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Home My WebLink AboutPCA - 2021 Demolitions Proj No. 121-036 - Green Demolition Contractors, 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 JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS July 25, 2023 Mr. Jason Bennett Green Demolition Contractors, Inc. 315 Brighton Street, Suite 1 LaPorte, IN 46350 j asonk greendemolitioninc. com RE: Project Completion Affidavit — 2021 Demolitions — Project No. 121-036 Dear Mr. Bennett: At its July 25, 2023 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $362,670. 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 ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT JORDAN V. GATHERS MURRAY L. MILLER :yap_''%_ CITY OF SOUTH BEND, INDIANA ` pal .1u� 4�ij BOARD OF PUBLIC WORKS;: PROJECT COMPLETION AFFIDAVIT,;; .y PROJECT NAME 2021 Demolitions PROJECT NO 121-036 FINAL COST $362,670.00 CONTRACT SIGNED 1/11/2022 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION 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. Execu d this day of J ofte 20 �'-� Green Demolition Contractors, Inc. Company Name hSignat re � � r Sup e Co m any Ad c rreess Printed Name Lg46364 br-tz T-r( �6356 City, State, Zip WITNESSESS: Before me, under 'gned Notary Public in and for said country and state, personally appeared JgSoh Jeny�, and acknowledged his/her signature to the above Project Completion Affidavit on the 21 s day of Jvh e- , Zei Zo23, Notary f nature II AA My Commission Expires �41ge+ AA �oatwe f( Printed Name County of Residence JANET M OOMMER Notary Public - Seal Porter County - State of Indiana Commission Number NP0746920 My Commission Expires Feb If the Ccnt(acto( is a orporblfcp , the following certificate will be executed. C t�R . del certify that I am Secretary of the Corporation executing this release; that o who signed this release on behalf of the contractor was then I C e o o aid Corporation; that said release was duly signed for and on behalf of said yi Corporation b of ' governin dy, and is within the scope of corporate powers: C� Corporate Seal A4 4 el ,J. rcug ln 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. && ,L-uw- Date: 7/5/2023 Con ruction Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Joseph R. Molnar, Vice President Gary A. Gilot, Member Jordan V. Gathers, Member Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: July 25. 2023 Final Waiver of Lien State oflndiana, County of Lop r+e- SS: Q Cott �e h being duly sworn that he/swis the vib e l f (Name of Officer) T�- (Title) -- le) &4,-b-*3 ��of Gf e eyt a ~ r4- �hSav�tng contracted with C;+..,�o u-{-r t Q (Contractor) (Owner) to furnish certain materials and/or labor as follows: e w+o 1 i + `ors (Description) for a project Imown as OA I D-'W10 located at Y et r 1'o u 3 to c ct'"r `':P n 5 and owned by and does hereby further state on the behalf of the aforementioned subcontractor/supplier.- (PARTIAL WAMM) that there is due from the Contractor the sum of Dollars ($ 0) ❑ 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 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 fpW balance ue &LT- hZ-U"q(r22J contractor *9 sum of o0 r f�i = fwts ou3Q a fi-eI eVEH �a $ oa � Tl ❑ receipt of which is hereby ackmowledged; 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. THSFORE, 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, Banished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and farther certified that no other patty has any claim or right to a } Ron on account of any work performed or material Burnished to the undersigned for said project, and within the scope of this Affidavit and Waiver ofLien. # t e rrwio - fi'� h rQ af5C . By .r-- � } (Authmized Representative) STATE OF D M ANA ) } SS: i ST. JOSEPH COUNTY Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared -JS ovl B e n h t: and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN SS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the 21 day of vot e- JANET M 00 ER Notary Public - Seal NO ubIie S tare Porter County - State of Indiana My Commission Expires: Commission Number NP0746920 i p r Feb 16 2031 '-�14 Ef Oki h)Cl Residing in County, Notary Public Name BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 07/5/2023 Name Kvle Ludlow Department Public Works BPW Date 07/25/2023 Phone Extension 9157 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 n Other: n Ease. /Encroach Information Company or Vendor Name Green Demolition Contractors, Inc. New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract U Yes U If Yes, Approved by Purchasing ® No MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Nos 2021 Demolitions 121-036 V & A Demolitions PO# 0014260 & 0014284 Acct. No# PR-00012665 $362,670.00 Purpose/Description _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 ( %1