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CITY OF SOUTH BEND, INDIIANA � <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETI0N AFFIDAVIT <br />PROJECT NAME Monroe Street Parking Lot <br />PROJECT NO 117-043 FINAL COST $225,138.93 <br />CONTRACT SIGNED 5/23/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install a new parkinq area and vacate or repave portions of Monroe St. <br />iflffli11 3� 11201 <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�t the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend whic ere a part of the above Contract. <br />Executed this <br />S <br />Printed Name <br />2018 Walsh Kelly Inc. <br />Company Name <br />24358 State Road 23 <br />Company Address <br />South Bend, IN 46614 <br />City, State, Zip <br />WITNESSIESS: <br />Before me, the undersigned Notary Public in, and for said country and state, personally appeared <br />Dustin Hilary and acknowledged his/her signature to the above Proie�Mpletion Affidavit on <br />the kith air of, Se ber 201 1 1 A K H tJ E C� F Fi <br />Notary Public. Sta1a at Indiana <br />:SEAL; St. JoaoPhCounty <br />nn expires <br />Naig ature i,Ayo�rimisiliIrS <br />iune 00, 20 22 <br />June 5, 2022 <br />Alzsha Krueger .._..._. <br />Printed Name County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed, <br />1, J. Wchael SchaLun certify that I am Secretary of the Corporation executing this release; that <br />Dustin Hiiary who signed this release on behalf of the contractor <br />VP of Sot of said Corporation; that said release was duly signed for r� orita"IJ`�fai'a <br />g y p p � <br />Corporation�A� fits o ni bod and is within the scope of corporate powers: z <br />Secretary's Sig at rep <br />r rte foal: <br />J. Iicl�ae Schaum ° <br />Printed NarAe AM1ry a"' <br />DEPARTMENT OF PUBLIC WORKS APPROVAL �z���r� �tD4�������:w <br />This project is acceptable for fin approval and we recommend to the Board of Public Works that it be ordained. <br />.,�_..... Date: t <br />is <br />Constructiont tiger <br />BOARD OF PUB IC WORKS APPROVAL <br />�k I , <br />Gary A. Gilot, President . an a Fritzberg,t/rIld <br />Therese J. Dorau, Member ,Dames A. Mueller, Member <br />Date. % C> o 7 �;2. (3 ✓ ' <br />UL� <br />Elizabeth A. Maradik, Member <br />,..Lin a M. Martin, Clerk <br />