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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />'16 <br />PROJECT COMPLETION AFFIDAVIT' <br />PROJECT NAME -Tucker Drive <br />PROJECT NO 116-118A FINAL COST $309,203.68 <br />CONTRACT SIGNED 4/24/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Tucker Drive roadwav improvement and exnansion of turninu radii. <br />M111110114*14111100 <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 whichwri5)e a part of the above Contract. <br />Executed this d gust Walsh & Kelly Inc, <br />Company Name <br />Signat 24358 State Road 23 <br />Dustzvol'ary, VP of South Bend Area Company Address <br />Prmted Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSES& <br />Before me, the undersigned Notary Public in and for said country and state:, ersonaly appeared <br />Dustin Hilary and acknowledged his/I , 11 1 R �o pletion Affidavit on <br />the 27ft1. doyot I August 201 8 Notary Public, stets of Indiana <br />St, Jos e p h Cou n ki <br />My commission Expires <br />Notary Signature JYIRmiss2qjL:0p&,202 2 e 5, 2 <br />Alisha naLeger <br />Printed Name County of Residence St, Joseph <br />If the Contractor is a corporation, the following certificate will be executed, <br />J. Michael Schaufn certify that I am Secretary of the Corporation executing this release; that <br />Dustin Hilary who signed this release on behalf of the contractor was then <br />d A-rpn of said Corporation; that said release was duly signed for and on <br />Corp ation t city of I *0 ruing body, and is within the scope of corporate powers: bk, K E 1-4 .0 <br />_r % <br />Secretary's o <br />J. Yel &Jiam <br />Printed Name s 1. <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is gcceptable fol a pproval and we recommend to the Board of Public Works that it be <br />I <br />Date. <br />ConstructiTJEger '%'-- <br />BOARD J JDF PUBLIC WORKS PROVAL Date: I <br />AM <br />Gary A. GHot, President Suza6na M. Fritzberg, Member R,, 7- <br />11 1 1- -fl, A Maradik, Member <br />Therese J. Dorau, Member James A. Mueller, Member <br />M. Martin, <br />