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HomeMy WebLinkAboutChange Order No 1 & PCA - Prairie Ave. Water Main Loop Proj No. 117-068 - 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 May 9, 2023 Mr. Matthew D. Cain HRP Construction, Inc. 5777 Cleveland Rd., P.O. Box 266 South Bend, IN 46624-0266 j eredb(ae,hrpconstruction. com RE: Change Order No. 1 (Final)/Project Completion Affidavit Prairie Ave. Water Main Loop - Project No. 117-068 Dear Mr. Cain: At its May 9, 2023 meeting, the Board of Public Works approved the Final Change Order for this project, be increased by $35,527.02. The final contract amount is $1,707,027.02. In addition, the Project Completion Affidavit for this project was approved in the amount of $1,707,027.02. Copies of the Change Order and Project Completion Affidavit are enclosed for your records. If you have any further questions, please call this office at (574) 235-9251. Sincerely, Is/ Theresa Heffner 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 DEPARTMENT OF PUBLIC WORKS' PROJECT CHANGE ORDER DATE: 1/5/2023 PROJECT NO: 117-068 PROJECT NAME: Prairie Ave Water Main Loop CONTRACT DATE: 12/14/2021 CHANGE ORDER NO: 1 (Final) SUBJECT OF CHANGE ORDER: PCR #1- All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns. The original contract sum $ 1,671,500.00 Net change by previously authorized change orders $ 0.00 The contract sum prior to this change order $ 1,671,500.00 By this Change Order, the project amount is [-xl increased F] Decreased $ 35,527.02 The new contract sum including this change order $ 1,707,027.02 This Change Order represents a total change of 2.13 % Total change for entire project 2.13 % Original contracted completion date/time Extension of date/time by previous change orders Date/time extension by this change order New completion date/time &TCONTRACTOR Contractor Signature Matthew D. Cain, President Printed Name and Title HRP Construction, Inc. Company Name 5777.Qleveland Road Address South Bend, IN 46628 City, State, Zip 9/1/2022 0 days 0 days 9/1/2022 RECOMMENDED FOR APPROVAL CL&e, ?,I, f (- 04/15/2023 CONSTRUCTION MANAGER CITY OF SOUTH BEND CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS M111 Elizabeth A. Maradik, President Gary A. Gilot, Member Joseph R. Molnar, Vice President Jordan V. Gathers, Member � #-I- Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: May 9, 2023 PROJECT NAME PROJECT NO CONTRACT SIGNED PROJECT DESCRIPTION WITNESSETH: CITY OF SOUTH BEND, INDIANA d BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT Prairie Ave Water Main Loop 117-068 FINAL COST $1,707,027.02 12/14/2021 MAINTENANCE AGREEMENT ENDS 12" Water Main installation 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 10th day of March 120 23 HRP Construction, Inc. Company Name Signature 5777 Cleveland Road Nancy Knapik, Vice President Company Address Printed Name South Bend, IN 46628 City, State, Zip WITNESSES& Before me, the undersigned Notary Public in and for said country and state, personally appeared Nancy Knapik and acknowledged his/her signature to the abov the 10th day of March 20 23 CYNTHIA L. VANHESTE �11 /� '►i,�?•^••.e : Notary Public, State of Indiana �a�Y Tf - T.� n= St. Joseph County f *SEALS* = �1 Commission Number 681273 NYary Signature My Commission Expir '%,,�aD' ugh 6,NR024nmisslon Expires Cynthia L. Vanheste )24 Printed Name County of Residence St. Joseph If the Contractor is a corporation, the following certificate will be executed. 1, Nancy Knapik certify that I am Secretary of the Corporation executing this release; 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 Corporationby C;� byA'uthority of its governing body, and is within the scope of corporate powers: Secretary s Signature Corporate Seal Nancy Knapik, Secretary 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. g a ee �, 7�1, %j L/c, u.1Za%/-, ` Date: 04/15/2023 Construction Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Joseph R. Molnar, Vice President Jordan V. Gathers, Member Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: May 9, 2023 MAINTENANCE BOND KNOW ALL MEN BY THESE PRESENTS: Bond No. MNT9382683 That HRP Construction Inc. PO Box 266 5,777 Cleveland Rd South Bend, IN 46624-0266 as Principal, hereinafter call Contractor, and Fidelity and Deposit Company of Maryland Chiragn 11 60606 , as Surety, hereinafter call Surety, are held and firmly bound unto City of South Bend Board of Public Works _, as Obligee, hereinafter called Owner, in the penal sum of $ $170,702.70 for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS, Contractor has by written agreement, dated December 14,2021 4 entered into a contract with Owner for Praorin Aypni ja..�&.qtpr M;fln I nnil; E&gj&d Na 117--ZU —1 in accordance with the General Conditions, the Drawings and Specifications, which contract is by reference incorporated herein, and made a part hereof, and is referred to as the Contract. NOW, THEREFORE, the condition of this obligation is such that, if Contractor shall remedy any defects due to faulty materials or workmanship, and pay for any damage to other work resulting therefrom, which shall appear within a period of three (3) year(s) from the date of substantial completion of the work provided for in the Contract, then this obligation to be void; otherwise to remain in full force and effect. Bond shall be effective from January 4, 2023 to January 4, 2026. PROVIDED, HOWEVER, that Owner shall give Contractor and Surety notice of observed defects with reasonable promptness. SIGNED and sealed this 14th —day of March —, 2023 HRP Construction Inc. cipal By ', (Seal) '6 Matthew D. �n, resident Fidelity and Deposit Company of Maryland 0- L Je r L. Kasz'nia, Attoflney-in-Fact ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE, COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint William J. CERNEY, III, Nicole L. BICKNELL, Jennifer L. KASZNIA, Pamela S. HIGGINBOTHAM, Megan E. RIESENBERG, Faith D. HUNT, Mark E. WOBBE, Barbara E. PEARSON, and Theresa M. BURNS, of South Bend, Indiana, Sandra L. JUNK, and Jordan M. SCHEIBER, of Fort Wayne, Indiana and Wesley L. MANTOOTH, and Lisa M. THOMAS, of Indianapolis, Indiana, its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 17th day of September, A.D. 2021. ,µµlg 40 01atk 0f, �,{4iMiAfttl��,� i%' "W'k+ Ste` taiffi(jt+, kay6 4f.Z Yiifjy % 0 SEAISEAI'a S By: Robert D. Murray Vice President By: Dawn E. Brown Secretary State of Maryland County of Baltimore ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND On this 17th day of September, A.D. 2021, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Robert D. Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. vY+e+rtrY3lra� �, Constance A. Dunn, Notary Public My Commission Expires: July 9, 2023 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 1 Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 14th day of March 2023 mob UAL Brian M. Hodges, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 www. reportsfclaims&zuri chna. corn 800-626-4577 HRP CONSTRUCTION EXCAVATING-SEWERS-WATERMAINS 11QV0&n3 90 Be cof's-Ewice" INVOICE SOLD TO: City of South Bend Board of Public Works 227 W. Jefferson Blvd. South Bend, IN 46601 NO: 1599-8 DATE: 1/5/2023 PROJECT NO.: 117-068 QUANTITY QUANTITY ORDERED SHIPPED DESCRIPTION UNIT PRICE UNIT AMOUNT Prairie Avenue Water Main Loop Project No. 117-068 Work Completed to Date $ 1,707,027.02 Retainage $ 85,351.35 Net Work $ 1,621,675.67 Less Previous Billings $ 1,587,831.68 Total Due This Invoice $ 33,843.99 1599-8 CV FINAL CO Equ-10ppottunity 2-Ay." Shipping: 5777 Cleveland Road South Bend, IN 46628-9418 Phone 574-271-7800 Mailing: P.O. Box 266 South Bend, IN 46624-0266 FAX 574-271-0524 =: = Document G702® -1992 Application and Certificate for Payment TO OWNER: City of South Bend PROJECT: South Bend Prairie Avenue APPLICATION NO: g Distribution to: PERIOD TO: 1/05/2023 OWNER ❑ FROM CONTRACTOR: HRP Construction Inc. VIA ARCHITECT: HWC, Inc. CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. AIA Document G703®, Continuation Sheet, is attached. 