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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME <br />Wastewater Treatment Plant - Digester 2 U saes" " pgrade and Digester Gas Clisaning <br />PROJECT NO. <br />111-029 FINAL $5,930,037.00 <br />COST <br />CONTRACT <br />06/25/2013 MAINTENANCE AGREEMENT <br />SIGNED <br />ENDS <br />PROJECT <br />DESCRIPTION <br />Digester 2: new draft tube mixers, process piping, pumps, building <br />improvements. <br />Digester Gas Cleaning System installed for energy recovery <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having <br />been completed, the City of South Bend, its officials and agents are hereby released from all claims and <br />demands whatsoever arising under or by such contract, and that the contractor performed the work within the <br />scope of the Specifications <br />and Standards of the City of South Bend which were a part of the above Contract. <br />Executed this +, <br />day of _ 20 j <br />J <br />Grand River Construction <br />Signature <br />Company Name <br />bax i(I ho " <br />5025 40th Avenue <br />Printed Name <br />Company Address <br />_Hudsonville, Michigan 49426 <br />WITNESS <br />City/State/Zip <br />Before me, the undersigned Notary Public in and for said country and state, personall appeared <br />�aV ic( C-Oct-b-' , and acknowledged his/her signature to the above Prbr€�kgyrrn �fifn Affidavit <br />on the l4+l'1 day of Se 12t 201 (P NOTARY PUBIJC - STIA. E 0f MICHI&AN <br />C( 9 COUNTY OF OTTAWA <br />Notar Si n ture MY Cam 10 Ex it July 16, 2019 <br />My Commission Exffl% in they rZ <br />�iS�i (?SS V'LP r <br />Printed Name County of Residence 6'EkLr.l.L)al` <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, _bn u i , certify that 1 am Secretary of the Corporation executing this release; that <br />Qnud L 't.c who signed this release on behalf of the contractor was then <br />CF-Q of said Corporation; that said release was duly signed for and on behalf of <br />said Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />— L�� 6V6-t. <br />Secretary's Signature <br />Printed Name <br />Corporate Sea] <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for final approval and we recommend to the Board of Public Works that it be <br />ordained so. <br />l�14";tailW Date: 09-0Q-%0/(0 <br />Construction Manager <br />BOARD OF PUBLIC <br />AL Date: It1:5bo ((o <br />�'i , C s,,- <br />A. Gilot, President mid P. Relos, lMeinber James A. Mueller, Member <br />Ida <br />p. <br />)eth A. Maradik, Member Therese J. ora ember M. Martin, Clerk <br />