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5✓; <br />O 0- <br />CITY OF SOUTH BEND, INDIANA �% <br />BOARD OF PUBLIC WORKS ��'g <br />PROJECT COMPLETION AFFIDAVIT ''.h� <br />PROJECT NAME Chet Waggoner Court <br />PROJECT NO 116-005 FINAL COST $625,856.95 <br />CONTRACT SIGNED 8/23/2016 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Installation of a new road with utilities off of Dylan Drive <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 or <br />by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend which were a part of the above Contract. <br />Execute this 3 y Tan 201 7 HRP Construction Inc <br />Company Name <br />Signature 5777 Cleveland Rd <br />Matthew D. Cain, President Company Address <br />Printed Name <br />South Bend, IN 46628 <br />City, State, Zip <br />WITNESSES: <br />Before me, the undersigned Notary Public in and for said county and state, personally appeared <br />Matthew D. Cain and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 13/t/h day of January 201 7 <br />Notary Signaturd My Commission Expires <br />Cindv Ilanheste <br />Printed Name <br />County of Residence <br />3/6/24 <br />St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Nancy Knapik certify that I am Secretary of the Corporation executing this release; that <br />Matthew D. Cain who signed this release on behalf of the contractor was then <br />President of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Corporate Seal <br />Nancy Knapik _ <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable fqr fillal approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: Z , -7 • I l <br />Construction6mger <br />BOARD OF PUBLIC WORKS APPROVAL Date: ��i <br />U <br />Gary A. Gilot, President 3 ,u NN n i, Pe. rze'¢r{ r�tE..eee Elizabeth A Maradik, Member <br />Therese J. Dorau, M ber Jame A. Mueller, Member in a M. Martin, Cler c <br />