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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />'SOYTMe <br />CITY OF SOUTH BEND, INDIANA 5 6e <br />BOARD OF PUBLIC WORKS n r <br />PROJECT COMPLETION AFFIDAVIT <br />Ignition Park Infrastructure Phase 1C (Division A) <br />4/14/2015 MAINTENANCE AGREEMENT ENDS <br />Site Improvement and infrastructure project at Ignition Park <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��ee its off ials and agents are hereby released from all claims and demands whatsoever arising under or <br />by such %o aEf �a epcontractor perfor ed the work within the scope of the Specifications and Standards of the City <br />of South Bend ich w a art of the a Contract. <br />201 7 Walsh Kelly Inc. <br />Company Name <br />aignaaare 24358 State Road 23 <br />nusti_n Hilary, South Bend Area Manager Company Address <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Dustin Hilary , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 1 th day of January 201 7 <br />N tary Signature IMy Commission Expires June , 7, 2023 <br />Amy Elizabeth Turoin <br />Printed Name County of Residence Marshall <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, J . Michael Schaum certify that I am Secretary of the Corporation executing this release; that <br />Dustin Hilary who signed this release on behalf of the contractor was then <br />SB ea Manag of said Corporation; that said release was duly signed fi <br />rpopioW Authoyi A yI s governing body, and is within the scope of corporate powers: <br />Signature <br />chaum <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable fo( inal approval and we recommend to the Board of Public Works that it <br />Date: l Q 17 <br />Construction MAlIrrsher <br />BOARD F PUBLIC W RKS APPROVAL Date:II�F/rie�7 <br />Gary A. clot, President Elizabeth A. Maradik, Member Suzanne M. Fritzberg, Member <br />James A. Mueller. Member <br />J. Dorau, <br />M. Martin, <br />