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Home My WebLink AboutPCA - 2024 Thermoplastic Striping Proj No 124-025 - CE Hughes Milling, The Air Marking1316 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 28, 2025 Ms. Caroline Hughes CE Hughes Milling, Inc. DBA The Airmarking Co. 1544 N. SR 25 Rochester, IN 46975 carolinegairmarkin .cg om RE: Project Completion Affidavit — 2024 Thermoplastic Striping — Project No. 124-025 Dear Ms. Hughes: At its January 28, 2025 meeting, the Board of Public Works approved the Project Completion Affidavit for this project in the amount of $16,704. 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 4AVf A,{ CITY OF SOUTH BEND. INDIANA; BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME Thermoplastic Striping PROJECT NO 124-025 FINAL COST $16.704.00 CONTRACT SIGNED 9/24/2024 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Strinina at nortaae/lathrov and rK)rta¢e/boland round-abouts 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. this daN of, —� ��2021. Name WITNESSESS: e1/ _ the day ofN , �. SFAS. No Sianat e t CE Hughes Milling, Inc., DBA The Air Markina Co. Company Name 1544 N SR 25 Company Address Rochester. IN 46975 Notary public, State of Indiana Royd Cour* Commission Number NP0739934 My Commission Expires March 20, 2030 x f Tres Printed NamL County of Residence If the Contractor is a corporation, the following certificate will be executed. I, certiA, that I am Secretary of.the Corporation executing this release-, that f''fmy,%Ai vq. vWakuS _ who signed this release on behalf of the contractor was then — F itsikk+ a of said Corporation; that said release was duly signed for and on behalf of said Corporation by Autilprity of its governing body, and is within the scope of corporate powers: �v — Secretarv's Sig'nattureCorporate Seal 2-, W k 1� fM.'U 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. &A Z-,' t Date: 1/9/9094 Cons etum Manager CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Elizabeth A. Maradik, President Gary A. Gilot, Member Murray L. Miller, Member Joseph R. Molnar, Vice President Breana Micou, Member Attest: Theresa M. Heffner, Clerk Date: January 28, 2025 cay-DUv�t �t('C0hes (Name of Officer) CE I- ehes Mi,lliv"O' my ., of DgA The AErvu.a{zrivLO Co (Subcontractor/Supplier) FINAL WAIVER OF LIEN being duly sworn that he/she is the having contracted with ares�devut (Title) City Of south gevO (Contractor) to furnish certain materials and/or labor as follows: Themt.opLasti a stripLo'CA (Description) for a project known as 124-025 Tk 6 rn&oph2sti c stripi vLO (Name of Project) located at T>ort2ge/Lathrop RAg avLd l>OrtaOe/goLawd RAg and owned by CCtI Of South gevud (Owner) and does hereby further state on the behalf of the aforementioned subcontractor/supplier: FINAL WAIVER that the final balance due from the contractor is the sum of s�xteev, Thousawd sevev, r fvwudred :FOLtr DOLLars 00/1oo ($i6,7o4.00) (Amount Written Out) ❑ receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective 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 the above -described 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 further 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 said project, and within the scope of this Affidavit and Waiver of Lien. Date 2 I�1� Ua ,11nG,, �,E�rj ( rkpw By (F u on ed Representative) STATE OF VLd l a wa_ ) ,,o<�i P� -- ND�y�p� Sttaatee oR(Nndlana ;a. o=_ SS: _ SEAL; ? � councr cDmrnisC Number NP0739934 II �COUNTY ) '-'�My (ommlasion E � HDinN,. March: 2030 Before me, the undersigned, allotary Public, in an y appeared (1.WOI.w`�. S and acknowledged the execution of the foregoing Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the day of ail ( I A&A09K 2024 My Commission Expires: 1j OA� A� Notaig Public Si ature Residing in R)G,-4 n County Notary Public N e BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 01/09/2024 Name Kvle Ludlow Department Public Works BPW Date 01/28/2025 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 CE Hui New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Information DBA The Air Marking Co. ❑ Yes ❑ If Yes, Approved by Purchasing ® No ❑ WBE Completed E-Verify Form Attached ❑❑ Nos 2024 Thermoplastic Striping 124-025 Local Road & Street PR-00034249 PO-0033936 $16,704.00 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: