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PROJECT NAME <br />PROJECT NO. <br />CONTRACT <br />SIGNED <br />PROJECT <br />DESCRIPTION <br />Jal", M ova @I - <br />—Wastewater Treatment Plant D <br />116-05OR FINAL <br />COST <br />Gas Utilization <br />693,173.00 <br />12/22/2016 MAINTENANCE AGREEMENT 12/22/2020 <br />ENDS <br />Cleaned Gas Transmission Piping, Buffer Tank, and Instrumentation <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having <br />been completed, the City of South Bend, its officials, and agents are hereby released from all claims and <br />demands whatsoever arising tinder or by such contract, and that the contractor performed the work within the <br />scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. <br />Executed this day of 20 <br />Thieneman Construction, Inc. <br />Signature Company Name <br />Matt McCoy 17219 Foundation Parkway <br />Printed Name Company Address <br />Westfield, Indiana 46628 <br />City/State/Zip <br />WITNESS <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />1) ) 3,ti )1111 pjj _, and acknowledged his/her signature to the above Project Completion Affidavit <br />on the day A �-YLU u 201 <br />2 <br />20 Z_cp <br />Notary Sing nature My CR <br />5Q <br />Printed Naftie County o04 <br />C,Q �O�\ <br />If the Contractor is a corporation, the following certifys ill be executed, <br />1, Michael E. Robinson certify that I am S etary of the Corporation executing this release; that <br />Matt McCoy who signed this release on behalf of the contractor was then <br />Project Manager of said Corporation; that said release was duty signed for and on behalf of <br />said Corporation by Ant of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature Corporate Seal <br />Michael E. Robinson <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for final approval and we recommend to the Board of Public Works that it be <br />ordained so, <br />Date: 90/8 <br />Construction Manager <br />BOARD OFPUBLIC KSAPPROV Date: <br />, 4 <br />Gary A, Gilot, President Suzary_aW. Ntzi3e'r"g"', JMernb�er _J_arnes A. Mueller, Member <br />, Q-k <br />Elizabeth A. Maradik, Member Therese J. Doran, Member inda M. Mart insalariV­ <br />