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HomeMy WebLinkAboutROW Occupancy & Encroachment Agreement - Rockne House Move – Wolfe House Movers1316 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 April 23, 2024 Mr. Andrew Heck Wolfe House Movers of Indiana, LLC 117 W. State Road 114 North Manchester, IN 46962 andrewkwolfehousemovers. com RE: Right -Of -Way Occupancy and Encroachment Agreement Dear Mr. Heck: At its April 23, 2024 meeting, the Board of Public Works approved the above referenced agreement for the house move from 1006 St. Vincent Street (Rockne House) to 1105 N. Foster St. Enclosed please find a copy of the agreement 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 BRIANA N. MIcou RIGHT-OF-WAY OCCUPANCY AND ENCROACHMENT AGREEMENT This Right -of -Way Occupancy and Encroachment Agreement (hereinafter the "Agreement") is made and entered this 23_d:, day of April * 2024 ("Effective Date"), by and between the City of South Bend, Indiana (ihe "City"), a municipal corporation, through its Board of Public Works, and Wolfe House Movers of Indiana, LLC, with a principal office location at 10 Birch LN, Bernville. PA 19506 and an Indiana office location at 117 W. State Road 114, North Manchester, Indiana 46962 (collectively referred to herein as the "Permittees"), each a party and collectively the parties. Recitals WHEREAS, the Permittees desire to occupy and utilize portions of the City's Right -Of - Way to transport a house (the "Property") from a parcel of land located at 1006 St. Vincent Street, South Bend, Indiana 46601 ("Current Location") to a parcel located at 1106 Foster Street, South Bend, Indiana 46616 ("New Location"), as more particularly described and depicted on Exhibit A, incorporated herein by reference and attachment; and WHEREAS, the City has agreed to grant Permittees a temporary and non-exclusive privilege to occupy and use City Right -Of -Way to transport the Property in accordance with the schedule and route specified in Exhibit A ("Approved Schedule and Route"), and in accordance with and subject to the terms, conditions and limitations of this Agreement. NOW, THEREFORE, for and in consideration of the mutual covenants, and obligations contained herein, and other good and valuable consideration received by each party, the sufficiency of which is hereby acknowledged, the parties agree as follows: 1. IncorMration of Recitals. The foregoing recitals are hereby incorporated into this Agreement in their entirety. 2. Grant of Permit. The City hereby grants to Permittees a temporary and non-exclusive personal privilege and permission to enter upon the City Right -Of -Way in accordance with the Approved Schedule and Route to transport the Property to the New Location, as described and depicted on Exhibit A, and subject to the following terms and conditions: Permittees' Responsibilities a. Provide the City with pre- and post -transport photos and video of the truck route area for damage assessment. Permittees will provide the City with a written summary of existing damage for City's confirmation and written concurrence, b. Provide the City a detailed traffic control maintenance plan indicating location of barricades, road closure signs, traffic detour route, etcetera. The Permittees will be responsible for implementing the plan following receipt of City Engineering written approval. c. Restore or replace City Property over and above pre-existing damage as documented in Section 2 a above caused during transport activities, including but not limited to: i. Streetlights ii. Curbs, curb ramps, sidewalk, and signage to the same or better condition than existed prior to transport. iii. Permittees will utilize a certified arborist to trim any trees that need to be trimmed along the Approved Route. Permittees will not commence any tree trimming activities until they have coordinated the activities with the City Forrester. The Permittees agree to make repairs or replacements within 90 days of the date of damage. If the Permittees fail to complete the repairs or replacements within the aforementioned timeframe, the City shall have the right to make such repairs or replacements, the full and complete cost of which shall be borne by the Permittees. Permittees covenant and agree to reimburse the City its full cost and expense for any such repairs or replacements. If the Permittees provide the City with substantiation showing they are unable to complete the repairs or replacement within the 90-day timeframe due to conditions beyond their control, the City agrees to work with the Permittees to reach a mutually acceptable extended repair/replacement date(s) prior to self -performing the repairs/replacements. d. Immediately reinstall any signs removed during the house move transport once the house has vacated the area where the signs were located. e. Provide no parking signage along St. Vincent Street and Foster Street a minimum of 48 hours prior to the start of the house move transport. 3. Term. This Agreement and the Permit granted to the parties hereunder shall commence as of the date the Permittees commence any activities on or to City Property, real and personal, related to the Permittees' responsibilities under this Agreement, and shall continue until the completion of transport of the Property to the New Location and full restoration and/or replacement of damaged City property. 4. No Interest in Land Permittees understand, acknowledge and agree that this Agreement does not create an interest or estate in Permittees' favor in the City Right -Of -Way. The City retains legal possession of the full boundaries of its Right -Of -Way and this Agreement merely grants to Permittees the personal privilege to occupy and use the City Right -of -Way as described above throughout the term of this Agreement. 5. No Vested Right Notwithstanding any expenditure of money, time and/or labor by Permittees, this Agreement shall in no event be construed to create an assignment coupled with an interest or any vested rights in favor of Permittees. Permittees shall expend any time, money or labor at Permittees' own risk and peril. 6. Insurance. Permittees shall maintain at all times during the term of this Agreement, at Permittees' sole cost and expense, the following insurance policies: a. Comprehensive General Liability- Coverage on an occurrence basis from an insurance company licensed with the State of Indiana with at least a $5,000,000.00 combined single limit coverage on all risks. b. Workmen's Compensation — Statutory State of Indiana Employer's Liability - $100,000.00 c. Auto Liability — Bodily Injury and Property Damage combined single limit- $1,000,000.00. The City shall be named as an additional named insured on the Commercial General Line insurance policy Certificate of Insurance and Permittees shall provide the City with a Certificate of Insurance evidencing the same prior to the commencement of the activities contemplated under this Agreement. This insurance shall apply as primary insurance with respect to any other insurance or self-insurance programs afforded to the City. There shall be no endorsement or modification of this insurance to make it excess over other available insurance. Alternatively, if the insurance states that it is excess or prorated, it shall be endorsed to be primary with respect to the City. 7. Compliance with Law. Permittees shall adhere to and comply with all ordinances, laws, rules and regulations that may pertain to or apply to the activities contemplated under this Agreement. Permittees agree and warrant that they have procured or shall procure any licenses, permits or like permission required by law, if any, to conduct or engage in the Agreement activity, that Permittees will procure all additional licenses, permits or like permission hereinafter required by law during the term of this Agreement, and that Permittees will keep the same in full force and effect during the term of this Agreement. Permittees shall perform under this Agreement in accordance with all applicable legal requirements as of effective date. 8. Indemnification. To the fullest extent permitted by law, Permittees agree to indemnify, defend and save the City. its officers, agents, servants, employees, boards and commissions harmless from and against: a. Damage to Permittees' Property. Any and all claims, loss or damage (including reasonable attorney's fees) to the Permittees' Property or any property belonging to or rented by Permittees, its officers, servants, agents or employees, which may be stolen, destroyed, or in any way damaged, by any cause whatsoever in accordance with the activities contemplated under this Agreement. b. Damage to Others. Any claims, suits, judgments, costs, attorney's fees, loss, liability, damage or other relief, including but not limited to Workers' Compensation claims, to any person or property in any way resulting from or arising out of the existence of this Agreement and/or the existence, maintenance, use or location of the City Right -Of -Way. In the event of any action against the City, its officers, agents, servants, employees, boards or commissions covered by the foregoing duty to indemnify, defend and hold harmless, such action shall be defended by legal counsel of the City's choosing. The provisions of this paragraph shall survive any termination and/or expiration of this Agreement. 9. Breach and Limitation on Damages. If any party violates or breaches any term of this Agreement, such violation or breach shall be deemed to constitute a default, and the other party shall have the right to seek such administrative, contractual or legal remedies as may be suitable for such violation or breach; provided, however, that in no event shall the City be liable to Permittees for monetary damages of any kind relating to or arising from any breach of this Agreement, and that no action of any kind shall be commenced by Permittees against the City for monetary damages. In the event any legal action is brought by the City for the enforcement of any of the obligations of Permittees related to or arising from this Agreement and the City is the prevailing party in such action, the City shall be entitled to recover from Permittees reasonable interest and attorney's fees. 10. Notices. Any notice required or permitted under this Agreement shall be in writing and shall be sufficient if personally delivered or mailed by certified mail, return receipt requested, addressed as follows: To the City: To the Permitees: Kara Boyles, City Engineer Wolfe House Movers of Indiana, LLC County -City Building, 227 W. Jefferson 117 W. State Road 114 Blvd., 13th Floor, North Manchester, IN 46962 South Bend, IN 46601 Attn: �7— Notices mailed in accordance with the provisions of this paragraph shall be deemed to have been given on the third business day following mailing. Notices personally delivered shall be deemed to have been given upon delivery. 11. No Joint Venture or Partnership. This Agreement shall not be construed so as to create a joint venture, partnership, employment, or other agency relationship between the parties hereto. 12. No Personal Liability. No official, director, officer, agent or employee of the City shall be charged personally or held contractually liable under any term or provision of this Agreement, or because of their execution, approval or attempted execution of this Agreement. 13. Joint and Collective Work Product This Agreement is and shall be deemed and construed to be a joint and collective work product of the City and Permittees, and as such, this Agreement shall not be construed against any other party as the otherwise purported drafter of the same by any court of competent jurisdiction in order to resolve any inconsistency, ambiguity, vagueness or conflict, if any, in the terms or provisions contained herein. 14. Severability. The terms of this Agreement shall be severable. In the event any of the terms or provisions of this Agreement are deemed to be void or otherwise unenforceable, for any reason, the remainder of this Agreement shall remain in full force and effect. 