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Home My WebLink AboutPCA - West Side Quiet Zone Commercial Drive Relocation Proj No. 120-011 - Ritschard Bros., Inc.1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS October 27, 2020 Ms. Rachelle L. Dolniak Ritschard Bros., Inc. 1204 W. Sample St. South Bend, IN 46619 rit 1204&datacruz. com PHoNE 574/235-9251 FAx 574/235-9171 RE: Project Completion Affidavit — West Side Quiet Zone — Commercial Drive Relocation Project No. 120-011 Dear Ms. Dolniak: The Board of Public Works, at its meeting held on October 27, 2020, approved the Project Completion Affidavit for this project in the amount of $54,258. 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, s/Linda M. Martin, Clerk Enclosure GARY A. GILOT ELIZABETH A. MARADIK THERESE J. DORAU JORDAN V. GATHERS JOSEPH R. MOLNAR PROJECT NAME PROJECT NO CONTRACT SIGNED CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT H= West Side Quiet Zone - Commercial Drive Relocation 120-011 FINAL COST $54,258.00 12/19/2019 MAINTENANCE AGREEMENT ENDS Demo structure at 1522 Ford Street and remove and replace fencing and gates to relocate PROJECT DESCRIPTION commercial drive to the back of the property. 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. r ecuted this 16th ray of October , 20 20 Ritschard Brothers, Inc. uo r Company Name ignature 1204 West Sample Street Rachelle L. Dolniak Company Address Printed Name South Bend, IN 46619 City, State, Zip WITNESSESS:� Before me, the undersigned Notary Public in and for said county�tCrsfrpally appeared Rachelle L. Dolniak ,and acknowledged his/her signature tp' e.. 6ove Proj*�S completion Affidavit on he . 16th day of October , 20 ` 20 = ��: O� AR Y :� 4nwwb-� -' N tary Signature My Comraiissi6n Ift, "LX / 28 Michaela Ritschard q' Printed Name County of Re4dI OF ��k o\fit. Joseph If the Contractor is a corp ratio the following certificate will be executed. Donald Rit h d r . certify that I am Secretary of the Corporation executing this release; that a e D n • k who signed this release on behalf of the contractor was then Xcre n of said Corporation; that said release was duly signed for and on behalf of said y th its go f body, and is within the scope of corporate powers: gnature Corporate Seal Donald Ritschard, Jr. Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. Date: 10/13/2020 Construco6n Manager BOARD OF PUBLIC WORKS • Gary A. GilAAot, Preside nt n Elizabeth A. Maradik, Member Joseph R. Molnar, Member BOARD OF PUBLIC WORKS APPROVAL Date: October 27, 2020 Therese J. Damn, Member Jordan V. Gathers, Member ATTEST: Linda OfTarna Linda M. Martin, Clerk AFFIDAVIT AND WAIVER OF LIEN State of Indiana, County of S t . Joseph SS: Rachelle L. Dolniak being duly sworn that he/she is the President (Name of Officer) (Title) of Ritschard Bros., Inc. having contracted with City of South Bend (Subcontractor/Supplier) (Contractor) to furnish certain materials and/or labor as follows: Commercial Drive Relocation (Description) for a project known as West Side Quiet Zone — Commercial Drive Relocation (Name of Project) located at 1522 Ford Street, South Bend, IN and owned by Citv of 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 ($ ) ❑ receipt 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 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 Fifty—four Thousand Two Hundred Fifty—eight Dollars ($54,25B.00 ) ❑ receipt of which is hereby acknowledged; or ❑X 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 premises, any and all liens or claims whatsoever on the above -described property and improvements thereon an account of labor or 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 lien on account of any work performed or material fumis}ted to the unders' ed for said project, and within the scope of this Affidavit and Waiver of Lien. Ritschard Bros., Inc. By (Firm) (Authorized Representative) STATE OF INDIANA ) SS: ST. JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, in and for said C�gtxlfiyfti8�&tgtf, personally appeared Rachelle L. Dolniak and acknowledged the execution of the foregoing Affidavit and Wai*,�`r� c ROs IN WITNESS WHEREOF, I have hereunto subscribed M: � and affixtd1i_ p 4fficial seal on the 16 th day of October AR)• ,,,j,�� G��t✓��ui►� AUB0G N`aryPublic Signature •'_� My Commission Expires: 2 / 27 / 28"� Ritschard Residing in St. Joseph County, Indiana //'�� i3Oi F %, �`\` Notary Public Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 10/19/2020 Name Toy Villa Department Public Works BPW Date 10/27/2020 Phone Extension 5920 Required Prior to Submittal to Board BPW Attorney ❑ Attorney Name Dept. Attorney ❑ Attorney Name Purchasing I- Check the Appropriate Item Type — Required. for All Submissions ❑ Professional Services Agreement ❑ Contract ❑ Proposal ❑ Open Market Contract ❑ Amendment/Addendum ❑ Special Purchase, QPA ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Reject Bids/Quotes ❑ Proposal Opening ❑ C/O & PCA No. ® PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution n Other: n Ease./Encroach Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Information Ritschard Brothers, Inc. ❑ Yes[:] If Yes, Approved by Purchasing ❑ No ❑ WBE Completed E-Verify Form Attached ❑ Nos West Side Quiet Zone — Commercial Drive Relocation 120-011 LRSA Major Projects 251-0608-431.42-96 $54,258.00 Project Closeout off For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount $ Current Percent of Change: New Amount Total Percent of Change: Time Extension Amount: New ComDletion Date: Increase Decrease Increase Decrease