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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME 2017 Central Services Remodel <br />PROJECT NO 117-118 FINAL COST $55,258.00 <br />CONTRACT SIGNED 11/28/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Remodel of Central Services including carpet, drywall, paint, and lighting. <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 reieased 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 />Exeou this 11 th day of. May 201 8 <br />Signature <br />Robert A. Lingenfelter, President <br />Printed Name <br />Gibson -Lewis LLC <br />Company Name <br />1001 W. 11 th Street <br />Company Add',ress <br />Mishawaka, IN 46544 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Robert A- TAnclenfe.1ter and acknowledged his/her signature to the above Project Compietion Affidavit on <br />th � �lth day of May 8 <br />NotaSignature My Commission Expires <br />Elizabeth A. <br />Printed Name <br />July 10, 2024 <br />County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, certify that I am Secretary of the Corporation executing this release; that <br />who 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 />Secretary's Signature <br />Printed (Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This projects acceptable for in~ 1F pprovai and we recommend to the Board of Public Works that it be ordained so. <br />Date: :5, <br />Constructor �� ager <br />BOARD OF PUBLIC WORKS APPROVAL Date: �X)61,�,lx <br />Gary A. Gilot, President Suzanna M. Fritzberg, Member F r,7aR'eth A - aradik, Member <br />% <br />p ten„ <br />aLinTherese J. Dorau, Member Ja A. Mueller, Member 9M. �Martin, CI6 k <br />7 <br />