15. Governing Law. This Agreement shall be subject to and governed by the laws of the State of Indiana. Venue for the resolution of any disputes or the enforcement of any rights arising out of or in connection with this Agreement shall be in the courts of applicable jurisdiction within St. Joseph County, Indiana. 16. References in Agreement All references in this Agreement to the singular shall include the plural where applicable, and all reference to the masculine shall include the feminine and vice versa. If either reference shall be declared invalid, such decision shall not affect the validity of any remaining portion that shall remain in full force and effect. 17. Multiple Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. 18. Paragraph Headings. Paragraph headings are inserted for convenience only and in no way limit or define the interpretation to be placed upon this Agreement. 19. Binding Agreement on Parties. This Agreement shall be binding on the parties hereto and their respective successors and permitted assigns. 20. Assignment This Agreement and the obligations herein may not be assigned without the express written consent of each of the parties hereto. The License granted herein is personal to Permittees. Any attempt to assign this License will automatically terminate the license privileges granted to Permittees hereunder. 21. Entire Agreement This Agreement and its exhibits constitute the entire agreement and understanding between the parties and supersedes any prior agreement or understanding relating to the subject matter of this Agreement. 22. Modification. This Agreement may be changed, modified or amended only by a duly authorized written instrument executed by the parties hereto. Each party agrees that no representations or warranties shall be binding upon the other party unless expressed in or writing herein or in a duly authorized and executed amendment hereof. (SIGNATURE PAGES TO FOLLOW) G IN WITNESS WHEREOF, each of the parties hereto has caused this Agreement to be executed by its duly authorized representative as of the day and year first above written. CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member 1'1�— ff � Joseph R. Molnar, Vice President Briana Micou, Member lac, Attest: Theresa M. Heffner, Clerk Date: April 23, 2024 WOLFE HOUSE MOVERS OF INDIANA, LLC. By: Name: .143r 41ooe �1� Its: Gr c �rcr,;✓.,R-cT _� WOLFHOU-01 KMELSTROM ,4coR0 CERTIFICATE OF LIABILITY INSURANCE DATE(M/202YYY) 3/262024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Melissa Munsterman NAME: PHONE FAX (A/C, No, Ext): (651) 635-2764 (A/C, No):(651) 638-9762 Maguire Agency 1970 Oakcrest Avenue, Suite 300 Roseville, MN 55113 ADDRESS: mmunsterman@maguireagency.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Nova Casualty Company 42552 INSURED INSURER B : INSURER C : Wolfe House Movers of IN LLC INSURER D : 117 W. State Road 114 North Manchester, IN 46962 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM DD YYY POLICY EXP MM DD YYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X X MSMML10000214 11/6/2023 11/6/2024 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PECOT- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY Perperson) $ ANY AUTO MSMML10000214 11/6/2023 11/6/2024 OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X PROPERTY DAMAGE ent Per accident) $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE MSMXS10000047 11/6/2023 11/6/2024 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Cargo MSMML10000214 11/6/2023 11/6/2024 ACV ($10,000 Ded) 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required Habitat for Missions and The City of South Bend, 227 W Jefferson Glvd, South Bend, IN 46601, are included as an dditional Insured on a Primary/Non-Contributory basis and Waiver of Subrogation Applies Per Endorsement Form #AGLO135118, attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Habitat for Missions THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 4404 Technology Drive South Bend, IN 46628 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY EXTRA ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION I — COVERAGES, COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is amended as follows: 1. EXPECTED OR INTENDED INJURY EXTENSION Paragraph a. Expected Or Intended Injury is deleted and replaced by the following: a. "Bodily Injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 2. NON -OWNED WATERCRAFT EXTENSION Subparagraph (2) of g. Aircraft, Auto Or Watercraft is deleted and replaced by the following: (2) A watercraft you do not own that is: a. Less than 52 feet long; and b. Not being used to carry persons or property for a charge; This provision applies to any person who, with your consent, either uses or is responsible for the use of a watercraft. This insurance is excess over any other valid and collectible insurance available to the insured whether primary, excess, or contingent. 3. PROPERTY SOLD OR ABANDONED BY YOU Subparagraph (2) of j. Damage To Property is deleted and replaced by the following: (2) Premises you sell, give away, or abandon, if the "property damage" arises out of any part of those premises, and occurred from hazards that were known by you or should have reasonably been known by you at the time the property was sold, given away or abandoned. 4. The last paragraph of 2. Exclusions is deleted and replaced by the following: Exclusions c. through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with the permission of the owner, when the damage is caused by fire, lightning, explosion, smoke or leaks from automatic fire protective systems. A separate limit of insurance applies to this coverage as described in SECTION III — LIMITS OF INSURANCE. B. ADDITIONAL INSUREDS 1. SECTION II — WHO IS AN INSURED is amended to include, as an additional insured, any person(s) or organization(s) for whom a written contract or written agreement between you and such person(s) or organization(s) exists and requires such person(s) or organizations(s) to be added as an additional insured to your Policy. This additional insured status applies to liability because of "bodily injury", "property damage", or "personal and advertising injury", but shall not apply to any independent acts or omissions of such person or organization who qualifies as an additional insured. a. This endorsement applies only if the written contract or written agreement is: (1) Currently in effect or becomes effective during the term of this Policy; and (2) Executed prior to the "bodily injury", "property damage", or "personal and advertising injury". b. The insurance afforded to such additional insured only: (1) Applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. 2. The insurance provided to the additional insured by this endorsement applies as follows: a. The person(s) or organization(s) is an additional insured but only for liability caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In connection with premises owned by or rented to you; or (2) In the performance of your ongoing operations. AGLO1351118 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 4 with its permission. INSURED COMMERCIAL GENERAL LIABILITY b. If the additional insured is an architect, engineer, or surveyor, this insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services including: (1) The preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2) Supervisory, inspection, or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services by or for you. c. If the additional insured is a lessor of equipment, this insurance only applies to liability caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such additional insured and does not apply to any "occurrence" which takes place after the equipment lease expires. d. If the additional insured is a state or governmental agency or political subdivision and has issued a permit in connection with premises you own, rent, or control, this insurance applies only with respect to the following hazards for which the state or political subdivision has issued such permit: (1) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decoration and similar exposures; (2) The construction, erection, or removal of elevators; or (3) The ownership, maintenance, or use of any elevators covered by this insurance. e. If the additional insured is a state or governmental agency or political subdivision that has issued a permit or authorization with respect to operations performed by you or on your behalf, then this insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or "bodily injury", or "property damage" included within the "products -completed operations hazard". f. If the additional insured is a manager or lessor of insured premises, that person or organization is an additional insured but only with respect to liability caused, in whole or in part by the ownership, maintenance or use of that part of the premises leased to you. This insurance does not apply to: (1) Any "occurrence" that takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor of insured premises. g. If the additional insured is a grantor of a franchise, that person(s) or organization(s) is only an additional insured with respect to liability as grantor of a franchise to you. h. If the additional insured is an owner or has some other interest in land that has been leased to you, that person(s) or organization(s) is only an additional insured with respect to liability caused, in whole or in part by the ownership, maintenance or use of that part of the land leased to you. This insurance does not apply to: (1) Any "occurrence" that takes place after you cease to lease that land; (2) Structural alterations, new construction or demolition operations performed by or on behalf of the owner or other interest from whom land has been leased. L If the additional insured is a mortgagee, assignee, or receiver, that person(s) or organization(s) is only an additional insured with respect to liability caused, in whole or in part, by the ownership, maintenance or use of the premises by you. This insurance does not apply to structural alterations, new construction or demolition operations performed by or for that mortgagee, assignee, or receiver. j. If the additional insured has a controlling interest, that person(s) or organization(s) is an additional insured but only for liability caused, in whole or in part, by: (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy those premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that controlling interest. k. If the additional insured is a vendor, that person(s) or organization(s) is only an additional insured with respect to "bodily injury" or "property damage" caused, in whole or in part, by "your products" which are distributed or sold in the regular course of the vendor's business, but only if this Policy provides AGLO1351118 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 4 with its permission. INSURED COMMERCIAL GENERAL LIABILITY coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". (1) This insurance afforded to the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked under the instructions of the manufacturer for the sole purpose of inspection, demonstration, testing or the substitution of parts and then repackaged in the original container; (e) Any failure by the vendor to make inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of "your products"; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of "your products"; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in subparagraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of "your products". (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 3. With respect to the insurance afforded to an additional insured as provided in Paragraphs B.1. and B.2. above, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. With respect to the insurance afforded to an additional insured as provided in paragraphs B.1. and B.2. above, this insurance shall not increase the applicable Limits of Insurance shown in the Declarations. If an Additional Insured endorsement is attached to this Policy that specifically names a person or organization as an insured, then the above Paragraph B. ADDITIONAL INSUREDS does not apply to such person(s) or organization. 4. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance, is amended to include: For the purposes of this endorsement, this insurance shall be either primary, or primary and non- contributory if the written contract or written agreement between you and the additional insured requires primary, or primary and non-contributory status for the additional insured. This insurance shall be excess to any other policy providing additional insured coverage to the additional insured person or organization for the same claim or "suit". C. SECTION II — WHO IS AN INSURED is amended as follows: BROADENED NAMED INSURED Paragraph 3. is deleted and replaced by the following: 3. Any business entity organized under the laws of the United States of America (including any state thereof, its territories or possessions), or Canada (including any province thereof) will qualify as a Named Insured if there is no similar insurance available to that business entity, provided that one or more Named Insureds shown in the Declarations have, at the inception of the policy period, an ownership interest in such business entity of more than 50%. However, if a Named Insured has an ownership interest in a business entity of more than 50%, the business entity will not be a Named Insured if such business entity is an insured under AGLO1351118 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 4 with its permission. INSURED COMMERCIAL GENERAL LIABILITY any other liability policy or would be an insured under such policy but for its termination or the exhaustion of its Limit of Insurance. D. Paragraph 6. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under SECTION I — COVERAGES, COVERAGE A for damages because of "property damage" to any one premises while rented to you, or temporarily occupied by you with permission of the owner, when the damage is caused by fire, lightning, explosion, smoke, or leaks from automatic fire protective systems. E. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS are amended as follows: 1. KNOWLEDGE AND NOTICE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT The notification requirements of Paragraphs 2.a. and 2.b. Duties In The Event Of Occurrence, Offense, Claim Or Suit apply only when the "occurrence", offense, claim or "suit' is known to: a. You, if you are an individual; b. A partner or member if you are a partnership or joint venture; c. An officer or director if you are an entity other than a partnership, joint venture or limited liability company; d. A member or manager if you are a limited liability company; or e. An insurance manager, risk manager or other "employee" you designate prior to loss to give notice to us. Knowledge of an "occurrence", offense, claim, or "suit' by your agent, servant or "employee" shall not in and of itself constitute knowledge by you unless an individual in one of the positions listed above has actual knowledge. 2. FAILURE TO DISCLOSE HAZARDS The following is added to Paragraph 6. Representations: If you unintentionally failed to disclose all hazards or prior "occurrences" existing at the inception of this Policy, but reported such error or omission to us as soon as practicable after discovery, then we will not deny coverage under this Coverage Part because of such failure. This provision does not affect our right to collect any additional premium or exercise our right of cancellation or non -renewal. 3. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US The following is added to Paragraph 8. Transfer Of Rights of Recovery Against Others To Us: We waive any right of recovery we may have against any person or organization when such waiver is required by a written contract that you have agreed to prior to any "occurrence", "suit' or the offense which caused the "bodily injury", "property damage" or "personal and advertising injury", provided that the "occurrence", "suit' or the offense which caused the "bodily injury", "property damage" or "personal and advertising injury" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. F. SECTION V — DEFINITIONS is amended as follows: 1. BODILY INJURY The definition of "bodily injury" in Paragraph 3. is deleted and replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. 2. PERSONAL AND ADVERTISING INJURY The definition of "personal and advertising injury" in Paragraph 14.b. is deleted and replaced by the following: Abuse of process; and malicious prosecution; All other terms and conditions of the policy remain unchanged. AGLO1351118 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 4 with its permission. INSURED April 13, 2024 Board of Public Works 227 W Jefferson Blvd South Bend, IN 46601 RE: 1006 St. Vincent Street (Rockne House) Move to 1105 N. Foster St. Habitat for Missions is seeking approval to relocate the home located at 1006 St. Vincent St to 1105 N Foster St. The planned move date is May 2, 2024. The house move is being performed by Wolfe House Movers of IN, LLC. This home is the former home of legendary Notre Dame Football Coach Knute Rockne. We hope to save this piece of local and national history, refurbish it, and sell it this fall. Habitat for Missions partners with local non -profits on these projects. This project's recipient is Covenant Christian School of Mishawaka. Covenant Christian will receive 90% of the proceeds of the project to help raise money for their planned expansion. There are additional trees that were identified by the City Forrester that need to be trimmed or removed along the route. There are 3 addresses affected and those property owners have been notified. A copy of the notification letter is included in the packet. The removed trees will be replaced within 60 days following the house move. There is also a copy of the house move route included in your packet and the plan for the road closure. We have partnered with State Barricading, and they advise a rolling road closure along St. Vincent as the house moves down the road to reduce the impact of the move on the motorists. We are cognizant of the damage done by the tree trimmer this past summer to the trees along the route. We apologize to everyone affected by this act. We were advised that the tree trimmer we hired for the work had performed work for a recent house move in the city and was aware of the permitting requirements for such work. The new tree trimmer is licensed with the city and will pull the proper permits. We are also cognizant of the neighbors' concerns about the house move and the impact it could have on the future development of the neighborhood. We understand their concerns but whether the house moves to its new location or if it is demolished to make way for development at 1006 St Vincent, the moving of the house will not change the outcome of the future development. We certainly wish to preserve the history of the house rather than to have it demolished. We look forward to answering any questions at your meeting on April 18th and in the public meeting on April 23rd Sincerely, Garry Potts II, Agent Enc Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmaiI.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 HOUSE MOVE TREE NOTICE April 8, 2024 <<Property Owner>> «Owner Address> <<City>>, <<ST>> <<Zip>> RE: House Move from 1006 St Vincent to 1105 Foster Tree Trimming As we prepare to finalize the house move along St. Vincent Street, we have met with representatives from Higher Ground Tree Care (city -licensed arborist) and have had conversations with Brent Thompson (City of South Bend's Forrester). We have identified trees that need to be trimmed or removed along the route to allow for the home to safely pass through the corridor. The list of addresses and trees is provided below with comments from Mr. Thompson as to if they will be cut down or need to be replaced. Any removed trees will be replaced as part of the project. We expect tree work to begin soon. If you have any questions, please contact Brent Thompson at the City of South Bend or Garry Potts 574-229-0635. Thank you, Garry Potts -2- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmaiI.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 1003 St Vincent IN 171 1-1-4- L--iitt -3- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmail.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 26.5" Red Oak is in good condition. 14", 6", and 6" limbs need to be removed. I think it can be saved -4- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmaiI.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 fr_ • ft -5- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmail.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 26" Norway maple poor condition 8", 4", 4" limbs need to be removed. I think it can be saved. 1004 St Vincent M Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmaiI.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 714 HAB 11 L AL 16" Redbud fair condition 7" limb needs to be removed. I think tree removal. 1034 Foster on St Vincent N�� -8- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmail.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 23" Silver maple poor condition 12" limb needs to be removed. I think tree removal. IN Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmail.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 22.5" Sycomore fair condition 19" limb needs to be removed. I think tree removal. -10- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmail.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 HOUSE MOVE ROUTE c 6 � �J A Mev�e aj aQin�',�N 7 ' •� NO Qt�alaaoj Q.s'cLo A�oN' 32 uw�� t: -11- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmail.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 -12- Habitat for Missions, 6280 W Windsor Drive, McCordsville, IN 46055 richardsw8899@gmaiI.com habitatformissions.com https://www.facebook.com/habitatformissions/ 219-401-2322 227 W. JEFFERSON BOULEVARD SUITE 1316 COUNTY -CITY BUILDING SOUTH BEND, INDIANA46601 d PHONE 574/235-9251 w FAX 574/ 235-9171 TDD 574/ 235-5567 1865 CITY OF SOUTH BEND DEPARTMENT OF PUBLIC WORKS SPECIAL TRUCKING PERMIT *FAX OR MAIL FORM 3 WORKING DAYS (EXCLUDES WEEKENDS) BEFORE REQUIRED 48 HR PUBLIC NOTICE **48 HR PUBLIC NOTICE ANNOUNCED UPON APPROVED FORM ***THIS APPLICATION EXPIRES 30 DAYS FROM SUBMISSION DATE x❑ Oversize ❑x Overweight ❑ Hazardous Material ❑ Superload Submission Date: Applicant Name: Wolfe House Movers of IN LLC. Phone #: 260-224-2615 Fax #: 260-982-7410 Email: andrew@wolfehousemovers.com Application #: Route: From: 1006 St. Vincent St, South Bend, IN To: 1105 N Foster St, South Bend, IN Travel Date: ❑ Single Lane Occupancy ❑x Multi -Lane Occupancy Time(s): From: 8:00 AM To: 2:00 PM Contact: Andrew Heck Phone # 260-224-2615 Load Description: House on hydraulic dollies. Will barricade route using combination of type III barricades and off -duty olice officers/vehicles Length: 38' Width: 31' Height: 36'+ Vehicle Description: Weight (Gross:) 150,000 Ibs Max Weight (Single Axle): 25,000 Ibs Number of Axles: 6 Axle Spacing: Rear Steerable Axle: ❑x Yes ❑ No Vehicle Type: ❑ Tractor -Trailer ❑ Truck -Trailer ❑ Truck E Other/Towed Has the route been driven previously? If so, provide the date. ®Yes ❑ No Will the load be delivered within the City? If so, consult Ordinance Section 21-07.05. for regulations. ®Yes No ❑ Attach the following: ❑X Route Map ❑x Axle configuration for vehicles over 5 axles For County route permit contact: 574-235-9626 For INDOT route permit contact: 219-325-7523 OFFICE USE ONLY: ❑ Approved Comments: ❑ Approved as Noted ❑ Revise ❑ Revise as Noted Engineering Division Authorized Signature: Date: Oversize/Overweight/Hazardous permits requires a non-refundable