HomeMy WebLinkAboutLong Term Occupancy Permit - 1130 South Bend Ave.1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
CITY OF SOUTH BEND TAMES MUELLER, MAYOR
BOARDU IC WORKS
March 10, 2020
Mr. Daniel D. Fitzgerald
5201 E. Terrace Dr.
Madison, WI 53718
RE: Long Term Occupancy Permit — 1130 South Bend Ave., South Bend, IN
Dear Mr. Fitzgerald:
PHONE 574/235-9251
FAX 574/235-9171
The Board of Public Works, at its meeting held on March 10, 2020, approved the Long Term Occupancy
Permit for the placement of a staging space to construct a new office building at 1130 South Bend Ave.
This permit will be valid from February 24, 2020 to September 1, 2020.
If you have any further questions regarding this matter, please call this office at (574) 235-9251.
Sincerely,
lAnda. M. Martin, Clerk
Enclosure
GARY A. GILOT ELIZABETH A. MARADIK THERESE J. DORAU JORDAN V. GATHERS JOSEPH R. MOLNAR
City of South Bend/Public Works
� OIITIJ 4 227 W. Jefferson Blvd
' South Bend, IN 46601
#_ Application and Permit
INS Long Term Occupancy of City Right -of -Way
Applicant: _ITITITITIT n Group
Horizononstructlo 2/14/2020Date:
Applicant Address: 5201 East Terrace Drive, Suite 300 Madison, WI 53718
Project Site Address: 1130 South Bend Ave. South Bend, IN
Note: Occupancy limited to street(s) immediately in front of construction site.
Nature and extent of Occupancy (e.g.: proposed construction activities, equipment proposed
to occupy public right-of-way, construction deliveries, etc.):
For staging area and to protect public safety while constructing new 4 story
-s 1 -tot-Tmm ' twe westofi�lie a . ..__ __.
Duration of Occupancy: 6.5 months
Signature of Applicant:
THE TERMS AND PROVISIONS OF CHAPTER 6, ARTICLE 5 and CHAPTER 18, ARTICLE 7, Sec 18-62 OF THE
SOUTH BEND MUNICIPAL CODE ARE INCORPORATED HEREIN IN THEIR ENTIRETY. FAILURE TO COMPLY
WITH THESE PROVISIONS SHALL RESULT IN CANCELLATON OF THIS PERMIT.
THIS PERMIT SHALL BE CONDITIONED UPON THE EXECUTION AND FILING WITH THE BOARD OF PUBLIC
WORKS OF A BOND IN AN AMOUNT APPROVED BY THE BOARD OF PUBLIC WORKS, CONDITIONED TO
INDEMNIFY, SAVE AND KEEP HARMLESS THE CITY OF SOUTH BEND, INDIANA, FROM ANY AND ALL LOSS,
EXPENSE, COST OR LIABILITY OF ANY KINDS WHATSOEVER WHICH THE CITY MAY SUFFER OR BE PUT TO
FROM OR BY REASON OF ANY ACT OR THING DONE OR NEGLECT TO BE DONE, OR BY VIRTUE OF THE
AUTHORITY GIVEN IN SUCH PERMIT.
TO BE COMPLETED BY CITY STAFF ONLY:
Bond/Fee Amount: $
Date Bond/Fee Filed:
Compliance with CH 6, ART 5 and CHI 8, ART 7, Sec 18-62 of the South Bend Municipal Code
Fee Paid
Date Issued: _ Issued By:ww
BOARD OF PUBLIC WORKS
h JI
President Mem
Member """'T Member
V 1.11.19
City of South Bend Public Works
J y.. Engineering Division
227 W. Jefferson, County City Building 1316
South Bend, IN 46601-1830
Phone: 574.235.9251
Email: rowpermitsoffice@southbendin.gov
TRAFFIC CONTROL AND OCCUPANCYREQUEST
"SUBMIT 5 WORKING DAYS MINIMUM PRIOR TO PROJECT START DATE
PLAN YOUR START DATE ACCORDINGLY TO AVOID DELAYS
Complete 1 - 5 In or1 ~ e submittals cannot be rac �seci° Ails Lwrnittais re uir W occftpanc�+ f�oncl and in�i Lan0! g
Parking Lane Travel Lane Full Road Closure Z Alley Sidewalk Treelawn
2 Excavation/Boring? > Requires Excavation Form Sidewalk? > Requires Sidewalk permit
New Approach? > Curb Cut application
Submission Date„ 2/17/2020 Applicant/Company: Horizon Construction Group
Name: Chad Gernand Email Address: c.gernand@horizondbm.com
Office Phone #: 414 ) 322-1146 Horizon Construction Grou cell X Contractor Performing Work: P
Chad Gernand (414) 322-1146 Office
3 On -Site Contact: Phone #: Cell X
Project STREET ADDRESS (eg: 110 W. Smith RD.): 1130 South Bend Ave. South Bend, IN
d To): from Corby to South Bend Ave.
