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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME -MPAC-POTO Chandelier Support <br />PROJECT NO 117-03,4 FINAL COST $258,044.74 <br />CONTRACT SIGNED 8/812017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Installation of a support system for the POTO chandelier. <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 />q - <br />febr,�Z <br />Execqte this Itf-) yof aA&D Constructors, LLC <br />Company Name <br />b(mature 1449 Kimber Lane, Suite 103 <br />"D Company Address <br />Printed Name Evansville, IN 47715 <br />City, State, Zip <br />WITNESSES& <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />3. le el- , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 141 TLt , day of FC-6rv-4, 201' " <br />'Notary Signature � c'-) My Commission Expires <br />Printed Name County of Residence <br />If the Contractor is a corporation, the foilowing certificate will Ibe executed. <br />I, Nerd certify that I am 3-etretary of the Corporation executing this reiease; that <br />who signed this release on behalf of the contractor was then, <br />i �,C-r - F 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 />gnature Corporate Seat <br />'6A (AZA Lt L <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable f fi I approval and we recommend to the Board of Public Works that it be ordained so. <br />g,24 , Date: z <br />Constructio tl� eager <br />BOARD go P1K VAL Date: <br />",111A 17 17 <br />Gary A. Gflot(Aesident —SuzahaV. Fri berg, M166mbf Ei'izaTe6 A. Wnidik, Member <br />Therese J. Dorau, ember James A. Mueller, Member 'Lin da M. Martin, Clerk <br />