payment of $35 made payable to the City of South Bend Superload permits requires a non-refundable payment of $50 made payable to the City of South Bend Payment Method: ❑ Credit Card ❑ Check ❑ Cash Version 2.0 [1/31/2022] -13- _yOL-fit 227 W. JEFFERSON BOULEVARD �fo� PHONE 574/235-9251 SUITE 1316 COUNTY -CITY BUILDING�PEA�E r�>i FAX 574/ 235-9171 SOUTH BEND, INDIANA46601 x x TDD 574/ 235-5567 1865 CITY OF SOUTH BEND DEPARTMENT OF PUBLIC WORKS SPECIAL TRUCKING PERMIT REFERENCE GUIDE Definitions Hazardous Material is any item or agent (biological, chemical, radiological and/or physical), which has the potential to cause harm to humans, animals or the environment, either by itself or through interaction with other factors. Oversize Vehicle is any vehicle that exceeds: a. Thirteen (13) feet six (6) inches in height, or b. Eight (8) feet six (6) inches in width, or c. Forty (40) feet in length for a single vehicle, or d. Sixty (60) feet in length for a two -vehicle combination, or e. Sixty-eight (68) feet for a truck -trailer or truck -wagon combination. Overweight Vehicle is any vehicle that exceeds: a. Eighty thousand (80,000) pounds gross vehicle weight, or b. Twelve thousand (12,000) pounds on the steering axle, or c. Twenty thousand (20,000) pounds on a single axle, or d. Thirty-four thousand (34,000) pounds on a tandem axle, or e. Eight hundred (800) pounds per inch of rim width and subject to the axle weights above. Superload Vehicle is any vehicle that exceeds: a. Fifteen (15) feet in height, or b. Sixteen (16) feet in width, or c. One hundred ten (110) feet in length, or d. One hundred twenty thousand (120,000) pounds gross vehicle weight. -14- Version 2.0 [1/31/2022] LW�OLLFL HOUSE & BUILDING MOVERS Wolfe House Movers, LLC 117 W. State Road 114, North Manchester, IN 46962 office: (260) 982-0302 Habitat for Missions Building Relocation Steel & Cribbing Layout Sheet Number: Drawn by: Mike Brovont Date: 8.2.23 1 LW�OLLFL HOUSE & BUILDING MOVERS Wolfe House Movers, LLC 117 W. State Road 114, North Manchester, IN 46962 office: (260) 982-0302 Habitat for Missions Building Relocation Dolly Layout Sheet Number: Drawn by: Mike Brovont Date: 8.2.23 2 CJ LJ - -------------------------------------------------- ■e m 8' 3' 25' 34, 6, ---- ------ LW�OLLFL HOUSE & BUILDING MOVERS Wolfe House Movers, LLC 117 W. State Road 114, North Manchester, IN 46962 office: (260) 982-0302 Habitat for Missions Building Relocation Elevation View Sheet Number: Drawn by: Mike Brovont Date: 8.2.23 3 eke---- 6' 3' 25' -17- ST. JOSEPH COUNTY CITY OF SOUTH BEND BUILDING DEPARTMENT RESIDENTIAL MOVING PERMIT APPLICATION ❖ Prior to applying for a Moving Permit, both a Demolition and Foundation Permit must be obtained: a. Demolition Permit for property that building(s) or structure(s) will be moved from: https://southbendin.gov/department/building/building-permits/ b. Demolition Permit for any building(s) or structure(s) to be demolished at the property where building(s) or structure(s) will be moved to: https://southbendin.gov/department/building/building-permits/ c. Foundation Permit for property that the building(s) or structure(s) will be moved to (Complete our New House/Accessory Structure Application(s) and provide all required documents. However, the fee will be a $40 flat rate for foundation only, per building, and the contractor listed will be that who is doing the foundation work.): https://southbendin.gov/wp-content/uploads/2019/02/newhome20192-1.pdf CITY PROPERTY MOVING PERMIT REQUIREMENTS: 1. Complete Moving Permit Application 2. Moving Contractor must provide a Certificate of Insurance naming the City of South Bend as co-insured, showing: a. Property damage coverage in the amount of one million dollars ($1,000,000.00) b. Liability coverage in the amount of five million dollars ($5,000,000.00) 3. Provide affidavits from such applicable companies with facilities along the proposed route, certifying that the applicant has deposited with such company or agency satisfactory surety to cover the cost of any damage or changes in facilities resulting from the moving of the structure over the proposed route: a. All public utility companies b. Railroads c. Service companies d. Cable television companies 4. Provide approval documentation from the following departments: a. Bureau of Traffic and Lighting b. Police Department c. Park Department d. Engineering Department e. State Highway Department (if route includes any state highway) 5. All information shall immediately be forwarded to the Board of Public Works ❖ Once all items and application have been completed and submitted to the Building Department, the Building Department will provide a letter to the Board of Public Works, along with a copy of all related documents, requesting application and all related documents to be reviewed at the next Board of Public Works meeting ❖ After the Board of Public Works meeting, they will respond to our request, letter, application, and related documents with a stamp of approval, which will then allow the Building Department to issue this moving permit ❖ In the event that the Department denies the moving permit, the applicant shall have the right to request a hearing to review such denial 6. City of South Bend Code of Ordinances (Sec. 6-6.3.