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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME -Century Center Vestibule Heater Replacement <br />PROJECT NO 117-044 FINAL COST $,34,150.74 <br />CONTRACT SIGNED 12/12/2017 MAINTENANCE AGREEMENT ENDS, <br />PROJECT DESCRIPTION Replace vestibule heaters at the Centuiry Center, <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 />of South Bend which were a part of the above Contract. <br />Eed t is day, of J 1201 Edward J. White, Inc. <br />x7�,qktmk— Company Name <br />It 14 nature 1011 S. Michigan St. <br />Joe ICJ4," Company Address <br />Printed Name South Bend, IN, 46601 <br />City, State, Zip <br />k1i Vfin' <br />WITNESSESS: <br />Befol,e me, the undersigned Notary Public in and for said country and state, personally appeared <br />tjk,.44 and Af <br />be- acknowledged his1her signature to the above Project Completion fid <br />the S44- <br />day of Jut (,% 201 <br />-DQZ, <br />No Signature My Commission Expires 0 12L <br />A( <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, mickael I ayl certify that I am Secretary of the Corporation executing this release; that <br />f� ,.-k 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 />" <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: — <br />INC. <br />Secre4ry's Signature) <br />Qorpo*V-eX1,' <br />A <br />yr <br />ra <br />Printed Name <br />"-3 <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This projegLiaacceptabl rc fl a approval and we recommend to the Board of Public Works that it be arclainedJo. <br />Date: <br />Constructiow ager <br />BOARD OF PUBLIC WORKS APPROVAL Date• Id CV V <br />A <br />I , 4 <br />Gary A,Gresident (14'zaifna­10. Fr berg'Mem- bir Elizabeth A.%Maradik, Member <br />Hot,rV <br />L <br />Therese J. Dorau, Member James A. Mueller, Mernber 'Cq4da M. Martin, Clerk <br />