HomeMy WebLinkAboutPCA - Permanent Municipal Sanitary Sewer Easement Proj No. DP-20-041 - DEV H12, LLC Drive & Shine
ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT JORDAN V. GATHERS MURRAY L. MILLER
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
April 12, 2022
Mr. Haji Tehrani
DEV H12, LLC
16915 Cleveland Rd.
Granger, IN 46530
RE: Project Completion Affidavit – Permanent Municipal Sanitary Sewer Easement
Project No. DP-20-041
Dear Mr. Tehrani:
At its April 12, 2022 meeting, the Board of Public Works approved the Project
Completion Affidavit for this project.
A copy of the Project Completion Affidavit is enclosed for your records.
If you have any further questions, please call this office at (574) 235-9251.
Sincerely,
/s/ Theresa Heffner
Theresa Heffner, Clerk
Enclosures
TH/lh
April 12, 2022
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date: 4/1/2022
Name: Charlotte Brach Department of Public Works – Engineering Division
BPW Date: 4/12/2022 Phone Extension: 9246
Required Prior to Submittal to Board BPW Attorney X Attorney Name
Dept. Attorney Attorney Name
Purchasing
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
Other: Ease./Encroach
Required Information
Company or Vendor Name
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name Drive and Shine
Project Number DP20-041
Funding Source N/A
Account No. PR/PO # N/A
Amount N/A
Terms of Contract N/A
Special Contract Provisions N/A
Purpose/Description Project completion affidavit and final acceptance for City sewer main
constructed for the Drive and Shine development on SR23.
For Change Orders Only
Amount of
Increase
Decrease
$
($ )
Previous Amount $
Current Percent of Change:
Increase
Decrease
%
( %)
New Amount $
Total Percent of Change:
Increase
Decrease
%
( %)
Time Extension Amount:
New Completion Date: