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, ,,1i 1,9141114" <br />CITY OF SOUTH BEND, INDIANA Pei <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />Itl6S <br />r Treatment Plant Seconda Treatment Improvements <br />PROJECT NAME Wastewater �' reatmeI ... . , <br />PROJECT NO. 114-053 FINAL 13,886,920.98 �.... <br />COST _ <br />CONTRACT 09/03/2015 MAINTENANCE AGREEMENT 5/22/2021 <br />SIGNED ENDS <br />PROJECT Construct improvements at Aeration Basins, Final Clarifiers, Effluent Piping, <br />DESCRIPTION Flow Meters. Air MixinEr ui ment, and Gate Replacements at W WTP.. <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 under or by such contract, and that the contractor performed the work within the <br />scope of the Specifications and Sins ndards of the City of South Bend which were a part of the above Contract. <br />Executed this <br />r'da� 20 <br />.......... !:�Li 44- ThienemanITConstruction, Inc. <br />Signature Company an Name <br />Printed _ ,..'t 17219 Foundation Parkway_ <br />_1 WWWWW undati� <br />d Name �._..._....._. Company Address <br />Wes. �_..�........�...................... . <br />WITNESS City/State/Zip <br />e riders ned Notary Public in and for said country and state, personally appeared <br />Bt,dorc� me, the � "g <br />acknowledged his/her signature to the above Proj t l�lction Affidavit <br />on the ... °� an 201� _. P' ao1�c <br />�. P day o �',....._. <br />.r Nota SI ] ti,are M Commission Expires t Y _ Y pn <br />. � �w W <br />Y atM <br />Printed in <br />N me Count of Reside ce� �� <br />03 <br />If the Contractor 1s a corporation, the following certificate will be executed. <br />Icar r i , , 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 />' .lti � fr.. ­Aof said Corporation; that said release was duly signed for and on behalf of <br />s�pi1'1'p' ltthor <br />aa<,atity of its governing body, and is within the scope of corporate powers: <br />ecclar �Y's Signature re Corporate Seal <br />m. rN <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 />Constructnnanagery Date: <br />BOARD OF PUBLIC W71 A <br />PPROVA Date: ... 2, 7Lf- <br />Gary A. t ltlr't, Presid nt Suzam�:a rt.. c ember James A. Mueller, Member <br />`t,Ncrk. <br />Elizabeth A. M- aradik, rau <br />Member Therese J. o, Member I tttda M, Mailin„ <br />