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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECTNAME Martin Luther King Jr. Center HVAC Revisions <br />PROJECT NO. 116PO64 FINAL COST $379,708.00 <br />CONTRACT SIGNED MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION HVAC Revisions <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having <br />been completed, the City of South Bend, its officials and agents are hereby released from all claims and <br />demands whatsoever arising under or by such contract, and that the contractor performed the work within the <br />scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. <br />Execute tl's of January 20 17 <br />Herrman & Gnet7, Tnr_ <br />gnr Company Name <br />trry Cripe 225 S. Lafayette $lvd. <br />Printed Name Company Address <br />Smith Band, TN 46601 <br />City/State/Zip <br />WITNESSES <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Larry Cripe , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 16th day of January , 2017 <br />Notary Signatu a My Commission Expires <br />7/13/2022 <br />Catherine J. Gnuber <br />Printed Name County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, Ka ht een A. Herrman, certify that I am Secretary of the Corporation executing this release; that <br />Larry Cripe who signed this release on behalf of the contractor was then <br />Power —of —Attorney 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 />Secre A SL re <br />Corporate Seal <br />Kathleen A. Herrman <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 <br />ordained so. <br />Date: Z • l 4 • l "1 <br />Construc of Manager <br />BO RD OF P> BI,I6'ROVAL Date <br />Gary A. Gilo , President Suzanna M. Fritzberg, Member <br />Jam A. Mueller, Member Therese J. D rau, Member <br />Elizabeth A.,Maar/adik,,�Member <br />i �st:. Y G( /"Y( <br />da M. Martin, Clerk <br />