PCA - Century Center North Bridge LED Lamp Retrofit Proj No 116-007A - Days Corporation

Home Browse Search

I o4� r�eF> CITY OF SOUTH BEND, INDIANA o, BOARD OF PUBLIC WORKS`''' PROJECT COMPLETION AFFIDAVIT PROJECT NAME Century Center North Bridge LED Lamp Retrofit PROJECT NO. 116-007A FINAL COST $4,653.00 CONTRACTSIGNED 1o/11/2016 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION Repair and Install LED lamps, Gaskets and needed mounting hardware. WITNESSETH: The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. Executed this 21st day of November 120 16 f�gJ^ Days Corporation SigtatIu'r^e Company Name IA' Lt, L I Av`^ O Fi 1-- a 55169 Co. Rd. 3 Printed Name Company Address Elkhart, IN. 46514 City/State/Zip WITNESSES Before me, the undersigned Notary Public in and for said country and state, personally appeared ttiJrv�, �V�+ and acknowledged his/her signature to the above Project Completion Affidavit on the day of bJew,,b(,v' , 201L. —No ary Signature My Commission Expires 4 -DA -aLoa � I I'dC e. L S i e v e ors Printed Name County of Residence E k h[g Y + If the Contractor is a corporation, the following certificate will be executed. I, certify that I am Secretary of the Corporation executing this release; that who signed this release on behalf of the contractor was then ofsaid Corporation: that said release was duly signed for and on behalf ofsaid Corporation by Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Corporate Seal Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. Date: l 29 • l 4 Constrr� ucc`ts"anager BOA— F PUBLIC WOR S APPROV L Date: v�L• Gary A. Gi t, President Suzanna . r , Fritzbee ber Elizabeth A. Maradik, Member n _ ., A. Mueller, Member Therese J. Dor$ti, Metftber \l i 0a M. Martin,