Project Location (Block limits/Streets From an
Y
e
... __ ..,
**Requested Start &End 2/24i20-9/1/26 O' Requested Start & End Times: 8:00am-5:00pm
**Occupancy beyond 90 days" requires-completi n of Long Term Occupancy Request Application.
Reason for Closure: For„public ,safety and „for staging space to construct new office building on
property to west of north/south alley requested for closure
4 _... _... ..._.....-. —- __ ....... m .... ................
Affected Customers, None no properties will be affected
Contractors are responsible for resolving safety issues and access concerns with affected customers
ATTACH THE FOLLOWING ITEMS: 1. Traffic Control Plan 2. Detour Plan 3. Barricades, Signs, or Flashers Placement
(Refer to MUTCD for Traffic Control Device Requirements) See reverse for Checklist
Failure to use traffic control for traffic restrictions or closures will result in stop work orders and/or delay in permitting.
5 THIS OCCUPANCY PERMIT REQUEST IS NON -TRANSFERABLE AND A SIGNATURE SUBJECTS THE NAMED CONTRACTOR/PERMITTEE
TO ALL APPLICABLE RULES, DUTIES AND OBLIGATIONS IMPOSED BY THE CITY OF SOUTH BEND MUNICIPAL CODE AND TO ALL
REGULATIONS IMPOSED BY THE SOUTH BEND BOARD OF PUBLIC WORKS.
Applicant Signature
ENGINEERING OFFICE USE ONLY:
Approved Approved as Noted
Comments:
Date
Revise Not Approved
City of South Bend/Engineering
Authorized Signature
Date:
Versinn 3 3
2/17/2020
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i
BOARD OF PUBLIC WORKS
�r South Bend, Indiana
at
RIGHT-OF-WAY OCCUPANCY BOND
" BOND NO. PB00567400015
Know all Men These Presents, that: 5201 East Terrace Drive Suite 300, Madison, WI 53718
l jort�,r�n t onstruc tion Gr0gj .Jn S:.. _ Address, City, Zip
Contractor 608.354.0866
Phone Number
As Principal and One Bala Plaza Suite 100, Bala Cynwyd PA 19004
I �2aia�l l Naga It3d"pLi tymInssut tdtcc Cant aany Address, City, Zip
Insurance Agency 630.300.2457
Phone Number
as sureties do hereby bind themselves, their heirs, executors, administrator and assigns, jointly and severally, to the City of
South Bend (hereinafter "City") for the payment of Five Thousand Dollars ($5,000.00).
The condition of this obligation is such that if the above Contractor shall in every detail execute and complete all
work undertaken by him in the streets and alleys of said City and on the sidewalks and driveways located on private property
but connecting to the streets and alleys of said City to the satisfaction of the Board of Public Works (hereinafter `Board") and
according to the general and special specifications adopted by said Board for right-of-way occupancy.
Whenever occupancy of the public tight -of -way shall be granted under permits from said City, the contractor shall
complete his work in a workmanlike manner and shall covenant to restore the occupied right-of-way to a like or better
condition than existed prior to the permitted use upon conclusion of the approved occupancy.
When occupancy is undertaken in the public right-of-way, the contractor shall properly barricade and provide signage
throughout the entirety of the obstructed path in a manner approved by the Board.
The Contractor shall immediately, whenever called upon, correct any improper traffic control plan such that traffic is
diverted in a manner satisfactory to the Board and operates in the best interest of the public.
The Contractor shall conform to all standards enumerated in the City municipal code when erecting any barricades
and signage for public occupancy.
All resulting damages from bad workmanship in the occupied zone shall be removed and repaired in a timely manner
as determined by the Board or property owner.
Every property owner who has work done under private contract shall have a right of action on this bond.
All parties shall forever save said City harmless from any loss or liability incurred through his fault.
It is hereby agreed between said parties that this bond shall be independent of all licenses and permits granted by said
City and shall not be affected by the renewal, renovation, extension, suspension or expiration of such licenses and permits.
This bond shall obligate all of said parties in each and every case of work done, and shall continue to so obligate said
parties until a written release from the obligation herein assumed shall have been given by said City through its Board.
A request for release must be made to the Board at least thirty (30) days in advance of the expiration date.
A yearly Continuation Certificate must be provided to the Board on or before the expiration date.
In the event that said City shall extend time to the above bound principal or principals, for the performance of any
contract work, or shall alter any contract with said principal or principals, such extension or alteration shall not in any way
operate to release the sureties on this bond.
Dated this 2list da,yof February ,20-1L. wel
_.
Contractor Signature Printed Name of Person Signing
Ikuitlt9ft8a6rStawit"tt4Otl._..
Insurance Company Printed Name of Person Signing
Roxanne Jensen, Attorney -in -Fact
BOARD OF PUBLIC WORKS
South Bend, Indiana
RIGHT-OF-WAY OCCUPANCY BOND
This bond is to be signed in individual names of partners and by at least two resident freehold
sureties or by a Surety company.
15
PHILADELPHIA INDEMNITY INSURANCE COMPANY
One Bala Plaza, Suite 100
Bala Cynwyd, PA 19004-0950
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS: That PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and
existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint 1kiln Ltti,tp Sic %ristonher Illoydeo. KeIll Cath.,,1%_Ro, son ... I
j-plisgo-and Jr zal,"- rj nt AOXII 64 Services (:gpAigj its true and lawful Attorney -in -fact with full authority to execute on its behalf bonds,
undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company
thereby, in an amount not to exceed $15,L)64 .) �000 00,
This Power of Att(H ncy is granted and as sigiiod and sealed by facsimile undei and by the authority of the following Resolution adopted by the Board of Directors of
PHILADELPHIA IN01,MNITY INISURANCECOMPANY on the 14'h ol'NovVmber, 2016.
RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the
Company: (1) Appoint Attorney(s) in Fact and authorize the Attorncy(s) in Fact to
execute on behalf of the Company bonds and undertakings, contracts of indemnity and
other writings obligatory in the nature thereof and to attach the seal of the Company
thereto; and (2) to remove, at any time, any such Attorney -in -Fact and revoke the
authority given. And, be it
FURTHER
RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any
such Power of Attorney or certificate relating 11berelis by facsimile, and any such Power of
Attorney so executed and certified by facsimile signatures and facsimile seal shall be
valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached
IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT' TO BE SIGNED AND
ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 14"" DAY OF NOVEMBER, 2016
I 1i2 "I
(Seal) 1�5
Robert D O'Leary Jr,, President & CEO
Philadelphia Indemnity Insurance Company
On this 14"' day of November, 2016, before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said
that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY; that the seal affixed to said instrument is
the Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed
sea
Notary Public:
residing at:
(Notary Seal)
My commission expires:
1, Edwud Sayago, Corporate Sverciary ofP10LADE'LPHIA INDEMNITY INS(MANCE COMPANY, do licreby certify that the foregoing resolution of the Board of
Dawors and this PowvF orAttorncy issued puisinicit 1herclo on this 14o'day ol"Noveonber, 2016 are trice and correct and are still in full force and effect- I do further
certify that Robert D O'Leary Jr., who executed the Power ofAttomey as President, was on the date of execution of the attached Power of Attomey the duly elected
President of PHILADELPHIA INDEMNITY INSURANCE COMPANY,
In Testimony Whereof have subscribed my name and affixed the facsimile seal of each Company this LStday of RbaQ=" 03D
l it Edward Sayago, Corporate Secretary
PHILADELPHIA INDEMNITY INSURANCE COMPANY