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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />Sou H <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT,' <br />,ate <br />Park Infrastructure, Phase 1C: Division B <br />4/28/2015 MAINTENANCE AGREEMENT ENDS <br />The work under the above contract between the City of South Bend and the undersigned contractor having been <br />completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever <br />arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and <br />Standards of the City of South Bend which were a part of the above Contract. <br />Executed this 22nd day of August 201 6 Majority Builders, Inc. <br />Company Name <br />Signature 62900 US 31 South <br />Rick Slagle/President <br />Company Address <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Rick Slagle and acknowledged his/her signature to the above Project Completion Affidavit on <br />the <br />/22nd day of Aug�ust� 209 6 <br />NotAqj,gigriature My Commission Expires <br />Jill S1aRle <br />Printed Name <br />County of Residence <br />/16 <br />St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, Mark W. Slagle certify that I am Secretary of the Corporation executing this release; that <br />Rick Slagle who signed this release on behalf of the contractor was then <br />President of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Aut its gover j g body, and is within the scope of corporate powers: <br />'Sec(el&y's Sg ature <br />Corporate Seal <br />Mark W. Slagle <br />Printed Name <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 ordained so. <br />7=EOM V Q e Date: 8. 14. t t. <br />Construction Noilager <br />BOARD OF PUBLIC WORKS APPROVAL Date: <br />Gary A. Gilot; resident 199vid P. Relos, Member Eliza e h A. aradik, Member <br />Y IJc L <br />Therese J. DoraIX MeWber James A. Mueller, Member \Yndb M. Martin, Clerk <br />