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HomeMy WebLinkAboutPCA - Speed Hump Installation Proj No. 120-043 - Premium Concrete Services, 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 November 10, 2020 Mr. Max A. Yeakey Premium Concrete Services, Inc. 712 Richmond St. Elkhart, IN 46516 rbecker(kpremiumconcreteonline. com PHoNE 574/235-9251 FAx 574/235-9171 RE: Project Completion Affidavit — Speed Hump Installation — Project No. 120-043 Dear Mr. Yeakey: The Board of Public Works, at its meeting held on November 10, 2020, approved the Project Completion Affidavit for this project in the amount of $210,400. 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 JANEE M TOWNER NOTARY PUBLIC SEAL ELKHART COtiM STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12, 2026 COMMISSION NO.710399 PROJECT NAME PROJECT NO CONTRACT SIGNED PROJECT DESCRIPTION WITNESSETH: CITY OF SOUTH BEND, INDIANA/�. BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT1H5 -Speed Hump Installation Bid 120-043 FINAL COST $210,400.00 8/25/2020 MAINTENANCE AGREEMENT ENDS Installation of s eed humps in various neighborhoods throughout South Bend. 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 t s L � day of 2Q,i a Premium Concrete Service, Inc. Company Name Signature 712 Richmond Street ffl ,A k 4C A KE q Company Address Printed Name Elkhart, IN 46516 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared NA&`(EAI~Ed _, and acknowledged his/her signature to the above Project Completion Affidavit on the C� day of LJC-f013t R , 20A 10 N tary Signature My Commission Expires i) br1% !2 Printed Name County of Residence �[��jq 12T If theContractoris a corporation, the following certificate will be executed. I, MAN Y, I Y, EA certify that I am Secretary of the Corporation executing this release; that x EA who signed this release on behalf of the contractor was then of said Corporation; that said release was duly signed for and on behalf of said Corporation Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Corporate Seal MA x���:� 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: 11 /02/2020 Construct' n Manager November 10, 2020 BOARD OF PUBLIC WORKS Qt— Gary A. Gilot, President n ' Elizabeth A. Maradik, Member BOARD OF PUBLIC WORKS APPROVAL Date: Therese J. Doran, Member Jordan V. Gathers, Member ATTEST: �ntda c�PTaz;,, Joseph R. Molnar, Member Linda M. Martin, Clerk Final Waiver of Lien JANEE M TOWNER NOTARY PUBLIC SEAL ELKHART COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12, 2026 COMMISSION NO, 710390 State oflndiana, County of ELJ(kAk.T SS: `4 EA K>r� being duly sworn thathe/she is the (Namr�ea�o`f0ificer) (Title) of �REitlIU41�St►I.11 l�—I:yl(jr having contracted with City of South Bend (Contractor) Moe% _ (Owner) to fumis]r cettahr materials and/or tabor as follows; for a project known as located at � AR1 ous N Ct e�H DoRH T!{ SOLll j"UTA I Sm SouTN ! /& AJ U Bend and does hereby further state on the behalf of the aforementioned suhconttactox/supplier: (PARTIAL WAIVER) that there is due from the Contractor the sum of ❑ receipt of which is hereby nclmtowledged; 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 WAIV )that the final bal ce dum g �,the contractor is a sum of �ltltJ� r� cA6Tiacu5AN0� ❑ receipt ofwhich is hereby acknowledged; or ® 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-descrlbedproperty and improvements thereon an account of labor' ox material or boot, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and f irthor certified thatno other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for saidpr loot, and within the scope of this Affidavit and Waiver ofLlen. tT.rMMYl �i�( 91t S 9VI C5 , TNC . By nm) (Authorized Representative) STATE OF INDIANA COUNTY ) Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared MA1VuA tom' f` and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. {� IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the f'1 day of CTCIlai�(2 200 •Dn N tary Public Signature My Commission Expires: oaLa lapa-� Signature �t �A� Conn .7kc N • ota) P, Residing in County, 1J01 K)Nfl Notary Public Name NfAINTENANCE BOND KNOW ALL fv[EN BY THESE PRESENTS: Bond Nc MNT2420247 That, Premium Concrete Services, Inc.; 712 Richmond S[, Elkhart IN46516 as Principal, and Old Republic Insurance the laws of the State of Wiseol the State of Indiana unto the City of South Bend a corporation oanized unde authorized to do a surety business in as Barely, are held and firmly bound as obligee in the sum of 1'wen[y-one-fhous.