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Home My WebLink AboutPCA - Grandview Ave & RR Qwick Kurb Installation Proj No. 117-114 - Selge Construction Co., 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. Robert Kuhns Selge Construction Co., Inc. 2833 South I ITH St. Niles, MI 49120 aswinehart&selgeconstruction. com RE: Project Completion Affidavit — Grandview Ave. & RR Qwick Kurb Installation Project No. 117-114 Dear Mr. Kuhns: At its April 25, 2023 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $17,785. 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 CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT -.-- PROJECT NAME Grandview Ave and RR Qwick Kurb Installation PROJECT NO 117-114 FINAL COST $17.785.00 CONTRACT SIGNED December 13, 2022 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION -Install Qwick Kurb, provided by the City, on Grandview Ave at the railroad Mdi WITNESSETH: crossing. 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. Execu d this 7th d y f April gft 2023 Signature Justin Butler, Vice President Printed Name Selge Construction Co., Inc. Company Name 2833 South 11 th Street Company Address Niles, MI 49120 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Justin Butler , and acknowledged his/her signature to the above Project Completion Affidavit on the 7th dl_of April it Rak 0023. � s y ~ otary Signature VMy Commission Expires 10/27/2027 Allison Swinehart Printed Name County of Residence Berrien If the Contractor is a corporation, the following certificate will be executed. I, Allison Swinehart certify that I am Secretary of the Corporation executing Justln Butler who signed this release on behalf of the contract Vice President of said Corporation; that said release was duly signed for ar jC pore#ion by Auth". of its governin body, and is within the scope of corporate powers: Secretary's Signature Allison Swinehart Printed Name `y��Ca� [•4 J V'pl�� r�i a COuNl YRELIC`• y its lel"eA-g was themb'B127� 2U7 be or 1p Id Corporate Seal 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: Construction Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS V'a( Elizabeth A. Maradik, President Gary A. Gilot, Member Joseph R. Molnar, Vice President �181 Jordan V. Gathers, Member 611 X. Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: Anril25.2023 Final Waiver of Lien State of Indiana, County of Berrien SS: Justin Butler being duly sworn that he/she is the Vice President (Name of Officer) (Title) of Selge Construction Co., Inc. having contracted with City of South Bend (Contractor) (Owner) to furnish certain materials and/or labor as follows; Install Qwick Ku rb (Description) for a project known as Grandview Ave and RR Qwick Kurb Installation (Name of Project) located at Grandview Ave at the NICTD and Norfolk Southern crossings ' and owned by City of South Bend (Owner) and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there is due from the Contractor the sum of Dollars ❑ receipt of which is hereby aclmowledged; 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 Seventeen Thousal2d Seven Hundred Eighty Five Dollars and Zero Cents L$17,785.00) _ ❑ receipt ofwhich is hereby acknowledged; or i ❑ the payment of which has been promised as the sole consideration forthis Affidavit and Final Waiver of Lieu which shall become effective only upon receipt of such payment. !!! TBEREFORE, 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 au account of labor or material or both, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and farther certified that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this Affidavit and Waiver of Lien. , Selge Construction Co., Inc. B c y r '-'' i President Michigan (Fim) (AuthmizedRepresentative) STATE OF� 1 ) Berrien ) SS: ; 31x 19EM COUNTY ) Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared Justin Butler and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, Ihave hereunto subscribed my name and affixed my o alai seal on the 7th day of - - April BIEI%,20 yL�� r i C.O. rb;-, � ".��1 otsiy Public Signature My Commission Expires: 10/27/2027 ' q` ' --1 =Allison Swinehart ! Residingin Michigan County, Berrien; �'�, y��r'°8r' �FllotarypublicName BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 04/07/2023 Name Becca Plantz Department Public Works BPW Date 04/25/2023 Phone Extension 5998 Review and Approval Required Prior to Submittal to Board Diversity Compliance and Inclusion Officer ❑ Officer Name Michael Patton BPW Attorney ❑ Attorney Name Dept. Attorney ❑ Attorney Name Purchasing ❑ Check the Appropriate Item Tvne — Michael Schmidt 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 Construction Co., Inc. YesU If Yes, Approved by Purchasing ❑ No ❑ WBE Completed E-Verify Form Attached ❑❑ Nos Grandview Ave and RR Qwick Kurb Installation 117-114 Local Roads & Streets — Streets & Alleys PO-20695 $17,785.00 Lump Sum Install Qwick Kurb provided by the City on Grandview Ave at the NICTD and Norfolk Southern grade crossings as a supplemental safety measure for the quiet zone. For Change Orders Only Amount of ❑ Increase $ ❑ Decrease ($ ) Previous Amount Current Percent of Change New Amount Total Percent of Change: Time Extension Amount: Increase Decrease Increase Decrease New Completion Date: