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HomeMy WebLinkAboutPCA - Fire Station No. 8 Replacement Proj No 122-034 - R. Yoder Construction Inc1316 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 January 14, 2025 Mr. Jason Yoder R. Yoder Construction, Inc. 27453 County Rd. 150 Nappanee, IN 46550 shellykiyoderconstuction. com RE: Project Completion Affidavit — Fire Station No. 8 Replacement — Project No. 122-034 Dear Mr. Yoder: At its January 14, 2025 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $4,087,535.70. 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/hh 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 Fire Station No. 8 Replacement PROJECT NO 122-034 FINAL COST $4,087,535.70 CONTRACT SIGNED 9/12/2023 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Remove/ Replace Fire Station # 8 WITNESSETH: The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. Executed thi 26th day of eC r 2024 R. Yoder Construction, Inc. Company Name Signature grllr 27453 County Rd.150 Mason Yoder Company Address Printed Name Nappanee, IN 45550 o�� City, State, Zip ogo ITNESSESS: U1�GEN 4 E ' efore me, the undersigned Notary Public in and for said country and state, personally appeared aw.�o� ason Yoder and acknowledged his/her signature to the above Project Completion Affidavit on o0°$ c 26thdyyay--of December , 2024 otary Signature My Commission Expires May 23, 2027 ° nnette Wiseman Printed Name County of Residence Elkhart If the Contractor is a corporation, the following certificate will be executed. I, Kevin Yoder , certify that I am Secretary of the Corporation executing this release; that Jason Yoder 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 Corporation by Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Corporate Seal Kevin Yoder Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for fmal approval and we recommend to the Board of Public Works that it be ordained so. 111�1„ Lu- Date: 1 /6/2024 struction Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President • 0 — Gary A. Gilot, Member Murray L. Miller, Member M Joseph R. Molnar, Vice President Btre�ana Micou, Member 1 4 Attest: Theresa M. Heffner, Clerk Date: January 14, 2025 Final Waiver of Lien State oflndiana, County of Elkhart SS: Jason Yoder being duly swom that he/she is the President (Name of Officer) (Title) of R. Yoder Construction having contracted with City of South Bend (Contractor) (Owner) to furnish certain materials and/or labor asfollows: New Construction of Fire Station (Description) for a project known as Fire Station #8 Replacement (Name of Project) located at 2402 S. Twyckenham Dr. South Bend, IN 46614 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 ($ ) ❑ receipt of which is hereby acltowledged; or ❑ the payment of which lies been promised as the sole consideration for this Affidavit and Final Waiver of Licnwhich is given solely with respect to said amount, and which waiver shall 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 _($ 204,376.)78 ❑ receipt of which is hereby acknowledged; or thepsyment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become offeetive 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 die above -described property and improvements thereon an account of labor• or material ar botb, ftunished b the undersigned th(1reto, subject to limitations or conditions expressed herein, if any; and further cartifled that no other party has any claim or right to a lien on account of any work performed or material tltmishod to the undersigned for said ct, and within the scope of this Affidavit and Waiver of Lien. R. Yoder Construction I'm By (F�) uthorizedRe sentative) STATE OF INDIANA ) SS: ST• JOSEPH COUNTY ) Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared 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 26th day of December 200 2024 . �V)yYVtG(i1 Notary Public Signature MyCommission Expires: May 23, 2027 Annette VUseman ti Residing in Elkhart Cowt , Indiana aNNErr EMaN tY Notary PublicNama t Notary Public, State of Indiana Elkhart Couray Commission N NP06450 4 O My cM missi 027%pires CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR❑ A/A DOCUMENT G707 SURETY ❑ OTHER PROJECT: (name, address) Fire Station No. 8 Replacement Project No. 122-034 TO (Owner) City of South Bend 227 W Jefferson Blvd Bond # 330627E ARCHITECT'S PROJECT NO: CONTRACT FOR: General Construction South Bend, IN 46601 CONTRACT DATE: 9/12/2023 CONTRACTOR: R YODER CONSTRUCTION, INC. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) Westfield Insurance Co. 1 Park Circle, P.O. Box 5001 SURETY COMPANY, Westfield Center, OH 44251 on bond of (here insert name and address of contractor) R YODER CONSTRUCTION, INC. 27453 Cty Rd 150 CONTRACTOR, Nappanee, IN 46550 hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety company of any of its obligations to (here insert name and address of owner) City of South Bend 227 W Jefferson Blvd South Bend, IN 46601 OWNER, as set forth in the said Surety Company's bond IN WITNESS WHEROF, The Surety Company has hereunto set its hand this 17th day of December 2024 Westfield Insurance Co. Surety Company Signature outhorizcd Represents Anent imess (/A g (seal): Karla Kn/c(_ i ( /l Attorney -in -Face Tiele Conroe Smith THIS POWER OF ATTORNEV SUPERCEDES ANV PREVIOUS POWER BEARING THIS SAME POWER #AND ISSUED PRIOR TO 10/12/21, FOR ANY PERSON OR PERSONS NAMED BELOW. General PowER No. aasos�z o0 Power Westfield Insurance Co. of Attorney Westfield National Insurance Co. CERTIFIED COPY Ohio Farmers Insurance Co. Westfield Center, Ohio Know Alf Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to Individually as a "Company" and collectively as "Companies," duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these presents make, constitute and appoint MICHAEL J. DOUGLAS, CHRIS M. STEINAGEL, CHRISTOPHER M. KEMP, ROBERT DOWNEV, CONNIE SMITH, KORY MORTEL, ELIOT MOTU, SAMUEL DUCHOW, JOINTLY OR SEVERALLY of HUDSON and State of WI its true and lawful Attorneys) -in -Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorneys) -in -Fact may do in the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: "Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity &Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney -in -Fact. may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary." "Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting held on February 8, 2000). In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto affixed this 12th day of OCTOBER A.D„ 2021 . ,�,,, c seals1e °'�a�u?!aNc`-•, `''P�t�"A��ti'''• \NSU�po,"�".�"'-„ WESTFIELD INSURANCE COMPANY /o,•• • F's �� ��'• •' :SG"': '4�••^^:"�!p'� WESTFIELD NATIONAL INSURANCE COMPANY Arrixed;t;.: '� 2!':t o:� s.o: •�,�;- 4'%': �" � OHIO FARMERS INSURANCE COMPANY ' �" ���L • ro � `_ �"t SEAI. • � ` 'ti: CNARTEAfQ iia 3 � ��•.,•, � rlY�i :.• ; p a3:• 1B4B ,ram �y��m. ,.---� M "�Mw,mHM�� ...* .. f State of Ohio """"' """" BY� County of Medina ss.: Gary W. tumper, Nationa Surely Leader and Senior Executive On this 12th day of OCTOBER A.D., 2021 ,before me personally came Gary W. Stumper to me known, who, being by me duly sworn, did depose and say, that he resides in Hartford, CT; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order. Notarial ,,,.�•����• ,,, seal ...,••`atAl •,,,, C-!/����� - Q/C�i� s '•�. (/ Affixed �P: "'••�"'•�. State �f Ohio =:N q .✓. �� o David A. Kotnik, Attorney at Law, Notary Public Count of Medina ss.: �' '~• .T .- My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code) ,.rf OF O `' I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still In full force and effect; and furthermore, the resolutions of the Boards of Directors, set out In the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 17th day of December A.D., 202a . ,7C�.�4.1., =n '__ nO•Sl�' Y]lx •�m-= Q�CNIJtTfBfQ�3� �� � t Secretary rer. ,,zi'• '��'•. '' Y0 '.o=' � <�, Frank A. Carrino, Secretary ,..... „P ,. .. .. ._ .... , BPOAC2 (combined) (O6-U2) Document G706 Contractor's ATTldavit of Payment of Debts and Claims PROJECT: (Name and address) Fire Station No. 8 - S. Bend 2402 S. Twyckenham Dr. South Bend IN 46614 TO OWNER: (Name and address) City of South Bend Board of Public Works 227 W. Jefferson Blvd. South Bend, IN 46601 STATE OF: Indiana COUNTY OF: Elkhart ARCHITECT'S PROJECT NUMBER: 2172201870 CONTRACT FOR: General Construction CONTRACT DATED: ARCHITECT: CONTRACTOR: SURETY: OTHER: The undersigned hereby certifies that, except as listed below, payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: 1. Consent of Suretyto Final Payment. Whenever Surety is involved, Consent of Surety is required. AIA Document G707, Consent of Surety, may be used for this purpose Indicate Attachment ® Yes ❑ No The following supporting documents should be attached hereto if required by the Owner: 1. Contractor's Release or Waiver of Liens, conditional upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subcontractors and material and equipment suppliers, to the extent required by the Owner, accompanied by a list thereof. 3. Contractor's Affidavit of Release of Liens (AIA Document G706A). CONTRACTOR: (Name and address) R. Yoder Construction Inc. 27453 CR 150 Nappanee, IN ,465�5500 `) (Signature authorized re esentative) Jason Yoder, President (Printed name and title) Subscribed and sworn to before me on this date: fpec"„GPn44-G, Zcpe�w Notary Public: a,yt,(,w �WV�.4' ►1 vt My Commission Expires: May 23, 2027 ANNETiE WISEMAN r 'x Notary public, State of Indiana Eslshad Countyy y0 F Comml ion # NP0720450 > My Commission Ex Ires Me 23, 2027 p AIA Document G706 —1994. Copyright©1970 and 1994. All rights reserved. "The American Institute of Architects,"'American Institute of Architects; "AIA; the AIA Logo, and "AIA Contract Documents" are trademarks of The American Institute of Architects. This document was produced at 09:51:35 ET on 12/26I2024 under Order No.2114509091 which expires on 02114/2025, is not for resale, is licensed for one-time use only, and may only be used in accordance with the AIA Conlrad Documents®Terms of Service. To report copyright vlola0ons, a -mail tlocintoQaiaconiracts.com. User Notes: (3B9ADA5D) AIA Document G706°A -1994 Contractor's Affidavit of Release of Liens PROJECT: (Name and address) Fire Station No. 8 - S. Bend 2402 S. Twyckenham Dr. South Bend IN 46614 TO OWNER: (Name and address) City of South Bend Board of Public Works 227 W. Jefferson Blvd. South Bend, IN 46601 STATE OF: Indiana COUNTY OF: Elkhart ARCHITECT'S PROJECT NUMBER: 2172201870 CONTRACT FOR: General Construction CONTRACT DATED: OWNER: <J ARCHITECT: ❑ CONTRACTOR: ❑ SURETY: ❑ OTHER: ❑ The undersigned hereby certifies that to the best of the undersigned's knowledge, information and belief, except as listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers of materials and equipment, and all performers of Work, labor or services who have or may have liens or encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner out of the performance of the Contract referenced above. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: 1. Contractor's Release or Waiver Of Liens, conditional upon receipt of final payment. CONTRACTOR: (Name and address) R. Yoder Construcrion Inc. 27453 CR 150 Nappanee, IN 465 2. Separate Releases or Waivers of Liens from BY: Subcontractors and material and equipment (SignatuolKfauthorized suppliers, to the extent required by the Owner, representative) accompanied by a list thereof. Jason Yoder, President (Printed name and title) Subscribed and sworn to before me on this date: den 2G, Notary Public: a'LyU&1 j�1VJ(iYi/apt My Commission ExpjML. May 23, 2027 AIA Document G706A —1994. Copyright ®1962 and 1994. All rights reserved. "The American Institute of Architects," "American Institute of Architects;' °AIA; the AIA Logo, and °AIA Contract Documents" are hademarks of The American Institute of Architects. This document was produced at 09:53:41 ET on 12/26I2024 under Order No.2114509091 which expires on 02/14/2025, Is not for resale, is licensed forone-time use only, and may only be used In accordance with the AIA Contract Documents®Terms of Service. To report copyright violations, a -mail doclnfoQalacontracts.com. User Notes: (MMDAK) ASBESTOS FREE STATEMENT OWNER: City of South Bend 227 W Jefferson Blvd South Bend, IN 46601 PROJECT: Fire Station no. 8 Replacement Project No. 122-034 Gentlemen: The undersigned hereby certifies that to the best of our knowledge, information and belief, all materials incorporated into the above referenced project are free of asbestos contained materials or are not in excess of amounts allowed by Local/ State standards, laws, codes, rules, and regulations, the Federal Environmental Protection Agency (EPA Standards Administration and/or Federal Occupational Safety and Health Administration (OSHA) standards whichever is more restrictive. R. Yoder Construction, Inc. By Signed Jason Yoder. President Printed Name and Title Date Sworn to and subscribed before me, a Notary Public in the State of Indiana, the County of Elkhart on this 26th day of December 20 24 May 23, 2027 Notary Public My Commission Expires ANNE7TE WISEMAN � Nolary Public State of Indiana E Elkhart County G emission S NP0720458 y> „` .* My Commission Expires May 23, 2027 Maintenance Bond Warranty Term in years 1110 Farmers Insurance Co. Westfield Group sin One Park Circle, P O Box 5001 Westfield Center, OH 44251-5001 �II��lT►L�3 �=��7 �l �� Bond Number 33o627F KNOW ALL BY THESE PRESENTS, That we, R YODER CONSTRUCTION, INC. as Principal, and OHIO FARMERS INSURANCE COMPANY, a corporation organized under the laws of the State of Ohio and duly authorized to do business in the State of, Ohio as Surety, are held and firmly bound unto City of South Bend as Obligee, in the penal sum of Four Million Eighty -Seven Thousand Five Hundred Thirty -Five Dollars and 70/100 {$ $47087, 535.70 ), to which payment well and truly to be made we do bind ourselves, our and each of our heirs, executors, administrators, successors and assigns jointly and severally, firmly by these presents. WHEREAS, the said Principal entered into a Contract with the Obligee, dated the 12th day of September , 2023 a copy of which is hereto attached and made a part hereof, for NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal shall guarantee that the work will be free of any defective materials or workmanship which become apparent during the period of 3 year(s) following completion of the Contract then this obligation shall be void, otherwise to remain in full force and effect, provided however, any additional warranty or guarantee whether expressed or implied is extended by the Principal or Manufacturer only, and the Surety assumes no liability for such a guarantee. Signed, sealed and dated this 174eh Karla Heffron {Witness} fitness) day of December 2024 , PRINCIPAL R YODER CONSTRUCTION, INC. OHIO FARMERS INSURANCE COMPANY Connie Smith Attorney -in -Fact THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME POWER #AND ISSUED PRIOR TO 10/12/21, FOR ANY PERSON OR PERSONS NAMED BELOW. General � POWER No. 4s3os�2 00 Power Westfield Insurance Ca. of Attorney Westfield National Insurance Co. CERTIFIED COPY Ohio Farmers Insurance Ca. Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a 'Company' and collectively as "Companies," duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these presents make, constitute and appoint MICHAEL J. DOUGLAS, CHRIS M. STEINAGEL, CHRISTOPHER M. KEMP, ROBERT DOWNEY, CONNIE SMITH, KORY MORTEL, ELIOT MOTU, SAMUEL DUCHOW, JOINTLY OR SEVERALLY of HUDSON and State of WI its true and lawful Attorneys) -in -Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorneys) -in -Fact may do in the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: 'Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity &Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney -in -Fact. may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary." "Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting held on February 8, 2000). !n Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto affixed this 12th day of OCTOBER A.D., 2021 . gld1l/NUy tNtltt Ut, Cor orate ♦ ••� I tt It ,� ,//•1ldly! p rP, g�gt,� ''�•, .�`` �r�� ' , ,.�'" ''�,,, WESTFIELD INSURANCE COMPANY seals �,t'o ��.•••••••�C,�•,+ .�,•``�P��••••••� �!v`SG ; _.••'�QS�NSU�/,��•, WESTFIELD NATIONAL INSURANCE COMPANY Affixed �1��!;' wa ? n ;� � .o: '-.'A '; ria' R'�= OHIO FARMERS INSURANCE COMPANY �, �,P' � fit'/ • ..* . • • `,,` � �j/'/ t�•,��` �' �414N/=� tt/t ttll! // t 1tNt•` /'��•+IIIUt/tsttl State of Ohio BY� � County of Medina ss.: Gary W. tumper, Nationa Surety Leader and Senior Executive On this 12th day of OCTOBER A.D., 2021 ,before me personally came Gary W. Stumper to me known, who, being by me duly sworn, did depose and say, that he resides in Hartford, CT; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order. Notarial Seal Affixed .-- - J\fit` 0.� L, n',•%I 9' r State of Ohio �, ,�. •�'�o� David A. Kotnik, Attorney at Law, Notary Public County of Medina ss.: ';,�.y ��•T�.- My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code) •4,.a,•Il tlt•�1', I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; and furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 17th day of December A.D., 2024 . ••,,►tat/t/NI• !/ j14t1{1ltt tt r, /././IYl1 u• � Secretary ,�,t .�. .ram =;�'•. •:Q = �;:• 1�4� '� •..,....r � •.,, ,t•' �. . ,•.• ' � Frank A. Carrino, Secretary "•�4111M11� •+tl llt/l1tH/ Nllt/1t1Vt BPOAC2 (combined} (06-42) BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 01/06/2024 Name Kvle Ludlow Department Public Works BPW Date 01/14/2024 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 R. Yoder Construction U Yes U If Yes, Approved by Purchasing ® No E] MBE ❑ WBE Completed E-Verify Form Attached ❑❑ Nos Fire Station No. 8 Replacement 122-034 South Side DA TIF PR-00025426 PO-0026318 087.535.70 Purpose/Description _Project Closeout For Change Orders Only Amount of Increase $ Previous Amount ❑ Decrease Current Percent of Change New Amount Increase Decrease Increase Total Percent of Change: Decrease Time Extension Amount: New Completion Date: