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Change Order & PCA - Fellows Streetscape Broadway to Ewing Proj No 116-041B - Walsh & Kelly Inc
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Change Order & PCA - Fellows Streetscape Broadway to Ewing Proj No 116-041B - Walsh & Kelly Inc
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4/2/2025 1:21:08 PM
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Board of Public Works
Document Type
Projects
Document Date
2/27/2018
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CITY OF SOUTH BEND, INDIANA <br />BOARD OF IPUBLIIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME -Fellows Streetscape <br />PROJECT NO 116-041 B FINAL COST $458,503.00 <br />CONTRACT SIGNED 6/27/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT IDESCRIPTION Install now curb, sidewalk, sod, and trees along Fellows St. <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 Bond,, it als and age are hereby released from all claims and demands whatsoever arising under or <br />0 ,t, a by such contract, n at th contractor erformed the work within the scope of the Specifications and Standards of the City <br />e � <br />of South Bend w i were part of th bove Contract. <br />9th <br />Executed thl:qt - it <br />of Walsh & Kelly <br />2� !T Company Name <br />Sign u7r 24358 State Road 23 <br />Ytin Hilar-y Company Address <br />Wred Name South Bend, IN 46614 <br />City, State, Zip <br />WITNES,SESS: <br />Before me:, the undersigned Notary Public in and for said country and state, personally appeared <br />11istin Mary and acknowledged his/her signature to the above Project Completion Affidavit on <br />the f19th ll"Jai of January, .201 8 <br />Notary Si na ALj IWA—k-RGtGER Commlss6on Expires 6/5/22 <br />Alisha N,IarY Public, State <br />Printed Name Fxp4eS <br />of Residence St. Joseph <br />If the Contractor is be executed, <br />J. Michael S <br />certify that I am Secretary of the Corporation executing this release; that <br />Dustin Hiljry <br />who signed this release on behalf of the contractor was th, <br />South Bend Area-Mmap-er <br />of said Corporation; that said release was duly signed for and op'0MI)19 !,141'a'o <br />Corporation b AuP��&i Of its <br />d r I g body, and is within the scope of corporate powers; IN , <br />c) <br />Secretary's Si store J. Michael SchaLun <br />tCfl <br />orporate Seal <br />J. Michaey/Schaum <br />Printed Name <br />"Oe <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />INM P" <br />This project is acceptable fbr fi I approval and we recommend to the Board of Public Works that it be ordaind449q t 4110%� <br />Date: <br />Construction tiger <br />BOARD40 PUBLICq/WORKS APPROV L Date: <br />Gary A. Gil(Yt, President <br />,Sdz a . Fritlberg- M6-M6er Elizabeth A. Maradik, Member <br />---1`$dza <br />I(MINW., <br />1h I <br />James A. Mueller, Member Li % nda � , Martin, Clerk I <br />Therese J. Dorau, Member <br />
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