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q �d�,YSY�tl p y <br />CITY OF SOUTH BEND, INDIANA <br />k <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVITr.,u <br />PROJECT NAME <br />Navarre Street Milling and Asphalt Overlay Base Bid & Alt#1 <br />PROJECT NO <br />117-128 FINAL COST $49,503.50 <br />CONTRACT SIGNED <br />12/21/2017 MAINTENANCE AGREEMENT ENDS <br />Perform milling of surface, provide and install HMA surface pavement, and pavement striping <br />PROJECT DESCRIPTION <br />and markinqs on Navarre St. from Michiqan St. to St. Joseph. <br />Wrr,011*19:0r: <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 at the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend4hl were a part of the above Contract. <br />I'tin Hilary, VP of South Bend Area <br />Printed Name <br />201 8 Walsh & Kelly, Inc. <br />Company Name <br />24358 SR 23 <br />Company Address <br />South Bend, IN 46614 <br />City, State, Zip <br />Before e, th g Notary <br />ry p Fo� <br />A KRU�fGEana <br />Before me, theundersi ned Nota Publ9 m and for paid count and state, �orsar�rnp��ra�n 1�ele RDUStIn Hrla and acknowled ed his/her si nature to the above Pro'• +Indiana <br />trtwair <br />the lit day f ea er 2018 !,AL St,Jo,ephCounty <br />" My Commission Expires <br />4 WW„` June 05„ 2022 <br />'�A�YdtlPWliv' <br />Note gr afore My Commission Expires <br />Alisha Krue er <br />Printed Name County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, J. Michael Schaum certify that I am Secretary of the Corporation executing this release; that <br />Dustin Hila ; who signed this release on behalf of the contractor was then <br />VP of So Bend Area �„ of said Corporation; that said release was duly signed for and on <br />Corpor ti n b athority i overning body, and is within the scope of corporate powers: % I W � <br />?I 9 <br />Secretary" &9nature � �" T f �" � /. )� � <br />J. Mi 04 <br />el S ha um r A <br />Prante Name S A.L <br />mm <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project acceptable f f` I approval and we recommend to the Board of Public Works that it be ord rm/ l ') I , t° �ww� <br />"r�/Plllttttl <br />Date: <br />Construction tiger <br />BOARD OF PUBLIC WORKS APPROVAL Date: a� „ ,,� )C)( el <br />M ry mMember Elizabeth Map , <br />Ga A. GIN t� President LSunna M. Fri't�lsrs o adik, Member <br />Therese J. orau, Member aratte er. .. <br />/1 't"!n�ta M. Martin, Clerk. <br />