1.ORIGINAL CONTRACT SUM ............ 2. NET CHANGE BY CHANGE ORDERS 3. CONTRACT SUM TO DATE (Line 1 f 2) . 1,671,500.00 35,527.02 ........... $ 1,707,027.02 4. TOTAL COMPLETED 8 STORED TO DATE (Column G on G703) ...... $ 5. RETAINAGE: a. 5.0 %of Completed Work (Columns D + E on G703) b. 5.0 % of Stored Material (Column F on G703) Total Retainage (Lines 5a + 5b, or Total in Column I of G703) 1,707,027.02 85,351.35 85,351.35 6. TOTAL EARNED LESS RETAINAGE.................................... $ 1,621,675.67 (Line 4 minus Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ...................... $ 1,587,831.68 (Line 6f om prior Certificate) 8. CURRENT PAYMENT DUE ............................................. $ 33,843 999 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 minus Line 6) RANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $ $ Total approved this month $ 35,527.02 $ TOTAL $ 35,527.02 $ ET CHANGES by Change Order $ 35,527.02 CONTRACT FOR: ARCHITECT ❑ CONTRACT DATE: 12/14/2021 CONTRACTOR ❑ PROJECT NOS: 117-068/ FIELD ❑ OTHER ❑ The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: HRP Construction Inc. By: R�_ Date: March 9, 2023 State of: Indiana NaiftcyKnapik, Vice P t CYNTHIA L. VANHESTE `�,� County of: St. Joseph a�¢Y p&ef Notary Public, State of Indiana Subscribed and sworn to before z SEAL.'•o=_ St. Joseph County me this 9th day of March 2023 ' * ' *� Commission Number 68t273 %iHp1A�P` myCommission March 06 2024irBs ,nnE` Notary Public: My commission expires: 03/06/2024 Cynthia L. Vanheste ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising this application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNT CERTIFIED............................................................................. $ (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT: By: Date: This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA Document G7021 —1992. Copyright ® 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The "American Institute of Architects," "AIA," the AIA Logo, "G702," and "AIA Contract Documents" are registered trademarks and may not be used without permission. To report copyright violations of AIA Contract Documents, e-mail copyright@aia.org. s� + A .-r Document G70311 -1992 Continuation Sheet AIA Document G702®, Application and Certificate for Payment, or G732TM, Application and Certificate for APPLICATION NO: 8 Payment, Construction Manager as Adviser Edition, containing Contractor's signed certification is attached. APPLICATION DATE: 1/05/2023 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 1/05/2023 ARCHITECT'S PROJECT NO: 117-06A A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % FINISH RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G + C) (C _ G) (If variable rate) (D + E) (Not in D or E) (D+E+F) 1 WM 12" DIP (Base Bid) 464,300.00 464,300.00 0.00 464,300.00 0.00 23,215.00 1A WM 12" DIP Directionally Drill 183,680.00 183,680.00 0.00 183,680.00 0.00 9,184.00 2 Structure Backfill, Type 1 or 2 52,360.00 23,452.00 2,483.35 25,935.35 26,424.63 1,296.77 3 US 20 Jack & Bore (12" Carrier Pipe) 234,500.00 236,600.00 0.00 236,600.00 (2,100.00) 11,830.00 4 Gate Valve & Box 12" 21,000.00 21,000.00 0.00 21,000.00 0.00 1,050.00 5 Fire Hydrant Assembly 30,000.00 30,000.00 0.00 30,000.00 0.00 1,500.00 6 Air Release ValveNault 24,000.00 24,000.00 0.00 24,000.00 0.00 1,200.00 7 Conn Existing WM 8,000.00 8,000.00 0.00 8,000.00 0.00 400.00 8 1" Corp Stop Water Service 2,100.00 2,100.00 0.00 2,100.00 0.00 105.00 9 1" Type K Copper Water Service 2,960.00 2,645.50 0.00 2,645.50 314.50 132.28 10 Curb Stop & Box 2,100.00 2,100.00 0.00 2,100.00 0.00 105.00 11 HMA Surface 9.5mm Type C 11,100.00 11,100.00 0.00 11,100.00 0.00 555.00 12 HMA Intermediate 19.5mm Type C 12,000.00 12,000.00 0.00 12,000.00 0.00 600.00 13 HMA Base 25.Omm Type C 23,100.00 23,100.00 0.00 23,100.00 0.00 1,155.00 14 PCCP 12" SR 23 Pavement Base 55,000.00 0.00 0.00 0.00 55,000.00 0.00 15 Recycle Conc No 53 Pvmt Sub -base 18,500.00 18,500.00 0.00 18,500.00 0.00 925.00 16 HMA Approaches 26,875.00 6,039.71 0.00 6,039.71 20,835.29 301.99 17 PCCP Approaches 5,340.00 5,251.00 0.00 5,251.00 89.00 262.55 18 Stone Driveway Repair (Undist) 1,500.00 2,237.00 0.00 2,237.00 (737.00) 111.85 19 Milling 1-1/2" 20,236.00 0.00 0.00 0.00 20,236.00 0.00 20 HMA Resurface Type C 1-112" 33,820.00 0.00 0.00 0.00 33,820.00 0.00 21 Utility Allowance 10,000.00 0.00 0.00 0.00 10,000.00 0.00 22 Clearing Right -of -Way 98,000.00 98,000.00 0.00 98,000.00 0.00 4,900.00 23 Erosion Control 33,000.00 27,720.00 5,280.00 33,000.00 0.00 1,650.00 24 Seeding & Restoration 66,750,00 21,137.50 45,612.50 66,750.00 0.00 3,337.50 25 Pvmt Mark, Thermo Solid WH 4" 2,337.00 2,622.00 0.00 2,622.00 (285.00) 131.10 26 Pvmt Mark Casino Park Lot Yellow 4" 230.00 0.00 0.00 0.00 230.00 0.00 27 Dewatering 1.00 0.00 0.00 0.00 1.00 0.00 28 Lawn Restore Sod & Topsoil 8,610.00 23,534.00 0.00 23,534.00 (14,924.00) 1,176.70 29 Maintenance of Traffic 125,132.00 125,132.00 0.00 125,132.00 0.00 6,256.60 30 Construction Engineering 9,969.00 9,969.00 0.00 9,969.00 0.00 498.45 31 Mobilization/Demobilization 85,000.00 63,882.60 21,117.40 85,000.00 0.00 4,250.00 GRAND TOTAL 1,671,500.00 1,448,102.31 74,493.26 1,522,595.57 148,904.43 1 76,129.79 AIA Document G703® -1992. Copyright ® 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The "American Institute of Architects," "AIA,' the AIA Logo, "G703," and "AIA Contract Documents" are registered trademarks and may not be used without permission. To report copyright violations of AIA Contract Documents, e-mail copyright@aia.org. = =AIA Document G703 -1992 Continuation Sheet AIA Document G702®, Application and Certificate for Payment, or G732TM, Application and Certificate for APPLICATION NO: 8 Payment, Construction Manager as Adviser Edition, containing Contractor's signed certification is attached. APPLICATION DATE: 1/05/2023 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 1/05/2023 ARCHITECT'S PROJECT NO: 117-068 A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL BALAN ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % FINISSHH RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G+C) (C G) (Ifvariablerate) (D + E) (Not in D or E) (D+E+F) CHANGE ORDER ITEMS: CO Addl Item #11-HMA Surf 9.5mm TY C 14,127.40 21,598.78 0.00 21,598.78 (7,471.38) 1,079.94 CO Addl Item #12-HMA Inter 19.5mm TY C 15,332.95 25,650.03 0.00 25,650.03 (10,317.08) 1,282.50 CO Addl Item #13-HMA Base 25.0mm TY C 39,462.50 39,266.15 0.00 39,266.15 196.35 1,963.30 CO Addl Item #15-53 Subbase Recyc Conc 34,500.00 32,916.50 0.00 32,916.50 1,583.50 1,645.82 CO Add[ Item #22-Clear Right of Way 65,000.00 65,000.00 0.00 65,000.00 0.00 3,250.00 CO Addl Item #29-Maintenance of Traffic 38,868.00 38,868,00 (38,868.00) 0.00 38,868.00 0.00 GRAND TOTAL 1,878,790.85 1,671,401.77 35,625.26 1,707,027.02 171,763.82 85,351.35 AIA Document G7031-1992. Copyright ® 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The "American Institute of Architects," "AIA," the AIA Logo, "G703," and "AIA Contract Documents" are registered trademarks and may not be used without permission. To report copyright violations of AIA Contract Documents, e-mail copyright@aia.org. Partiaf Waiver of Lien STATE OF INDIANA, as: Whereas, the undersigned HRP CONSTRUCTION INC. has been heretofore em- ployed by City of South Bend to furnish certain material and labor, to -wit: Prairie Avenue Water Main Loop, for the property owned by City of South Bend and located on Prairie Avenue, City of South Bend , County of St. Joseph , State of Indiana. Now THEREFORE, KNOW YE, That the undersigned, for and in consideration of $ 33, 843.99 