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Home My WebLink AboutPCA - SE Park Playground Resurfacing Proj No 123-043 - Sinclair Recreation LLC1316 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 Ms. Diane Sinclair Sinclair Recreation, LLC 176 E. Lakewood Blvd. Holland, MI 49424 diane&sinclair-rec.com; richksinclair-rec.com RE: Project Completion Affidavit — Southeast Park Playground Resurfacing Project No. 123-043 Dear Ms. Sinclair: At its November 28, 2023 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $261,000. 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 MURRAY L. MILLER BREANA N. MIcou CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME Southeast Park Playground Resurfacing PROJECT NO 123-043 FINAL COST $261,000.00 CONTRACT SIGNED 07-11-2023 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Replacement of PIPSurfacing at the Southeast Park Playground 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 ��ards of the City of South Bend which were a part of the above Contract. Execlated,lbis 2nd day of o ember .2023 Sinclair Recreation Company Name Signature 176 E. Lakewood Blvd. Diane Sinclair Printed Name Company Address Holland, MI 49424 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared Diane Sinclair , and acknowledged his/her signature to the above Project Completion Affidavit on the 2nd day of November 2023 Notary Signature My Commission Expires j,?XL9q Scott Bareman Printed Name County of Residence Ottawa If the Contractor is a corporation, the following certificate will be executed. 1, Richard Sinclair certify that I am Secretary of the Corporation executing this release; that Diane Sinclair who signed this release on behalf of the contractor was then President of said Corporation; that said release was duly signed for and on behalf of said C oration by u ority f its governing body, and is within the scope of corporate powers: Secretary's SiOUL&A Corporate Seal Richard Sinclair 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. Date: Construction Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS 1at� a Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member Joseph R. Molnar, Vice President Briaannal�Miicou, Member � ./`' Attest: Theresa M. Heffner, Clerk Date: November 28, 2023 Final Waiver of Lien State of Indiana, County of SS: f �l 0 l IX being duly sworn that he/she is the O v DI _ (Name of officer) ` (Title) of S`I neat r 1`CC V�(Jl_'f' 00 having contracted with City of South Bend (Contractor) LL (Owner) to famish certain emnterlals and/or labor as fa3lows; POI)CPA1 to P[ of (f . S0 r- -a G1 n (Description for a project known as Sy"L+�nec c't Qar)< (Name of Project) located at 0� 101 5. St . L.p to 1 S 13J A a e v d+ 1 4 b b 1 "7 and owned by _ City of South Bend -- (Owner) — and does hereby further state on the behalf of the aforementioned subcontractor/supplier: (,PARTIAL WAIVER) that there is due from the Contractor the sum of Dollars (S ❑ receipt of which is hereby aclntowledged; or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver ofLienwhich is given solely with respect to said amount, and which waiver sball 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 ❑ receipt of which is hereby acimowledged; or ® the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective onlyuponreceipt 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, AmAshed 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 it lien on account of any work performed or material banished to the undersigned for said praj ct, and within the scope of tbis Affidavit and Waiver of Lien. l 51 A C 106 ( �C.1'�01`l i 6 /1 By (Firm) (A6thdflzed Representative) STATE OF DMIANA ) ) SS: ST. JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared 7 and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the /d - day of 0trfX#C _ 2023 � 1 5igaa My Commission Expires: D /— / 7- Ze ZS- Residing in 6 mNw¢ County, Notary P bh0 N t:t t SS Notary Public, State of Michigan County of Ottawa My Commission Expires January 17, 2025 Acting in the County of _f�7 s+¢s•,7 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 11/22/2023 Name Patrick Sherman Department Public Works BPW Date 11/28/2023 Phone Extension 5601 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 ❑ Mickey Lovey Check the Appropriate Item I Professional Services Agreement ❑ Contract ❑ Open Market Contract ❑ Bid Opening ❑ Quote Opening ❑ Proposal Opening ❑ Chg. Order, No. I-1 Other: Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Michael Schmidt ❑ Amendment/Addendum ❑ Bid Award ❑ Quote Award ❑ C/O & PCA No. ❑ Traffic Control Information Sinclair Recreation, LLC All Submissions U Proposal ❑ Special Purchase, QPA ❑ Req. to Advertise ❑ Title Sheet ❑ Reject Bids/Quotes ® PCA ❑ Resolution Ease./Encroach ❑ Yes ❑ If Yes, Approved by Purchasing ® No MBE ® WBE Completed E-Verify Form Attached ❑ Yes No Southeast Park Playground Resurfacing 123-043 PR-00024809 456-10-101-121-444000--PROJ00000445 $261,000.00 Lump Sum _Remove and replace poured in place playground surfacing at Southeast Park. 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: