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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC 'WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME 2017 Tree Plantings <br />PROJECT NO 117-009B FINIAL COST $a19,000.00 <br />CONTRACT SIGNED 9/1212017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Plant'inq of various trees throughout curb & sidewalk project areas, <br />7i►KALIIZ&9l*M: <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 Contract. <br />Exehi's South Bend which were a Q�()1 a 6rt the ahoy ,%01 �� Fuerlaringer Landscaping & Design, Inc. <br />�� Company Name <br />Signature 22530 Brick Road <br />� (ZARZ 40-Company Address <br />Printed Name South Bend, IN 46628 <br />City, State, Zip <br />WITNESSES& <br />Before me, the undersigned Notary Public in and for said count <br />ry and state, ersonall appeared <br />d ,! - a 4,2�?,r�,[s , and acknowledged his/her � t %8' 9' � �, r Ietion Affidavit on <br />the da rib �Y ALIC C, Nd kIfdLE`� <br />yof !,-,A, 201 7 . x INdIRNA <br />�~ NO�TNJO8EF"li COUNTY <br />�u ,, x i�res 9126f2p24 is <br />,r. <br />Notary Signature <br />Printed Name County of Residence <br />If the C tEpp <br />ion, the following cerkificute will be executed. <br />I, ""Cr.�t 1�2 _„ certify that I amSecretary of the Corporation executing this release; that <br />411 <br />j 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 oratiots governiing body, and is within the scope of corporate powers: <br />Secret ry's Signature <br />� f � Corporate Seal <br />Printed ame �t <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for h approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: it. eg.t" <br />Construction er <br />BOARD OF PUBLIC WORKS APPROVAL Date: <br />Gary A, Gllot resident Suzanna M. Fritzberg, Member izabeth A. Maradik, Member <br />Therese J. Dora , Me er James A. Mueller, Member inda M. Markin, <br />