Dollars, the receipt of which is hereby acknowledged, hereby and now waives and releases unto the said owner of said premises, any and all lien, right of lien or claim of whatsoever kind of character on the above described building and real estate, TOAND FOR SAM AMOUNT, on account of any and all labor material, or both, fumished for or incorporated into said building by the undersigned, up to this date, and they further certify that the consideration moving to the undersigned for executing this PARTIAL WAIVE OF LIEN has been mutually given and accepted as apart payment to or on account of the said Owner for said building and real estate. Signed, sealed and deliveried this 9th day of March 20 23 Signed <-�c Nancy Knapik Personally appeared before me this 9th day March 2023 , Nancy Knapik who, being duly sworn on oath, says: That he is Vice President of the HRP CONSTRUCTION INC. and that he hereby acknowledges the execution of the foregoing instrument for and on behalf of said Corporation and at their special instance and request. My Commission Expires This instrument prepared by: Nancy Knapik Notary Public Cynthia L. Vanheste ,<<. CYNTHIA L. VANHESTE 111 r` t lky p�dNotary Public, state of Indiana a'"' St. Joseph County .SEAL: ,: * Commission Number 681473 My commission Expires March 06, 2024 NRP CONSTRUCTION I EXCAVATING-SEWERS-WATERMAINS (1410 of 'S" E V 1 a F- INVOICE SOLD TO: City of South Bend NO: 1599-9 Board of Public Works DATE: 1/5/2023 227 W. Jefferson Blvd. PROJECT NO.: 117-068 South Bend, IN 46601 QUANTITY QUANTITY ORDERED SHIPPED DESCRIPTION UNIT PRICE UNIT AMOUNT Prairie Avenue Water Main Loop Project No. 117-068 Work Completed to Date $ 1,707,027.02 Retainage Net Work $ 1,707,027.02 Less Previous Billings $ 1,621,675.67 Total Due This Invoice $ 85,361.36 1599-9 ZILWIOPPO'dunity E-Pfo3el Shipping: 5777 Cleveland Road South Bend, IN 46628-9418 Phone 574-271-7800 Mailing: P.O. Box 266 South Bend, IN 46624-0266 FAX 574-271-0524 s ­­-AIA Document G702 -1992 Application and Certificate for Payment TO OWNER: City of South Bend PROJECT: South Bend Prairie Avenue APPLICATION NO: 9 Distribution to: PERIOD TO: 1/05/2023 OWNER ❑ CONTRACT FOR: ARCHITECT ❑ FROM CONTRACTOR: HRP Construction Inc. VIA ARCHITECT: HWC, Inc. CONTRACT DATE: 12/14/2021 CONTRACTOR ❑ PROJECT NOS: 117-068/ t FIELD ❑ OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. AIA Document G703®. Continuation Sheet, is attached. 1.ORIGINAL CONTRACT SUM ................................................. $ 2. NET CHANGE BY CHANGE ORDERS .............................. 3. CONTRACT SUM TO DATE (Line I f 2)..................................... $ 4. TOTAL COMPLETED & STORED TO DATE (Column G on G703) ...... 5. RETAINAGE: a. 5.0 % of Completed Work (Columns D + E on G703) $ b. 5.0 % of Stored Material (Column F on G703) $ Total Retainage (Lines Sa + 5b, or Total in Column I ofG703)...... $ 6. TOTAL EARNED LESS RETAINAGE.................................... $ (Line 4 minus Line 5 Total) 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ...................... $ (Line 6 from prior Certificate) 6. CURRENT PAYMENT DUE ..................... 9. BALANCE TO FINISH, INCLUDING RETAINAGE (Line 3 minus Line 6) 1,671, 500.00 35,527.02 1,707,027.02 1, 707, 027.02 1,707,027.02 1,621,675.67 ........................ I$ 85,351.35 RANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner $ $ Total approved this month $ 35,527.02 $ TOTAL $ 35,527.02 $ ET CHANGES by Change Order 1 $ 35,527.02 The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: HRP Construction Inc. By: k_ ��� Date: March 9, 2023 State of: Indianaancy Knapik, Vicep . CYNTHIA L. VA:Expires HESTE County of: St. Joseph a�x. ..... *d9 � Notary Public, statef Indiana Subscribed and sworn to before Z: SEAL;"= St. Joseph Conty me this day of rt , * Commission Numb681273 9th y March, 2023 -; , ...