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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME <br />2017 Curb and Sidewalk Div. B,,C, D,E & F <br />PROJECT NO <br />117-008 FINAL COST $268,381,00 <br />CONTRACT SIGNED <br />5/23/2017 MAINTENANCE AGREEMENT ENDS <br />Removal and replacement of concrete sidewalk, concrete curb, ADA compliant concrete curb <br />PROJECT DESCRIPTION <br />ramps, and concrete approaches. <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 />I <br />of South Bend which were a part of the above Contract, <br />Executed this 19th day of June .201 8 ZiolkowsId Construction, Inc. <br />!��J �c -1 Company Name <br />/Signature 4050 Ralph Jones Drive <br />Bill Favors President & CFO Company Address <br />Printed Name South Bend, IN 46628 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Bill Favors -. and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 19th dall i f Jrrne 2018 <br />LYNN D VINiN:G <br />Sea[ <br />March 6, 202 Notary Public.. State of Indiana <br />Notary S My Commission Exp�ires ri <br />MY commission Expires mar 6,2o2s <br />Lynn D. Vining IM] <br />Printed Name County of Residence Elkhart <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, Charles Lewis certify that I am Secretary of the Corporation executing this release; that <br />Bill Favors who signed this release on behalf of the contraopmewthoo <br />President & CFO of said Corporation; that said release was duly signed jo?'% $0 . V id <br />its governing body, and is within the scope of corporate powers. «4 -I <br />0 <br />Secretary's Signature <br />0 V AC -Iry <br />porid <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL 1. <br />This project is acceptable for final approval and we recommend to the Board of Public Works that <br />M <br />Construction Manager <br />BOARD OF PUBLIC WORKS APPROVAL Date: <br />AA IIJAA,,-- <br />Gary A. Gilot,'Pfeside!nt , Suzan e(W Fr'6156& Meo6er Ehab 66 A Maradilc, We­-M-er <br />