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aaourx <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Marriott Hotel Site Development at Hall of Fame <br />PROJECT NO 116-021 FINAL COST $820,196.87 <br />CONTRACT SIGNED 6/28/2016 MAINTENANCE AGREEMEI <br />PROJECT DESCRIPTION <br />LTA noI:6 1=119: <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 />Execu this 1 a t day of February 2017 Majority Builders Inc <br />Company Name <br />Signature ( 62900 US-31 <br />Rick Slagle Company Address <br />Printed Name South Bend, IN, 46614 <br />City, State, Zip <br />WITNESSES: <br />Before me, the undersigned Notary Public in and for said county and state, personally appeared <br />Rick Slagle and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 1st dayof February ,201 7 <br />Notary Signature —My Commission Expires <br />Shane Blotkamp <br />Printed Name County of Residence <br />November 8, 2024 <br />Elkhart <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Mark W. Slagle certify that I am Secretary of the Corporation executing this release; that <br />Rick Slagle 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 byA thor2y of Its governing body, and is within the scope of corporate powers: <br />5ecre+ s Sign ture <br />Corporate Seal <br />_ Mark W. Slagle <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />Thisproject is acceptable toff' al approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: J0 t7 <br />Constructio pager <br />VlqA�� <br />Gary A. Gilot, President <br />,-� Lr'� <br />Therese J. Dora , M&fber <br />BOARD OF PUBLIC WORKS APPROVA <br />Suzanna M. Fritzberg, Member <br />`I <br />Jam s A. Mueller, Member <br />