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MyMN.�11Pd ,��, W <br />CITY OF SOUTH BEND, INDIANAk <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 C <br />PROJECT NO <br />117-064 FINAL COST $433,57116 <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 />of South Bend wbidAere, a part of the above Contr.pt,. <br />Executed t6 tlr da of G�art� 2018 Walsh & Kelly, Inc. <br />- - <br />Company Name <br />24358 SR 23 <br />Company Address <br />Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSETS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Dustin JELIM and acknowledged his/her signature to the above Project Completion Affidavit on <br />the �1 ay e€ �t'�i119 201 8 <br />Notair ja ure _ My Commission Expires 6/5/22 <br />Alisha Krueger <br />Printed Name County of Residence St. j o, ,Ph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I,w[�t certify that I am Secretary of the Corporation executing this release; that <br />Dist -ill Minry who signed this release on behalf of the contractor was the NI <br />011it <br />VP of 1'kmth-,R'Pnd Ai-rnn of said Corporation; that said release was duly signed for and on 'a 4# <br />Cor, 6ation by xAt ity of iKrn7inbody, and is within the scope of corporate powers: w*•«•...... 4y 00. <br />�. . <br />SecretVarme <br />gnature F� ' C) <br />�Cor "e-Seal <br />%.I _. ..0 E <br />Printed �� •.....P M. �� <br />DEPARTMENT OF PUBLIC WORKS APPROVAL IAN <br />This project is acceptable ford approval and we recommend to the Board of Public Works that it be ordained W.11111110% <br />"� • Date: ► t <br />Construction M er <br />�BOARD OF PUBLIC WORKS APPROVAL Date: 4)"' , .( <br />Gary A. Gilot, resident Suz rr M„ Fntzberg, Member Elizabeth A.� aradik, Member <br />T erase J. Do�auMe�� g CUtudl'er, Member Linda M. Martin, Clerk <br />