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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME -Olive Street Metronot Conduit <br />PROJECT NO 117-021 FINAL COST $128,650.50 <br />CONTRACT SIGNED 6/13/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install conduit and handholes along Olive St for future use by Metroniet <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 />Executed this day of 201 C & E Excavating, Inc. <br />Company Name <br />Signature 53767 County Road 9 <br />-ua6j, Company Address <br />Printed Name Elkhart, IN 46514 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for :said country and state, personally appeared <br />and acknowledged his/her signature to the above Project Completion Affidavit on <br />V� �Xf, 201 day of <br />-14o-tary Signatw&) My Commission Expires eu <br />CRAe,TOL, KVAAVC-7-, <br />Printed Name County of Residence eU4+Pq2T <br />If the Contractor is a corporation, the following certificate will be executed. <br />certify that I am Secretary of the Corporation executing this release; that <br />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 />Co ppration by Authority of its governing body, and is within the scope of corporate powers: <br />Co <br />ecre ry'k, Signatuire <br />Corporate Seal <br />Printed IN14ne <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable r fiqal ap�rovall and we recommend to the Board of Public Works that it be ordained so, <br />INNA =( Date: <br />Construcfior�M )mager <br />Gary A. Gilot, President <br />AVA A - <br />Therese J. borau, Member <br />BOARD OF PUBLIC WORKS APPROVAL Date: ( <br />Suzanna M. Fritzberg, Member <br />-Jame fA. Mueller, Member <br />Elizabeth A. Maradik, Member <br />On M. Martin, Clerk <br />