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Home My WebLink AboutPCA - 2022 Traffic Calming Rubberform Installation Proj. NO. 122-014A - HRP Construction Inc.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 TAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS April 25, 2023 Mr. Matthew D. Cain HRP Construction Inc. 5777 Cleveland Rd., P.O. Box 266 South Bend, IN 46624-0266 mattc kbMconstruction. com RE: Project Completion Affidavit — 2022 Traffic Calming Rubberform Installation Project No. 122-014A Dear Mr. Cain: At its April 25, 2023 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $141,120. 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 Hefner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT JORDAN V. GATHERS MURRAY L. MILLER OgOt�1Tq�� CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS�'f� PROJECT COMPLETION AFFIDAVIT PROJECT NAME 2022 Traffic Calming Rubberform Installation PROJECT NO 122-014A FINAL COST $141,120.00 CONTRACT SIGNED 9/27/2022 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Installation of Rubberform speed tables and cushions. 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. Executed this 6th day of April 2M.2023 HRP Construction Inc Company Name Signature `��—� 5777 Cleveland Rd Nancy Knapik, Vice President Company Address Printed Name South Bend, IN 46628 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Nancy Knapik , and acknowledged his/her signature to the above Project Completion Affidavit on the 6th day of April "X 2023 % CYNTHIA L. VANHESTE ! — t:Y �.&e*: Notary Public, State of Indiana xtSEAL�"" St. Joseph County Number 68 N ry Signature My Commission Expires Mar _'. * -Commission CommisSion Expires73 Cynthia L. Vanheste "'of,,,, O March 06, gg Printed Name County of Residence St. Joseph If the Contractor is a corporation, the following certificate will be executed. I, Nancy Knapik certify that I am Secretary of the Corporation executing this releasq;.:that Nancy Knapik who signed this release on behalf of the contractor was then' Secretary of said Corporation; that said release was duly signed for and on.behalf of said Corporation by Authority of its governing body, and is within the scope of corporate powers: Secretary's Sign5ture Nancy Knapik Corporate Seal 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. 1'<u& .L_4�6v-- Date: 4/18/2023 Coffitruction Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member JosepphlR. Molnar, Vice President U `l1 Jordan V. Gathers, Member Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: April 25, 2023 Final Waiver of Lien State of Indiana, County of St. Joseph SS: Nancy Knapik being duly sworn that he/she is the Vice President (Name of Officer) (Title) of HRP Construction Inc. having contracted with City of South Bend (Contractor) (Owner) to furnish certain materials and/or labor as follows: (Description) for a project known as 2022 Traffic Calming Rubberform Installation, Project No. 122-014A (Name of Project) located at Various Locations through out the City of South Bend and owned by City 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 lies 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 ffom the contractor is the sum of Seven Thousand Fifty Six Dollars and No Cents ❑ 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 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 perforined or material furnished to the undersigned for sold project, and within the scope of this Affidavit and Waiver of Lien. HRP Construction Inc. By —_ (Fim) :7i( 1 Representative) STATE OF INDIANA ) Nancy Knapik, Vice President SS: ST, JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared Nancy Knapik and acknowledged the execution of the foregoing Affidavit and Waiver of Lion. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seat on the 6th day of April 2423 Nobty Public Signature My Commission Expires: March 6, 2024 THIA ...... ��% Notary IPutili Residing in St. Joseph County, Indiana =$, :n St. dosNots@pii'ablicNs Commission Number 681273 my March Commission Expires BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 04/18/2023 Name Kyle Ludlow Department Public Works BPW Date 04/25/2023 Phone Extension 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 — 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 HRP Construction Inc ❑ Yes ❑ If Yes, Approved by Purchasing ® No ❑ WBE Completed E-Verify Form Attached El Yes No 2022 Traffic Calming Rubberform Installation 122-014A 251-442001 PR # 19224 $141,120.00 Project Closeout For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount $ Current Percent of Change: New Amount Total Percent of Change: Time Extension Amount: New Completion Date: Increase Decrease Increase Decrease