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Change Order No.2(final)-PCA - Demo of Vacant & Abandoned Houses, Phase IX Proj No 116-074B - Green Demolition Contractors, Inc.
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Change Order No.2(final)-PCA - Demo of Vacant & Abandoned Houses, Phase IX Proj No 116-074B - Green Demolition Contractors, Inc.
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3/31/2025 1:59:42 PM
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1/25/2017 9:55:26 AM
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Board of Public Works
Document Type
Projects
Document Date
1/24/2017
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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />,gi <br />CITY OF SOUTH BEND, INDIANA�pN <br />BOARD OF PUBLIC WORKS d. <br />PROJECT COMPLETION AFFIDAVITS.+" <br />Demolition of Vacant & Abandoned Houses, Ph. IX <br />116-074B FINAL COST $196,857.00 <br />Demolition of 11 Houses <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 thp above Contract. / r <br />Executed this day of , 201 C 1 Green Demilition Contractors, Inc. <br />Company Name <br />Si re 1427 W. Dickens Avenue <br />Company Address <br />Printed Name Chicago, IL. 60614 <br />City, State, Zip <br />WITNESSESS: <br />,=e eme, the,,undersigned Notary Public in and for said country and state, personally appeared <br />Clu/i3po�h and acknowledged his/her signature to the above Project Completion Affidavit on <br />the % St day of 0—e— , 201 / 6 KELLY ANN LANG <br />,l ,� n _ NOTARY PUBLIC — OFFICIAL SEAL <br />`7[�iWV 1 Y � 4 State of Indiana, LaPorte County <br />Notary Signature 0 My Commission Expires I'my Commission Ex ices: Oct <br />4 t,0-M--q <br />Printed Name County of Residence <br />If the Contractor i a corporation, the following certificate will be executed. <br />certify that I am Secretary of the Corporation executing this release; that <br />4 who signed this release on behalf of the contractor was then <br />of said Corporation; that said release was duly signed for and on behalf of said <br />Cor fo y Au ty of its governing body, and is within the scope of corporate powers: <br />Sec s ignat <br />+ Corporate Seal <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable or trial approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: 1 1• 1 8• l L <br />Constructio M ager / <br />BOARD F PUBLIC WORKS APPROVAL Date: <br />C-� <br />Gary A. Gilot, President `Suz nna M. Atz erg, M ber Elizabeth A Maradik, Member <br />C <br />Therese J. Do au, ember James A. Mueller, Member i, da M. Martin, Clerk <br />
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