• p My Commission March 06, 224 Notary Public: My commission expires: 03/06/2024 Cynthia L. Vanheste ARCHITECT'S CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on on -site observations and the data comprising this application, the Architect certifies to the Owner that to the best of the Architect's knowledge, information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the AMOUNT CERTIFIED. AMOUNTCERTIFIED............................................................................. $ (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) ARCHITECT: By: Date: This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA Document G7020 —1992. Copyright 0 1953, 1963, 1965, 1971, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The "American Institute of Architects," "AIA," the AIA Logo, "G702," and "AIA Contract Documents" are registered trademarks and may not be used without permission. To report copyright violations of AIA Contract Documents, e-mail copyright@aia.org. - -AIA Document G703 -1992 Continuation Sheet AIA Document G702®, Application and Certificate for Payment, or G732TM, Application and Certificate for APPLICATION NO: 9 Payment, Construction Manager as Adviser Edition, containing Contractor's signed certification is attached. APPLICATION DATE: 1/05/2023 Use Column I on Contracts where variable retainage for line items may apply. PERIOD TO: 1/05/2023 ARCHITECT'S PROJECT NO: 117-068 A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % FINISH RETAtNAGE NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G = C) (C G) (If variable rate) (D + E) (Not in D or E) (D+E +F) 1 WM 12" DIP (Base Bid) 464,300.00 464,300.00 0.00 464,300.00 0.00 0.00 1A WM 12" DIP Directionally Drill 183,680.00 183,680.00 0.00 183,680.00 0.00 0.00 2 Structure Backfill, Type 1 or 2 52,360.00 25,935.36 0.00 25,935.36 26,424.64 0.00 3 US 20 Jack & Bore (12" Carrier Pipe) 234,500.00 236,600.00 0.00 236,600.00 (2,100.00) 0.00 4 Gate Valve & Box 12" 21,000.00 21,000.00 0.00 21,000.00 0.00 0.00 5 Fire Hydrant Assembly 30,000.00 30,000.00 0.00 30,000.00 0.00 0.00 6 Air Release ValveNault 24,000.00 24,000.00 0.00 24,000.00 0.00 0.00 7 Conn Existing WM 8,000.00 8,000.00 0.00 8,000.00 0.00 0.00 8 1" Corp Stop Water Service 2,100.00 2,100.00 0.00 2,100.00 0.00 0.00 9 1" Type K Copper Water Service 2,960.00 2,645.50 0.00 2,645,50 314.50 0.00 10 Curb Stop & Box 2,100.00 2,100,00 0.00 2,100.00 0.00 0.00 11 HMA Surface 9.5mm Type C 11,100.00 11,100.00 0.00 11,100.00 0.00 0.00 12 HMA Intermediate 19.5mm Type C 12,000.00 12,000.00 0.00 12,000.00 0.00 0.00 13 HMA Base 25.Omm Type C 23,100.00 23,100.00 0.00 23,100.00 0.00 0.00 14 PCCP 12" SR 23 Pavement Base 55,000.00 0.00 0.00 0.00 55,000.00 0.00 15 Recycle Conc No 53 Pvmt Sub -base 18,500.00 18,500.00 0.00 18,500.00 0.00 0.00 16 HMA Approaches 26,875.00 6,039.71 0.00 6,039.71 20,835.29 0.00 17 PCCP Approaches 5,340.00 5,251.00 0.00 5,251.00 89.00 0.00 18 Stone Driveway Repair (Undist) 1,500.00 2,237.00 0.00 2,237.00 (737.00) 0.00 19 Milling 1-1/2" 20,236.00 0.00 0.00 0.00 20,236.00 0.00 20 HMA Resurface Type C 1-1/2" 33,820.00 0.00 0.00 0.00 - 33,820.00 0.00 21 Utility Allowance 10,000.00 0.00 0.00 0.00 10,000.00 0.00 22 Clearing Right -of -Way 98,000.00 98,000.00 0.00 98,000.00 0.00 0.00 23 Erosion Control 33,000.00 33,000.00 0.00 33,000.00 0.00 0.00 24 Seeding & Restoration 66,750.00 66,750.00 0.00 66,750.00 0.00 0.00 25 Pvmt Mark, Thermo Solid WH 4" 2,337.00 2,622.00 0.00 2,622.00 (285.00) 0,00 26 Pvmt Mark Casino Park Lot Yellow 4" 230.00 0.00 0.00 0.00 230.00 0.00 27 Dewatering 1.00 0.00 0.00 0.00 1.00 0.00 28 Lawn Restore Sod & Topsoil 8,610.00 23,534.00 0.00 23,534.00 (14,924.00) 0.00 29 Maintenance of Traffic 125,132.00 125,132.00 0.00 125,132.00 0.00 0.00 30 Construction Engineering 9,969.00 9,969.00 0.00 9,969.00 0.00 0.00 31 Mobilization/Demobilization 85,000.00 85,000.00 0.00 85,000.00 0.00 0.00 GRAND TOTAL 1,671,500.00 1,522,595.57 0.00 1 1,522,595.57 148,904.43 1 0.00 AIA Document G7030 -1992. Copyright