's Signature Printed Name AL DEPARTMENT OF PUBLIC WORKS APPROVAL. 0 This ro e tabI fo f 11 approval and we recommend to the Board of Public Works that it be Date: Constructi agr BOARD OF O LIC WORKS APPROVAL Date: z�l l *5 Zc d ()4 M1 4a:ry- �4,o V. . &, embe AA�lt, esident��. r Ehzabe6h A. Maradik, Member Therese J. Dorau, Member P', 9k .F� � ember •-Yinda M. Martin, Cl ZIOLKO 5KI Corwlrl«a *rll leltiar n, Inc. General Construction & Design/Build Building Strong Relationships Since 1974 FINIAL WAIVED OF LIEN State of Indiana, County of St Joseph, SS: Lynn D. Vining being duly sworn states that he is the Assistant Controller of Ziolkowski Construction, Inc. having contracted with Board of Public Works, City of South Bend, Indiana, to furnish certain material and/or labor for a project known as: Fire Station # 9 located at South Bend, IN and owned by City of South Bend, Indiana and does hereby further state on behalf of said Contractor that our construction lien rights against such property are hereby waived and released as noted: THIS WAIVER IS CONDITIONAL UPON PAYMENT OF $92,042.56 Then, UNCONDITIONAL for the full contract amount of $3,681,702.50 ZIOLKOWSKI Construction, Inc. By: _- , .wn+g Assistant Controller Lynu WITNESS MY HAND AND NOTARIAL SEAL this: 19,th day of November, 2019 Senn My commission expires January 28, 2023 Residing in St Joseph County, Indiana Wiest, Notary Public JENNIFER WIEST Notary Public, State of Indiana "« St. Joseph County SEAL Commission Commission N 663344 o,eiahs* MY Commission Expires Janus ory 28, 2023 CONSENT OF SURETY TO FINAL PAYMENT OWNER ARCHITECT AIA Document G707 CONTRACTOR (Instructions on reverse side) Bond No. 285057136 SURETY XOTHER TO OWNER: (Name and address) City of South Bend, Board of Public Works 1316 County -City Building South Bend, IN 46601 PROJECT: Fire Station No. 9 (Name and address) Project No. 116-012 ARCHITECT'S PROJECT NO: CONTRACT FOR: Fire Station No. 9 CONTRACT DATED: 3/13/2018 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address of Surety) Liberty Mutual Insurance Company 175 Berkeley Street, Boston, MA 02116 on bond of SURETY, (Insert name and address of Contractor) Ziolkowski Construction, Inc. 4050 Ralph Jones Drive, South Bend, IN 46628 ,CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of South Bend, Board of Public Works 1316 County -City Building, South Bend, IN 46601 OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: November 19, 2019 (Insert in writing the month followed by the numeric date and year.) Attest/ ltt'9e$S` J t1t4 K. Johnson Liberty Mutual Insurance Company (Surety) w. ignature of authorized representative) Adrienne C. Stevenson, Attorney -in -Fact (Printed name and title) AAA DOCUMENT 6707 rw CONSENT OF SURETY -to FINAL PAYMENT ww 1994 EDITION wr AIA 1594 ww THE AMERCAN INSTITUTE OF ARCH TECTS, 1715 NEW YORK AVENUE NW, WASH, INGTON, D,C 20005'-5292 ww wARNINGz ttnllconsod photocopying vloinlen U.S, copy- rlghl laws and Wil sublmel the vlotalor to 10901 pronoCaatNoo. G707-1994 State of GA County of Fulton ss: On November 19, 2019 ' before me, a Notary Public in and for said County and State, residing therein, duly commissioned and sworn, personally appeared Adrienne C. Stevenson known to me to be Attorney -in -Fact of Liberty Mutual Insurance Company the corporation described in and that executed the within and foregoing instrument, and known to me tmi be the person who executed the said instrument in behalf of the said corporation, and he duly acknowledged to, me that such corporation executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and year stated in this certificate above. My Commission Expires 8/23/2021 Maria Concbpcion Notary Public This Power of Attorney limits the acts of those named herein, and they have no authority to Liberty bind the Company except in the manner and to the extent fierain stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company Certificate No RP111196-969189 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALI. PERSONS By fHESF PRESENTS: That The Ohio Casually Insom,"ce Company is a corpolation duly orgalarzord under the laws of Ole State of Now ilampshire, that Liberty Mutual insurance Company is a corporation duly Organized under The laws of the State of Massachusetts and West Am can insurance COAl ts a corporation duly organized under the laws of the State of Indiana lheraln collectively called the *Comparties'), pursuant to and by authol herain set lorth, does hereby name constiliNte and Appoint, 1) Anti Adre Ll,�c C Sl,_ 11501 wir; I the CAY —01 — ----- execute, seat, a6nowfedq�_ard _d*$r, for and"Wrls; behalf iis_s7taTy —and is —Itban one Its t"M act and deed, any and all undertakings, bonds, recognizences and other surety obligations, in pursuance' of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Aficimey has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 3rd day of May . 2019 . N, ItIstv oy 11qS& INS 9 Liberty Mutual Insurance Company .,V The Ohio Casualty Insurance Company — v West Amal Insurance Company 1912 0,19191991 r) / 1,e By: Slate of PENNSYLVANIA County of MONTGOMERY ss 1UN a) � On One 3rd day of l 2019 befOrO ale Personally appearad'David lfllf, Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance ca -- Company„The bilive Casuatly Corripany, and —ftal Ainerican Insurance Company, and that ha, as such, being authorized so to do, execute the foregoing instrument for the purposes therein conWnisd by signing on behalf of the c0fPciations by himself as a duty authorized officer. or lea 0 02 4) 0) M CIO 0'a E t $i �? 12 WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written OPMMONweA EN LTNIN0FPNS,VLvl 1, Notal Seal Pall, CAATY F, L TOOM sfa N ",(: fil MeikovTov My Comm St. an E By: rOv V', " Power of Attornary, is made and executed Pursuant 10 and by Authority Of 1110 following By-laws and Authenizations of The Ohio Casuatty Insurance Comparty, Liberty mutual Oat',e Company, and West American liulwarice Company which T030olnins are now In full force and effect reading as lotDill ARTICLE IV - OFFICERS: Section 12, Power of Attorney, Any officer or other official, of ft Cerporall authorized for that purpose, in ivil by the Chairman of Ole Prieslidern, and sillill to such Irmitaten as the Chairman or via President may prescribe, shall appoint such as may be necessary to act in behalf of title Corporation to make, execute, seat, acknowledge and deliver as surety any and all undertakings, bonds, reciagnizances and other surety Obligations, Stich, attorneys-in4acl, subject to the Ilmulathons set forth in their respective powers of attorney, shalt have fail plower to blind the Corporaldovl by their signature and execution of any such mrshlartaInIs and to alfach thereto The seal of the Corporation, When so executed, sucli instruments shall be as binding as it signed by the President and attested to by the Sol Any power ot authority granted to any representative or aftorroy-40acl under file PlOvW01115 of this arliefe may bo revoked at anytime by the Board, the algirfill the President or by the officer at officers granting such power or auftfity. ARTICLE X111 - Execution of Contrail Section 5. Surety Bonds and Undertakings, Any officer at the Company authorized for that purpose in Writing by file chairman or the Presidont, and subject to such finlitafiDrs as the chainpran or vie president may prescribe, shall appoint such attorneys -In -fact, as may be necessary to act in behalf of the Company to make, exeoite, seal, acknowledge and deliver as surety ally slid 0 undoidaklags,1 bonds, recogriftances and other innely obligations. Such attonloys,ki-Jecl subject 10 die hatitalions Sol forth in their resPoclilivOl' powers Of Attorney, ShAtIf have full power to bind the Company by their signature and execution of any such instruments and to attach thal the seat of the Company When So exenited such Instruments shelf he as binding as it signed by The president and aftesled by The secretary, Certificate of Dosignalion - The President of the Company, acting pursuant to the Bylaws of the COMprifly, Authorizes David M. Carey, Assistant Secretary to appoint such ahomays-in- (act as MAY be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obltifolions, a Authorization - By unanimous consent at the Company's Board of Directors, the Company consents that layshnfle or mechanically reproduced signature of any assistant secretary of the Company wherever applearil" upon a caviled copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the some force and effect as though manually affixed. 1, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, avid West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked, IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 19th day of November , 2019 INS 11 fog N -,l WNau X 10 1 91 1919 1991 1 — CHU VA. V, By: 'Renee ,-��Y, s.7,�.nFg_cretary LMS-12873 LMIC l WAIC Multi Co062010 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 02/14/2020 �....._........._ Name Tov Villa �J Department Engi:neerin BPW Date 2/25/2020 Phone Extension 5920 R irAod Prior to Submittal to Board BPW Attorney E] Attorney Name Dept. Attorney EJ Attorney Name Purchasing ❑ Check the Appropriate Item l' "-_ Professional Services Agreement ❑ Contract El Open Market Contract ❑ Amendment/Addendum ] Bid Opening ❑ Bid Award Quote Opening El Quote Award [] Proposal Opening ❑ C/O & PCA No. I (final) R 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 qd.,16r All Submissions Required Information LJ Proposal Special Purchase, QPA Req. to Advertise F] Reject Bids/Quotes ® PCA ❑ Resolution Ease./Encroach ❑ Title Sheet Ziolkowski Construction, Inc. ............. ...___ __ ..... Yes If Yes, Approved by Purchasing Z No WBECompleted E-Verify Form Attached Nos Fire Station #9 _...... .__.... _............... 116-012 2018 Fire Station #9 Capital . 451.0901.422.42.02 _ M ...................... .............._....._..� $3,681,702.50 Project Closeout For "h ,nge_Orders Ot Amount of 1-1 Increase $ El Decrease $ Previous Amount $ .................. Increase % Current Percent of Change: Decrease (%) New Amount $ Increase % Total Percent of Change: Decrease%) Time Extension Amount: New Completion Date: