Change Order No 3 & PCA - Edison and Ironwood Road Corridor Rehabilitation Proj NO 116-070 - Rieth Riley Construction Co Inc

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CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS e i PROJECT COMPLETION AFFIDAVIT PROJECT NAME -Edison Road Corridor and Ironwood Road Corridor Rehabilitation, PROJECT NO 116-070 FINAL COST $1,330,517.10 CONTRACT SIGNED 6127/2017 MAINTENANCE AGREEMENT ENDS Perform 1.5" mill and resurface, HMA patching, curb ramp replacement, PROJECT DESCRIPTION! pavement marking replacement, and traffic signal improvements. WITNESSETH: The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. Executed this day of A/72,-,* ✓ 201 Rieth-Riley Construction, Co., Inc. Company Name Signature 25200 State Road 23 h�e Company Address Printed Name, South Bend, IN 46614 City, State, Zip WITNESSES& Before me, '2 the nder6ign d Notary Public in and for said country and state, personally appeared r-And acknowledged his/her signature to the above Project Completion Affidavit on the day of �gK) JI 201 Neta�y—signature My Commission Expires a./P Printed Name County of Residence J ti Vt ontra a or oration, the following certificate will be e ecof d. I C certify that I amacretary of the Corporation executing this release; that it-JOSAU.'I . . .......... /,q who signed this release on behalf of the contractor was then 7251a �lr_ 5 ,� aAa&j�-- of said Corporation; that said release was duly signed for and on behalf of Said Corporation by Authority of its ts governing body, and is within the scope of corporate, powers: SUE ANNE CIRA Secretary's Signature i Goal Corporote Seal Notary P0111c - State of 1008 St Joseph County Conoselop Empires Oct 22, 2022 DEPARTFANT OF PUBLIC WORKS APPROVAL This project is acc approval and we recommend to the Board of Public Works that it be ordained so. Date: 3 Construction �nager ,_ BOARD OF PUBLIC WORKS APPROVAL Date: A -on Gary A. Gi,lot, 'President Suzanne M. Fritzberg, Member Elizabeth A Maradik, Member Therese J. Doffu, Member Jame A. Mueller, Member Lin M. Martin, Clerk