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Home My WebLink AboutChange Order No. 1(Final) & PCA - Jefferson Alley Repair - Premium Concrete Services1316 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 November 26, 2024 Ms. Becky L. Yeakey Premium Concrete Services 712 Richmond St. Elkhart, IN 46516 becky&preiumservices.griup; rbeckerkpremiumservices.group RE: Change Order No. 1 (Final)/Project Completion Affidavit Jefferson Alley Repair - Project No. 124-048 Dear Ms. Yeakey: At its November 26, 2026 meeting, the Board of Public Works approved the Final Change Order for this project, be decreased by $9,161.48. The final contract amount is $27,243.52. In addition, the Project Completion Affidavit for this project was approved in the amount of $27,243.52. Copies of the Change Order and Project Completion Affidavit are 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/hh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT MURRAY L. MILLER BREANA N. MIcou o� urH vE4o CITY OF SOUTH BEND, INDIANA DEPARTMENT OF PUBLIC WORKS' PROJECT CHANGE ORDER 1865 # DATE: 10/30/2024 PROJECT NO: 124-048 PROJECT NAME: Jefferson Alley Repair CONTRACT DATE: 8/16/2024 CHANGE ORDER NO: 1 (Final) SUBJECT OF CHANGE ORDER: PCR #1-swapping 1800gal drywells for 900gal drywells All items completed substantially as planned. See attached Comparison of Estimate for overruns and underruns. The oriqinal contract sum Net chanqe by previously authorized chanqe orders The contract sum prior to this change order By this Change Order, the project amount is The new contract sum including this chanqe order This Change Order represents a total change of Total change for entire project Oriqinal contracted completion date/time Extension of date/time by previous change orders Date/time extension by this chanqe order New completion date/time C NTRA TOR C ontractor S nag&e j< Bee�,Lu 1. Yeabe nesrL�� Printed N me and Title Premium Concrete Services Company Name 712 Richmond St Address ❑ Increased X❑ Decreased 11 /15/2024 $ 36,405.00 $ 0.00 $ 36,405.00 $ 9,161.48 $ 27,243.52 -25.17 % -25.17 % 0 days 11 /15/2024 RECOMMENDED FOR APPROVAL CON RUCTION MANAGER CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS V'aa Elizabeth A. Maradik, President Gary A. Gilot, Member ",I-zil t Joseph R. Molnar, Vice President Briana Micou, Member Elkhart, IN 46516 Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk City, State, Zip Date: November 26, 2024 CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME Jefferson Alley Repair PROJECT NO 124-048 FINAL COST $27,243.52 CONTRACT SIGNED 8/16/2024 MAINTENANCE AGREEMENT ENDS Full depth resonstruction of the alley north of Jefferson BLVD between Williams and PROJECT DESCRIPTION Franklin 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. D2 Premium Concrete Services WITNESSESS: ' l the day of �� I 12024 Not y Signature My Commission Expires AN)ECO) TWMER Printed Name County of Residence Company Name 712 Richmond St Company Address Elkhart, IN 46516 City, State, Zip oaI p,Iac�aq ELK Air If th Contractor is a corporation, the following certificate will be executed. I, � #& N Ihti , certify. that I am Secretary of the Corporation executing this release; that f Yin L yin I11m who signed this release on behalf of the contractor was then PYCS i� of said Corporation; that said release was duly signed for and on behalf of said Corporation by Aut •ity of its governing body, and is within the scope of corporate powers: Secretary' ignature Corporate Seal 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 &I Date: 11 /18/2024 Constr tion Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS tjW�k Elizabeth A. Maradik, President Gfs�`i(at Gary A. Gilot, Member Murray L. Miller, Member M, Joseph R. Molnar, Vice President Blria�na MMiicou, Member I ' " /` Attest: Theresa M. Heffner, Clerk Date: November 26, 2024 N O Q N ¢C" n Zorn LL2C') O cao ZJ W W Co I-- U- �Oa B(D W Z 2Q N Q O Wg Z X U) QZ OZM -� UO2 �— Fn O QrnU W Q WV Final Waiver of Lien State of Indiana, County of �7 1 / _ SS: ( t' , being duly sworn that he he is the T (blame of fficer) (Tide) of lieml 11 �f)t rLk2►�ic25,/h (Contractor) having cantracted with to furnish certain materlais and/or labor as follows; �Y Q WNLE (Description) for a project lazown as located at and owned by of Project) (Owner) and does hereby further state ou the behalf of the aforementioned subcontractor/supplier: (PARTIAL WAIVBR) that thew is due from the Contractor the sum of ❑ receipt of which i:s hexeby aciatowledged; or (�Wn�1') ❑ t}te payment of which has been promised as the sole consideration. for this Ai�davit and FizlaI 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 WAIV)✓R that the final balance due frown the contracto is the sum of i t�..��c�►_ u.sn,no! �D hun(ik�rfi,— �F,r vr►. � 5zl►oo ($ oZ'�-, a4.�. 5Z ❑ receipt of which is hereby acknowledged; or Mize payment of which has been promised as the sole consideration forthis Affidavit and Final Waiver of Lieu which shall become effective only upon receipt of such payment. Tli6liEFORB, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever on the above-desczibed 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 fhrther certified that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for saidprojec , and withQthe sgope of,bas Affidavit and Waiver of Lien r—®� // STATB OF lNDitANA ) � - SS; ST. JOSEPH COUNTY before me, the undersigned, a Notary Public, in and for said County and State, personally appeared and aclatowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITN SS WHMOF, I have hereunto subscribed my name and affixed my official seal on theOM LN My Commission Expires: � �, � �?� �D 'Residing in county, � fy N Public signature RM IF . A day of UA COMMISSION NO, 710399 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 11/18/2024 Name Kvle Ludlow Department Public Works BPW Date 11/26/2024 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 New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Information Premium Concrete Services U Yes U If Yes, Approved by Purchasing ® No MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Nos Jefferson Alley Repair 124-048 River West TIF, Storm Capital PR- 00034695 PO- 0033330 $27,243.52 Purpose/Description _Project Closeout For Change Orders Only Amount of Increase $ Previous Amount ® Decrease ($ 9,161 $ 36,405.00 Increase % Current Percent of Change: Decrease New Amount $ 27,243.52 Increase Total Percent of Change: Decrease Time Extension Amount: 0 Days New Completion Date: 11/15/2024 17% 17%