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s9u3 <br />CITY OF SOUTH BEND, INDIANA %�; <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Hill St. & Colfax Ave, on Site Improvements <br />PROJECT NO 113-033 FINAL COST $182,715.29 <br />CONTRACT SIGNED 9/9/2014 MAINTENANCE AGREEMENT ENDS <br />Clearing, earthwork, grading installation of underground utilities, concrete approach, asphalt <br />PROJECT DESCRIPTION paving concrete curb and sidewalk. <br />WITNESSETH: <br />The work underth2 above ontract between the City of South Bend and the undersigned contractor having been <br />completed, the'Cfiy of S th Bend, its officials and agents are hereby released from all claims and demands whatsoever <br />arising under or by sue contract, and that the contractor performed the work within the scope of the Specifications and <br />Standards of the City f South Bend which were a part of the above Contract. <br />Execud this kith day of S,eytember 201 6 Walsh & Kelly, Inc. <br />7 ; -'�� Company Name <br />Sgnature 24358 State Road 23 <br />'Dustin Hilary, Area Manager Company Address <br />Printed Name South Bend, Indiana 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />D,,.at; n Hilary and acknowledged his/her signature to the above Project Completion Affidavit on <br />of <br />201C,_. <br />Notary Signa fe NotaryPubliaf9Kr9 4nji n Expires May 4, 2018 <br />Paula J Fuchs nai <br />JofR <br />Printed Name MA �flor�idence St Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, J. Michael Schaum certify that I am Secretary of the Corporation executing this release; that <br />Dustin Hilary who signed this release on behalf of the contractor was th <br />P y 9 `voFf 4f" <br />A of said Corporation; that said release was duly signed for and o Iaf <br />C por�i by Author' f governing body, and is within the scope of corporate powers: �.` g�........•.,4 <br />�3f L,^,RPORATF?2n <br />Secre ry's Signature = Co 11T9tewsealg 2 <br />SEAL : <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL �N�;ANP`����4� <br />This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained s00, 5. <br />Date: Q. t - t t. <br />Constructio - Hager <br />BOARD OF PUBLIC WORKS APPROVAL Date: 6 <br />Gary A. Gilot, President David P. Relos, ember Elizabe 1 A Maradik, Member <br />Therese J. Dorap, Wmber Jame A. Mueller, Member Unda M. Martin, Cleek <br />