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4yOli ly._y� <br />CITY OF SOUTH BEND, INDIANA a. `- <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Fellows Street and Dubail Street Neighborhood Improvements <br />PROJECT NO 116-041A (Division A) FINAL COST $54 217 75 <br />CONTRACT SIGNED 9/13/2016 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Restripe Fellows Street and Dean Johnson Parkway Place new signage <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 w e a part <br />y�(r <br />of the above Contract. <br />Execute is - day ofU 'OVEr? RE;?, 201 a Airmarking Co. Inc. <br />Company Name <br />//��ignaturer/�+ P.O. Box 526 <br />l_E co L 6 , E Company Address <br />Printed Name Rochester, IN 46975 <br />City, State, Zip <br />WITNESSESS: <br />efore me the undersigned Notary Public in and for said country and state, personally appeared <br />DREG L OUE and acknowledged his/her signature to the above Project Completion Affidavit on <br />the krday of B. R201(._. <br />NotarySignature S My Commission Expires <br />PE9W-4 L. PIKE <br />Printed Name County of Residence <br />M07of <br />ing certificate will be executed. <br />certify that I am Secretary of the Corporation executing this release; that <br />who signed this release on behalf of the contractor was then <br />said Corporation; that said release was duly signed for and on behalf of said <br />?Zqrporation by Authori o s 8 verning body, and is within the scope of corporate powers: <br />Secretary's Sign a Corporate Seal <br />PEN PWE <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 />Date: 1 1 • ZL - 14 <br />Construction a ager <br />�� BOAR OF PUBLICr �WORKS APPROVAL Date: � "� / 3 /lc <br />Gary A. Gilot, President Suzanna M. rritzbbeerg, M/e er Elizdbeth A. Maradik, Member <br />Therese J. Do au, tuber Jame A. Mueller, Member Lfno M. Martin, Clerk <br />