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00 <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME -Century Center Cooling Tower Replacement <br />PROJECT NO 1117-035 FINIAL COST $226,631.00 <br />CONTRACT SIGNED -7/11/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Replacement of Century Center cooling tower. <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 I � *'� day of. 201 Edward J. White, Inc. <br />\ X K A Company Name <br />Signbturg 1011 South Michigan Street <br />Company Address <br />Printed Name South, Bend, IN 46601 <br />City, State, Zip <br />WITNESSES& <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />r and acknowledged his/her signature to the above Project Completion Affidavit ',oh"" '<J rl <br />the I "Y+k day of 201 8 <br />Not afy Signature My Commission Expires <br />A(4 6 <br />Printed Name County of Residence <br />if the Contractor is a corporation, the following certificate will be executed. <br />I. certify that I am Secretary of the Corporation executing this release <br />6-(A�er-' , rwho 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 />Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />INc. <br />seqp6tary's Signaturr,) <br />&6r <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable forl'i I approval and we recommend to the Board of Public Works that it be Date: ordain�4,i* <br />"Ill"," 8 <br />1 <br />constructioyM nager -5/0 J <br />BOARD OF PUBLIC WORKS APPROVAL Date: 112c) <br />11A— - - ------------ <br />Gary A. Gilot, President Suizanna M. Fritzbergi, Member Elizabeth A. Maradik, Member <br />Therese J. Oorau, Member Jam— 6 A. Mueller, Member biiAa M. Martin, Clerk <br />' <br />