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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />4 <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />LANGLAB HVAC IMPROVEMENTS (DIVISIONS A, B, C, and D) . ... ... <br />117-024 FINAL COST $75,831.00 <br />11/28/2017 MAINTENANCE AGREEMENT ENDS <br />Remove four (4) unit heaters, install five (5) complete HVAC units, service two (2) existing <br />units, and associated electrical and miscellaneous work at Langlab located in South Bend, <br />Indiana. <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 off icialls 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 />,a4l.'-\ <br />Executed this da of 201 Dynamic Mechanical Services Inc. <br />Company Name <br />Signet r 16016 Chestnut Street <br />Company Address <br />Printed Name Wshawaka, IN 46545 <br />City, State, Zip <br />WITNESSESS.- <br />6 f re me, the undersigned Notary Public in and for said country and state, p( <br />.qand acknowledged his/her signature to the above Proj <br />the day of 201 <br />'Notary Signature 7ommission Expires <br />ca, �c <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following cerfificate will be executed. <br />"e. 'Px C-SC <br />-s e a ;that <br />[I),, V I certify that'll am Secretary of the Corporation executing: this li, i <br />nAA,kQA--�-,J 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 />Se&tgry's Signature Corporate Seal <br />& 1 `/% <br />Printed Name <br />IL DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable nal approval and we recommend to the Board of Public Works that it be ordained so. <br />\� Date: <br />;�7 <br />Constructi anager <br />BOARD PUBLIC VVORKS WPROVAL Date: <br />'Gary A. Gil-oC, President Suann`a/k rri'cz6dg,W*er Elizabeth A. Mar�adik, Member <br />Therese J. Ddrau, MeMber James A. Mueller, Member Gn6a M. Martin, Clerk <br />