Laserfiche WebLink
CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />sb �a7 <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME YORK ROAD SEWER REPAIRS (Div. A&B, & Alt.1) <br />PROJECT NO 115-139R FINAL COST $68,338,50 <br />CONTRACT SIGNED 12/12/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Repair damaged sewers, inlets and manholes near York Road and Crescent Oaks Subdivision. <br />WITNESSETH <br />The work under the above contract between the City of South (Bond 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 thi day of _ �-O _, 201 i? C & E Excavating, Inc. <br />Company Name <br />Signature 53767 CR9 N' <br />Company Address <br />Printed Name Elkhart, IN 46514 <br />City, State„ Zip <br />WITNESSESS: <br />B fare, me, the undersigned Notary Public in and for said country and state, personally appeared <br />k�56tVrw4- , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the t VI— day of 201 �y �/ ry �y / q ry <br />**v,AlYY1lPld/fA!/ JEFFRE9 L dONADIE,S <br />��d!'' t y Public. State of Indiana <br />Notary Signature My Commission Expires St. Jos®h Count <br />Commission N 709551 <br />MYy Con i M n Expires <br />026 <br />Printed Name County of Residence <br />If the C ntractor is a corporation, the following certificate will be executed. <br />I,Yi t tikwrU�lrcS certify that I am Secretary of the Corporation executing this release; that <br />I Q-A Bwho signed this release on 'behalf of the contractor was then <br />u of said Corporation; that said release was duly signed for and on behalf of said <br />orpora ion by thority of its governing body, and is within the scope of corporate powers: <br />Se reta s nature <br />� $ Corporate Seal <br />Printed Na e <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for fin approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: 's, - t 0 • I <br />Construction ° urger <br />BOARD OF PUBLIC WORKS APPROVAL Date: A') <br />Gary A. Gildt; President Suzanna M. Fritzberg, Member Eliza et A. Maradik, Member <br />Therese J. Dorau, Member Ja s A. Mueller, Member `::Ein a M. Martin, Clerk <br />