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Home My WebLink AboutPCA - Walker Field House Restoration Proj No. 120-010R - Acculevel Comm. Group1316 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 September 26, 2023 Mr. Nolan Beery Acculevel Commercial Group Inc. 8233 W. State Rd. 26 Rossville, IN 46085 nolankacculevel.com RE: Project Completion Affidavit — Walker Field House Restoration Project No. 120-OIOR Dear Mr. Beery: At its September 26, 2023 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $74,040. 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 ALEXANDRA DOLZ-LANE MURRAY L. MILLER "I�pv I if1s . I6 CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT la s PROJECT NAME Walker Park Fieldhouse Restoration PROJECT NO 120-01OR FINAL COST $74,040.00 CONTRACT SIGNED 2/14/2023 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. Executed this j r p��. day of 20; Acculevel Commercial Group Inc. Company Name Signature 8233 W State Rd 26 ,v 6 /., h & GGO-Z, Company Address Printed Name Rossville, IN 46085 City, State, Zip WITNESSESS: Before me, he undersigned Notary Public in and for said country and state, personally appeared Nolan ec-and acknowledged his/her signature to the above Project Completion Affidavit on the �] day of Cl_ 2001 No ary Signature My Commission Expires / A-) AA c L.l�--e Printed Name County of Residence �� ro C If the Contractor is a corporation, the following certificate will be executed. I, certify that I am Secretary of the Corporation executing this release; that who signed this release on behalf of the contractor was then of said Corporation; that said release was duly signed for and on be�h��f Corporation by Authority of its governing body, and is within the scope of corporate powers:��,�� Secretary's Signature Q a Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable final approval and we recommend to the Board of Public Works that it be ordained X 64-)_ Date: 9/7/2023 Co ruction Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS r, Elizabeth A. Maradik, President Gary A. Gilot, Member Joseph R. Molnar, Vice President Alexandra Dolz-Lane, Member Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: September 26, 2023 Final Waiver of Lien State of Indiana, County of 0-tali 5Y\ SS: rV-) Lbeing duly sworn that he/she is the , //��, aa Nfame oOfii ,r) (Title} of l.�.s`.OAA ' i eXa�~Ct Paving contracted with (Contractor) to furnish certain materials anchor labor as follows; tteA co al r LPM Q - (Description) for a project known as C9 t s (Name of Project} located at I W ► ® , and owned by and does hereby I'iuther 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 sball be effective only upon receipt of payment thereof by the undersigned; (FINAL AIVFR) that the final balanc due from the contractor is the sum: of _L$ Ili ()) 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 clainjm right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the sco this Affidavit and Waiver of Lien. (F) (Au zed Representative) STATE OF INDIANA ) SS: ST. JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared Nol a j ¢Seer y and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my a cial seal on the / h day of My Commission Expires: Residing in County, Notary Public Nacre BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 09/07/2023 Name Kvle Ludlow Department Public Works BPW Date 09/26/2023 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 Required Information Company or Vendor Name Acculevel Commercial Group 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 Walker Field House Restoration 120-01 OR EDIT and NPS Grant PR-00014932 $74,040.00 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