- Moving permit.): httos://Iibrarv.municode.com/in/south bend/codes/code of ordinances?nodeld=SUHITA CH6BU ART2BURUPR S6-6.3MOPE 7. Permit fee a. Any one or two story building over public streets or alleys: $125 b. Any building greater than two stories in height over public streets or alleys: $175 EXCELLENCE ACCOUNTABILITY I INNOVATION INCLUSION EMPOWERMENT 125 S. Lafayette Blvd. Suite 100 South Bend. Indiana 46601 p 574.235,9554 f 574.235.55411 www.southbendin.gov -18- MOVING PERMIT APPLICATION (RESIDENTIAL) ST. JOSEPH COUNTY CITY OF SOUTH BEND BUILDING DEPARTMENT COUNTY PROPERTY MOVING PERMIT REQUIREMENTS: 1. Complete Moving Permit Application 2. Moving Contractor must provide a Certificate of Insurance: a. Providing for a limit of not less than $500,000 for all damages arising out of bodily injury or death in any one occurrence b. Provide for a limit of not less than $100,000 for all damages arising out of injury to or destruction of property in any one occurrence c. Subject to that limit per occurrence, an aggregate limit of not less than $300,000 for all damages arising out of injury to or destruction of property during the policy period d. Shall include coverage for premises, operations, contractor's protective liability, products, completed operations, and blanket contractual liability e. See additional, general requirements at the link below for County Code of Ordinances (152.11) 3. Comprehensive Automobile Liability Insurance: a. The contractor shall carry for the duration of the contract comprehensive automobile liability insurance providing for a limit of not less than $500,000 for all damages arising out of bodily injury or death in any one occurrence. b. The policy shall also provide for a limit of not less than $100,000 for all damages arising out of injury to or destruction of property in any one occurrence. c. Such insurance shall include coverage for all owned, non -owned and hired vehicles. 4. Provide letters of inspections and affidavits of approval from companies with facilities along the proposed route, certifying that the applicant has deposited with such company or agency satisfactory surety to cover costs of any damage or changes in facilities resulting from the moving of the structure over the given route: a. All public utility companies b. Railroads (when required- see link for County Code of Ordinances, 152.09 & 152.10) c. Municipal departments (including County Engineer, etc. regarding trees, bushes, signs and/or structures located on county property) d. If the structure to be moved will be using state roadways and/or city streets during transport, provide state and/or city permit approval document(s) 5. All information shall immediately be forwarded to the Board of County Commissioners ❖ Once all items and application have been completed and submitted to the Building Department, the Building Department will provide a letter to the Board of County Commissioners, along with a copy of all related documents, requesting application and all related documents to be reviewed at the next Board of County Commissioners meeting ❖ The County Commissioners shall hear all evidence pertaining to the moving of the structure in question, as the move may affect the public health, safety or welfare of the citizens of the county, and/or any possible physical damage to streets, roadways, sidewalks and/or any other facilities or properties ❖ Within ten working days following the hearing, the County Commissioners shall issue an order to the County Building Commissioner to either issue or deny the requested permit ❖ In the event the County Commissioners should fail to issue such an order within the ten days, the County Building Commissioner shall automatically issue the permit. ❖ Please note: Prior to move, 72 hours' notification must be provided to all local law enforcement agencies, fire departments, Civil Defense Agency and County Engineering Department. 6. Saint Joseph County Code of Ordinances (Chapter 152: Building Regulations): http://library.amlegal.com/nxt/gateway.dil/Indiana/stoosephco in/stiosephcountyindianacodeofordinances?f=templates$fn=de fault.htm$3.0$vid=amleeal:stiosephco in 7. Permit fee a. Any one or two story building over public streets or alleys: $125 b. Any building greater than two stories in height over public streets or alleys: $175 EXCELLENCE I ACCOUNTABILITY. INNOVATION INCLUSION EMPOWERMENT 125 S. Lafayette Blvd. I Suite 100 South Bend. Indiana 46601 p 574.235,9554 f 574.235.55411 www.southbendin.gov -19- MOVING PERMIT APPLICATION (RESIDENTIAL) ST. JOSEPH COUNTY CITY OF SOUTH BEND BUILDING DEPARTMENT APPLICANT INFORMATION DATE: 01/26/2024 APPLICANT: Garry Potts ORG/BUSINESS: PHONE: 5742290635 EMAIL: gpotts@professionalpermits.com ADDRESS: 58171 Dragonfly Ct Osceola IN 46561 Address City State Zip PROPERTY OWNER: GREYSTONE DEVELOPERS LLC PHONE: 574.329.0743 EMAIL: jp@7.diamonds ADDRESS: 1130 South Bend Ave Ste 350 South Bend IN 46617 Address City State Zip PROJECT INFORMATION STRUCTURE BEING MOVED FROM: 1006 St. Vincent St, South Bend, IN TO: 1105 N Foster St, South Bend, IN DIMENSIONS OF STRUCTURE WHEN MOUNTED (please note dimensions of ALL structures separately): LENGTH: 40' WIDTH: 30' HEIGHT: 36'+ WEIGHT: 200,000 AXLE SPACING: see drawing PROPOSED ROUTE: FROM: St. Vincent St TO: N Foster St FROM: TO: FROM: TO: FROM: TO: FROM: TO: FROM: TO: MOVING CONTRACTOR: Wolfe House Mover of IN Ilc *Must provide Certificate of Insurance showing requirements as listed in the City or County Code or Ordinances I certify the above to be true and accurate to the best of my knowledge. 01 /26/2024 APPLICANT SIGNATURE DATE Garry P Potts II PRINT NAME VERIFY CONTACT IF DIFFERENT THAN APPLICANT EMAIL PHONE EXCELLENCE ACCOUNTABILITY I INNOVATION I INCLUSION I EMPOWERMENT 125 S. Lafayette Blvd. Suite 100 South Bend, Indiana 46601 p 574.235.9554 l f 574.235.5541 I www.southbendin.gov -20- BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 4/15/2024 Department Public Name Scott Kree2er BPW Date 4/23/2024 Phone Extension 9245 Required Prior to Submittal to Board BPW Attorney ® Attorney Name Michael Schmidt Dept. Attorney ❑ Attorney Name Purchasing ❑ Mikey Low 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. ❑ PCA ❑ Chg. Order, No. ❑ Traffic Control ❑ Resolution ® Other: ROW Occupancy and ❑ Ease./Encroach Encroachment Agreement Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description Information Wolfe House Movers of Indiana LLC. ❑ Yes ❑ If Yes, Approved by Purchasing ❑ No El MBE ❑ WBE Completed E-Verify Form Attached El Yes ❑ No N/A N/A N/A N/A N/A 1006 St. Vincent Street House Move Riaht-of-Wav Occupancv and Encroachment Agreement. House move operation on May 2, 2024 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