�nd Forty And Nn/100 ($21,040.00 ), lawful money of the United States of America, for the payment of which sum well and truly to he made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, family by these presents: SEALED evith our seals and dated tltis 30th day of October , 2020 WHEREAS, on the 25th day of Allk'LLST .2020 ,the said principal as contractor, entered into a cmtnact for Speed Hump Installation Bid; Project No. 120-043 For the sum of Two Hundred Ten Thousand Fpur Hundred Aud Nq/100 ($21 Q400.00 I; and, WHEREAS, under the terms of the specifications for said work, the said principal is required to give a bond in the amount of Twenty-one Iluousand Fony And No/100 ($$21 040.00 ), to protect the obligee against the result of faulty materials or workmanship for a period ofThreet3vear(s) from and after the date of the completion and acceptance of same, namely, until 10/30/2023 Now, THEREFORE, if the said principal shall fora period oFThree (3year firm and after the date of the completion and acceptance of same by said obligee replace any and all defects arising in said work whether resulting from defective materials or defective workmanship, then the above obligation to be void; otherwise to remain in full force and effect. Premium Con rete Services, Inc. Pri ncipa( By 6� Old Republic Insurance Company Surety B i Jennifer L. Kasznia Attorney -in -Fact ORSC 2d518fn95) #+*• 4` * OLD REPUBLIC INSURANCE COMPA1�rY - - POWER OF ATTORNEY KNOW ALL MEN 8Y THESE PRESENTS: That OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania stock insurance corporation, does make, constitute and appoint: NICOLE L BICKNELL, MEGAN E RIESENBERG, MARK EDWARD WOBBE, BARBARA E PEARSON, JENNIFER L KASZNIA, SANDRA L JUNK, WILLIAM J CERNEY, III, WESLEY MANTOOTH, THERESA BURNS, JORDAN SCHEIBER, LISA M THOMAS, FAITH HUNT, OF SOUTH BEND, IN its true and lawful Attorneys) -in -Fact, with unlimited power and authority for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof, (other than self-insurance workers compensation bonds guaranteeing payment of benefits, asbestos abatement contract bonds, waste management bonds, hazardous waste remediation bonds or black lung bonds)„ , as follows: : ALL WRITTEN INSTRUMENTS and to bind OLD REPUBLIC INSURANCE COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This appointment is made under and by authority of the board of directors at a meeting on December 10, 2019. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC INSURANCE COMPANY on December 10, 2019. RESOLVED FURTHER, that the chairman, president or any vice president of the Company's surety division, in conjunction with the secretary or any assistant secretary of the Company, be and hereby are authorized and directed to execute and deliver, to such persons as such officers of the Company may deem appropriate, Powers of Attorney in the form presented to and attachedto the minutes of this meeting, authorizing such persons to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship obligations of all kinds, other thah, bail bonds, bank depository bonds, mortgagedeficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note guaranty bonds. The said officers may revoke any Power of Attorney previously granted to any such person. RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the.Company (i) when signed by the chairman, president or any vice president of the Company's surety division and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (ii) when signed by a duly authorized Attorney -in -Fact and sealed with the seal of the Company (it a seal 6e required). RESOLVED FURTHER, that the signature of any officer designated above, and the seal of the Company, may be affixed by facsimile to any Power ofAttorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually affxed. IN WITNESS WHEREOF, OLD REPUBLIC INSURANCE COMPANY has caused these presents to be signed by its proper officer, and its corporate Seal to be affixed this 18TH day of FBBRUARY. 2020. OLD REPUBLIC INSURANCE COMPANY "f SEAL�ie= o\ STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS """" Vice President On this 18TH day of FEBRUARY, 2020 ,personally came before me, ALAN PAVLIC and SHEILA M. APPLEGATE to me known to be the individuals and officers of the OLD REPUBLIC INSURANCE COMPANY who executed the above instrument, and they eachacknowledged the execution of the same, and being by me duly sworn, did severally depose and say; that they are said off cers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said organization. 1:�aplAq`�., �'1�1u 'liter r M . _ �j.,`aau�°; � Notary Public �� My commission expires: 9/28/22 CERTIFICATE (Expiration of notary commission does not invalitlate this instrument) I, the undersigned, assistant secretary of the OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force. zz��``�� �� 45-53]4 ,,,,,,1;;�'�;q^w,� Signed and sealed at the City of Brookfield, WI this � day of C��'��f� o��""""r'e Assistant Secree a� .,,,,u„uu,,,,,,o„� GIBSON INSURANCE AGENCY, INC. 22851-B pOAOR101/2020 Date 11 /02/2020 Name Toy Villa Department Engineering BPW Date 11/10/2020 Phone Extension 5920 Review and Approval Required Prior to Submittal to Board Diversity Compliance ❑ Officer Name and Inclusion Officer BPW Attorney ❑ Attorney Name Dept. Attorney ❑ Attorney Name Purchasing ❑ Check the Appropriate Item Type — Re uired or 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 ❑ Other: ❑ Ease./Encroach Reauired Information Company or Vendor Name Premium Concrete Services, Inc. ❑ Yes❑ If Yes, Approved by Purchasing New Vendor ❑ No ❑ MBE/WBE Contractor Completed E-Verify Form Attached ❑ WBE ❑ Nos Project Name Speed Hump Installation Project Number 120-043 Funding Source Local Roads and Streets Account No. 251-06-600-506-442001 Amount $210,400.00 Terms of Contract Purpose/Description Project Closeout For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount $ Increase % Current Percent of Change: Decrease ( %) New Amount $ Increase % Total Percent of Change: Decrease ( %) Time Extension Amount: New Completion Date: