Laserfiche WebLink
`asou ru 8.ry. <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT , INO <br />PROJECT NAME Fire Station #7 HVAC <br />PROJECT NO 116-067 FINAL COST $11,760.00 <br />CONTRACT SIGNED 8/30/2016 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install a Ductless Single Zone Hear Pump in Fire Station #7, 1616 Portaqe Ave. <br />WITNESSETH <br />The work under the above contract between the City of South Bend and the undersigned contractor having been completed <br />the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under c <br />by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the Cit, <br />of South Bend which were a part of the above Contract. <br />Execut this 4th day of November 2016 Ideal Consolidated, Inc. <br />77;� j�a/l„�— Company Name <br />Signature 806 W. Sample St. <br />Fred Mohler Company Address <br />Printed Name South Bend, IN 46601 <br />City, State, Zip <br />WITNESSETS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Fred Mohler and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 4th day of November 201 6 <br />"h �nE�mmission Expires <br />JosepCount <br />nisslon # 654785 <br />08/01/22 <br />of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />Jennifer M. Brown certify that I am Secretary of the Corporation executing this release; that <br />Fred Mohler who signed this release on behalf of the contractor was then <br />Service Manager of said Corporation; that said release was duly signed for and on behalf of said <br />Co poration by uthority of its governing body, and is within the scope of corporate powers: <br />S car tas Signatll/V ture Corporate Seal <br />5ennifer M. Brown <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptablefo final approval and we recommend to the Board of Public Works that it be ordained so. <br />I Date: l l - l 14 <br />Constructio anager <br />BOAR OF PUBLIC WORP APPROVAL Date: <br />// <br />Gary A. Gil President S zanna . Fritzberg, 6 ember <br />, Elizabeth A Maradik, Member <br />Therese J. Dor u, Member James A. Mueller, Member ¢ a M. Martin, Clerk <br />