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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME College St & Sunnvmede Ave Traffic Calming <br />PROJECT NO 117-113 FINAL COST $37,400.00 <br />CONTRACT SIGNED 12/12/201�7 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install traffic calming devices at two (2) locations, all within the City of South Bend, IN, <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 />Execute his 11 th daY of - way 201 <br />e§gnaiu-re <br />Tom Lentz, Project Manager <br />Printed Name <br />SeIge Construction Co., Inc. <br />Company Name <br />2833 S. I 1th Street <br />Company Address <br />Niles, MI 49120 <br />City, State, Zip <br />WITNESSES& <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Torn,Lentz , and acknowledged his/her signature to the above Project Completion Affi <br />t e 1 day of ,,14a 201 8 <br />Notary Signature My Commission Expires 07/25/2020 <br />Vicki A. Priest <br />70177-417kp- "IR <br />County of Residence <br />10,47JIMS <br />I <br />F PUBLIC <br />(A My COMWSSION <br />7-25-2020 <br />If the Contractor is a corporation, the following certificate will be executed. -11111FIfIlIM, <br />1. Vicki A. Priest certify that I am Secretary of the Corporation executing this release; that <br />Tom Lentz who signed this release on behalf of the: contractor was then <br />P-rn-i imr-+ Manager of said Corporation; that said release was duly signed for and on behalf of said <br />Corp, ation'by Authority,pf its governing body, and is within the scope of corporate powers: <br />X <br />Secretary's Signature' Corporate Seal <br />Vicki A. Priest <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for -fin pproval and we recommend to the Board of Public Works that it be ordained so. <br />a -A Date: <br />Construcfion tiager BOARD OF PUBLIC WORKS APPROVAL Date: <br />Gary A, Gilot, President Suzarma M, Fritzberg, Member Eliza i5th'A Maradik, Member <br />Therese JI. trorau,'Member <br />James A. Mueller, Member <br />irlda M. Martin, Clerk <br />