C 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The "American Institute of Architects," "AIA," the AIA Logo, "G703," and "AIA Contract Documents" are registered trademarks and may not be used without permission. To report copyright violations of AIA Contract Documents, e-mail copyright@aia.org. RL Document a ■ © , Continuation Sheet AIA Document G702®, Application and Certificate for Payment, or G732TM, Application and Certificate for APPLICATION NO: 9 Payment, Construction Manager as Adviser Edition, containing Contractor's signed certification is attached. APPLICATION DATE: 1/05/2023 Use Column I on Contracts where variable retainage for line items may apply. PERIOD T0: 1/05/2023 ARCHITECT'S PROJECT NO: i 17.068 A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM DESCRIPTION OF WORK SCHEDULED FROM PREVIOUS PRESENTLY COMPLETED AND % FINISH RETAINAGE NO. VALUE APPLICATION THIS PERIOD STORED STORED TO DATE (G + C) (C—G) ('If variable rate) (D + E) (Not in D or E) (D+E+F) CHANGE ORDER ITEMS: CO Addl Item #11-HMA Surf 9.5mm TY C 14,127.40 21,598.78 0.00 21,598.78 (7,471.38) 0.00 CO Addl Item #12-HMA Inter 19.5mm TY C 15,332.95 25,650.03 0.00 25,650.03 (10,317.08) 0.00 CO Addl Item #13-HMA Base 25.Omm TY C 39,462.50 39,266.15 0.00 39,266.15 196.35 0.00 CO Add[ Item #15-53 Subbase Recyc Conc 34,500.00 32,916.50 0,00 32,916.50 1,583.50 0.00 CO Addl Item #22-Clear Right of Way 65,000.00 65,000.00 0_00 65,000.00 0.00 0.00 CO Addl Item #29-Maintenance of Traffic 38,868.00 0.00 0.00 0.00 38,868.00 0.00 GRAND TOTAL 1,878,790.85 1,707,027.02 0.00 1,707,027.02 171,763.83 0.00 p AIA Document G7030 —1992. Copyright ® 1963, 1965, 1966, 1967, 1970, 1978, 1983 and 1992 by The American Institute of Architects. All rights reserved. The "American Institute of Architects," "AIA," the AIA Logo, "G703," and "AIA Contract Documents" are registered trademarks and may not be used without permission. To report copyright violations of AIA Contract Documents, e-mail copyright@aia.org. FinafWaiver of .Dien STATE OF INDIANA, as: Whereas, the undersigned HRP CONSTRUCTION INC. has been heretofore em- ployed by City of South Bend to furnish certain material and labor,to- wit: Prairie Avenue Water .Main Loop, for the property owned by City of South Bend and located on Prairie Avenue City of South Bend , County of St. Joseph , State of Indiana. Now THEREFORE, KNOW YE, That the undersigned, for and in consideration of $ 85,351.35 Dollars, the receipt of which is hereby acknowledged, hereby and now waives and releases unto the said owner of said premises, any and all lien, right of lien or claim of whatsoever kind of character on the above described building and real estate, TOAMFOR SAID AMOUNT, on account of any and all labor material, or both, furnished for or incorporated into said building by the undersigned, up to this date, and they further certify that the consideration moving to the undersigned for executing this FINAL WAIVE OF LIEN has been mutually given and accepted as a part payment to or on account of the said Owner for said building and real estate. Signed, sealed and delivered this 9th day of March 20 23 Signed �> Nancy Knapik Personally appeared before me this 9th day March 2023 Nancy Knapik who, being duly sworn on oath, says: That he is Vice President of the HRP CONSTRUCTION INC. and that he hereby acknowledges the execution of the foregoing instrument for and on behalf of said Corporation and at their special instance and request. My Commission Expires Cynthia L. Vanheste This instrument prepared by: Nancy Knapik Notary Public City of South Bend Department of Administration & Finance Change Order Request Form Changing the line amount: You can only change a line amount if it has NOT been invoiced against. • If the line has NOT been invoiced — reduce the line amount to equal what it should be. • If the line has been invoiced — cancel the delivery remainder and finalize the