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CITY OF SOUTH BEND, INDIANA� <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME <br />Marriott Hotel Site Develo ment at Hall of Fame, Phase 3 Base Bid A & B <br />PROJECT NO <br />117-064 FINAL COST $221,830.64 <br />CONTRACT SIGNED <br />9/12/2017 MAINTENANCE AGREEMENT ENDS <br />Install new site improvements including, but not limited to, a parking lot, concrete sidewalks, <br />curbs, curb ramps, pavers, street lights, and landscaping... etc, located at the NW Corner of Dr. <br />PROJECT DESCRIPTION <br />MLK Junior Blvd and Jefferson Blvd in South Bend. <br />WITNESSETH: <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 />Executed till'o South Bend whi were apart of the above Contract. <br />th f December 1201 8 Walsh & Kelly,Inc. <br />Company Name <br />Si u,re ..... __, 24358 SR 23 <br />w t Hilary, VP of South Bend Area Company Address <br />..... <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />] and acknowledged his/her signature to the above Project Completion Affidavit on <br />the ay f Iec , nk-wr 2018 . <br />Notary S406ture �IT. <br />Ali sha K t,�er <br />................ ....__.......... <br />Printed Name <br />My Commission Expires 6/5/22 <br />County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, J. Mi.cbaeh &I'yi¢lt'l certify that I am Secretary of the Corporation executing this release; that <br />i la who signed this release on behalf of the contractor'"vlaYi j,,, <br />r of said Corporation; that said release was duly signed for a'"rrrea�j4 <br />Corp or Aof A horbty o its ernig body, and is within the scope of corporate powers« "` <br />�* <br />Secretar ignature <br />— <br />�rilMo rate <br />Printed Nam <br />DEPARTMENT OF PUBLIC WORKS APPROVAL DNA I,t <br />This project is acceptable-f f al approval and we recommend to the Board of Public Works that it be ordain �4i11 <br />Date: i <br />Constructio Eger <br />BOARD OF PUBLIC WORKS APPROVAL Date <br />Gary A. Gilot, POresident Su z M, Frntzber Member Elizabeth A. Maradik, Member <br />Therese J. Do u, Mer /A. ember ",Lin a M. Martin, Clerk <br />l�lkrd- b,S-u(livcrN <br />