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Home My WebLink AboutPCA - SE Neighborhood Center (United Way) Proj No. 119-093R - Robert Henry Corp.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 November 28, 2023 Mr. Brian S. Henry The Robert Henry Corporation 404 S. Frances St. PO Box 1407 South Bend, IN 46624 rkuntzkrobertheMcorp. com RE: Project Completion Affidavit — Southeast Neighborhood Center (United Way) Project No. 119-093R Dear Mr. Henry: At its November 28, 2023 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $1,259,278. 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 MURRAY L. MILLER BREANA N. MIcou CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME Southeast Neighborhood Center (United Way) PROJECT NO 119-093R FINAL COST $1,259,278.00 CONTRACT SIGNED 7/27/2021 MAINTENANCE AGREEMENT ENDS Site clearing and prep work for the new United Way building. Includes various aspects of PROJECT DESCRIPTION new site work. 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. Execp4d this 1 day of 202 3 The Robert Henry Corporation ! Company Name Signature 404 S. Frances St. n S_ Company Address Printed Name South Bend, IN 46617 City, State, Zip WITNESSESS: 11jefore me the undersigned Notary Public in and for said country and state, personally appeared and acknowledged his/her signature to the above Project Completion Affidavit on e day of 202 1 Notary Signature My Commission Expires \ J 1 ffy A D 1 d{�� LU o �6L I J)"1e—o5 Printe County of Residence If the Contrac or is a c rporation, the following certificate will be executed. I, 1 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 behalf of said Cor p tion by Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature �" ilia s a b lnti- Printed Name 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: 11 /16/2023 Cons tion Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS lau(4 Elizabeth A. Maradik, President �:? wM—WI Gary A. Gilot, Member Murray L. Miller, Member Joseph R. Molnar, Vice President Briana Micou, Member Attest: Theresa M. Heffner, Clerk Date: November 28, 2023 :....Nor. "n 0 GG -3 `0r� C OO -mod �3zW0 gym- � rnID N7 gn51 � O < CD R N QJi � FINAL WAIVER OF LIEN AND RELEASE OF RIGHTS TO WHOM IT MAY CONCERN: The undersigned, who is the President of The Robert Henry Corporation which is the General Contractor for the improvements constructed or being constructed on the premises hereafter identified, declares that his contract with The City of South Bend, Board of Public Works is in the total amount of $ 1,259,278.00 which includes extras and all change orders, on which he has received payment of $ 1,155,113.55 , prior to the final payment for which the undersigned has now submitted an application or invoice in the sum of $ 104,164.45 dated Jul 28 , 20 23 , the receipt and sufficiency of which said sum is hereby acknowledged by the undersigned. In consideration of the amounts and sums received, the undersigned does hereby waive and release to the Owner any and all liens or rights to liens upon said premises or upon improvements now or hereafter thereon, or upon the monies or other considerations due or to become due from the Owner or the General Contractor or from any other person, firm or corporation, said liens or rights to liens being on account of labor, services, materials, fixtures or apparatus heretofore furnished or which may be furnished at any time hereafter by or at the request of the undersigned. The premises as to which said liens or rights to liens are hereby released are identified as follows: Project Name: Southeast Neighborhood Center -United Way Address of Project: 405 E. Dubail Street City: South Bend County: St. Joseph State: Indiana Owner: United Way of St. Joseph Co. General Contractor: The Robert Henry Corporation The undersigned further represents and warrants that he is duly authorized and empowered to sign and execute this waiver on his own behalf and on behalf of the company or business for which he is signing; that he has properly performed all work and furnished all the material of the specified quality per plans and specifications and in a good and workmanlike manner, fully and completely; that he has paid for all the labor, materials, equipment and services that he has used or supplied or may hereafter use or supply to the above premises; that he has no other outstanding and unpaid applications, invoices, retentions, holdbacks, charge backs or unbilled work or materials as of the date of the aforementioned application or invoice; and that any materials which have been supplied or incorporated into the above premises were either taken from his fully -paid and open stock or were fully paid for and supplied as follows: (List the name of each party with whom you have a contract or purchase order to supply labor, and/or materials/equipment, showing the payment status under each contract or purchase order. Also show the value and status of labor, materials, and equipment you have furnished directly, listing your name as "supplier" in each such instance). CONTRACT PREVIOUS CURRENT BALANCE TO NAMES OF SUPPLIERS WHAT FOR PRICE PAYMENT PAYMENT BECOME DUE. All materials from fully paid stock. All labor fully paid TOTAL MATERIALS and LABOR to COMPLETE $ 1,259,278.00 $ 1,155,113.55 $104,164.45 $ 0.00 The undersigned further agrees and does hold harmless, reimburse and fully indemnify the Owner and The City for any losses or expenses should any such lien, claim or right to a lien be asserted, including attorney fees and costs. In addition, for and in consideration of the amounts and sums received, the undersigned hereby waives, releases and relinquishes any and all claims, rights or causes of action whatsoever arising out of or in the course of work performed on the above -mentioned project, contract or event, subject to and upon payment of a balance owing of $ 104.164.45 Signed, sealed and delivered this day of , .20 4_. 1) �j �p E (A1 l U t eprj4 (y Wd'XA t o. SEAL) t i � �y: � i (Individual or Corporake Name) (Signature) Title: I (1 t'� 12 _ Subscribed and sworn to before me this 1 day of 1P OtUn ba Lyndsey Devens NOTARY PUBLIC Notary Public, State of Indiana Signature St. Joseph County Commission Number NP0749763 { MY Commission Expires June 26, 2031 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 11/16/2023 Name Kvle Ludlow Department Public Works BPW Date 11/28/2023 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 Company or Vendor Name The Robert New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Information U Yes U If Yes, Approved by Purchasing ® No MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Nos Southeast Neighborhood Center (United Way) 119-093R River West TIF PR-00000249 PO- 0010837 $1,259,278.00 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