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CITY OF SOUTH BEND, INDIANA°u , aF <br />BOARD OF PUBLIC WORKS",_,� dl <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Jefferson and Tw ckenham Si nal Im rovements <br />PROJECT NO 116-027 FINAL COST $216,936.93 <br />CONTRACT SIGNED 12/21/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install new traffic equipment and ADA curb ramps throughout the intersection. <br />1►JI ���1��9�i <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 />this day of 0 ei "' 201 _.., , Martell Electric LLC <br />w <br />Company Name <br />e 4601 Cleveland Road <br />Company Address <br />South Bend, IN 46628 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally <br />w, and acknowledged his/her signature to the above Project Com leti4'?°�ffavit oRENA BALDWIN <br />Notary Public, State of Indiana <br />y t) a r'0 '° St Joseph County <br />the ..... _ .._. day of _ <br />sEM , Commission N 663664 <br />Dn <br />My Commission Expires <br />g y p�p�r,r.,,,a �bruary 28, 2023 <br />Nota I nature M Commission Expires <br />FB�m� <br />L� L <br />Printed Name County of Residence 51' :3- 5IF P a <br />If the Contractor is a corporation, the following certificate will be executed. <br />_ITITm_ITmmmmmmmm, ___ww, certify that I am Secretary of the Corporation executing this release; that <br />who signed this release on behalf of the contractor was then <br />ITITIT_mmmmmmm,m,w 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 />Secretary's Signature <br />Printed Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptahle foam. in I approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: 1 <br />Construction N�a �er <br />rJ <br />BOARD OF PU LIC WORKS APPROVAL Date: // 26 V <br />Gary A. Giloe, President a an a M. Fr4zberg, enber Elizabeth A. Maradik, Membe <br />r <br />Therese J, orau, Member <br />James A. Mueller, Member <br />M. Martin, Clerk <br />