individual line, then add a new line for the amount that should be remaining. Multiple PO lines: If you have changes to more than one line on the same PO, fill out a separate section for each line affected by the change order. Project POs: For change orders on project -related POs, this form must be approved by the Project Accounting Team as described in Supplement 508. PO Number PO-0014485 Line Number Add Line 3 - Change Order No. 1; Change Order Amount $35,527.02 Original Dollar Amount $1,671,500.00 (Original Bid Total New Dollar Amount $1,707,027.02 For liquidation request, enter $0 Reason Code if changed) Account 1: 620-06-604-608-431002 --> Move $16,636.53 to PO-0014485 Line 3 Financial Dimensions (fund-dept- Account 2: 622-06-604-620-442007 --> Move $18,829.50 to PO-0014485 Line 3 division -subdivision -main account) Account 3: 101-06-600-500-431000 --> Move $ 60.99 to PO-0014485 Line 3 Project Code if applicable) This change includes the finalization of PO-0000036 with HWC Engineering ($16,636.53), finalization of PO-0015001 with Christopher Burke Engineering LLC ($18,829.50), and a transfer of funds from Account 101-06-600-500-431000 to cover Change Order No. 1 for the subject project. This work included increased construction costs (net increase) due to the field relocation of a 12-inch water main along Prairie Avenue under Prairie Avenue pavement due to a utility conflict with Description of change (include NIPSCO gas. Engineering intends to issue Change Order No. 1 to Board of Public budget impact) Works for approval at its 05/09/2023 BPW Meeting. This transfer will allow for Change Order No. 1 to be approved by the Board of Public Works along with closeout documents, payment of remaining invoices and retainge payment before the end of May 2023. Note: Closeout of this project is critical. Proof of closeout will allow the City to request a $500,000 reimbursement payment from the Pokagon Band of Potawatomi Indians and the Pokagon Gaming Commission in accordance with their Water and Sewer Extension Agreement for this water main extension project. APPROVED BY PROJECT (PAT member's name and date to be completed by PAT member) ACCOUNTING TEAM (if applicable) PO Number Line Number Original Dollar Amount New Dollar Amount For liquidation request, enter $0 Supplement 508 Form - Change Order Request Form (1) - PO-0014485 1 of 4 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date: 05-01-2022 Name: Jacob M. Klosinski Department of Public Works — Engineering Division BPW Date: 05-09-2022 Phone Extension: 9496 Required Prior to Submittal to Board BPW Attorney X Attorney Name Michael Schmidt Dept. Attorney ® Attorney Name Michael Schmidt Purchasing ® Mickey Low / Ron O'Connor 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. 001 ❑ 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 Special Contract Provisions Purpose/Description Amount of El Previous Amount Information HRP Construction, Inc. (V-00000775) ❑ Yes❑ If Yes, Approved by Purchasing ® No ❑❑ WBE Completed E-Verify Form Attached ❑❑ Nos Prairie Avenue Water Main Extension 117-068 (PROJ00000069; PO-0014485) Water Works Capital; TIF-Southside Development #1; General Fund; Water Works Operations; 622-06-604-620-442007; 431-10-102-121-442001; 101-06-600-500- 431000; 620-06-604-608-431002 Final Project Cost with approval of CO#1: $1,707,027.02 The Division of Engineering and Division of Utilities (Water Works) requests the Board of Public Works approval of Change Order No. 1 and the Project Completion Affidavit for the subject project. Refer to attached detail regarding changes in scope increase and adjustment of final quantities. For Change Orders Only Increase $ 35,527.02 Decrease ($ ) $ 1,671,500.00 Increase Current Percent of Change: Decrease New Amount $ 1,707,027.02 2.13% Increase % Total Percent of Change: Decrease (2.13%) Time Extension Amount: 0 days New Completion Date: No Change - Project Completed on Time