Laserfiche WebLink
CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS. " <br />PROJECT COMPLETION AFFIDAVIT m <br />PROJECT NAME 2018 Tree and Stump Removal <br />PROJECT NO 118-048A FINAL COST $17,465.00 <br />CONTRACT SIGNED 7/24/2018 MAINTENANCE AGREEMENT ENDS <br />Perform tree and stump removals as identified in the specifications at various locations within <br />PROJECT DESCRIPTION the City of 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 which were a part of the above Contract. <br />Executed this 2A day off .G 201K & R Tree Service <br />/ �7 Company Name <br />re <br />k <br />1724 S. Grant Street <br />Company Address <br />Printed Name South Bend, IN 46613 <br />City, State, Zip <br />WITNESSESS:`"""i Eugenia R. Francoeur <br />fore me, the undersigned Notary Public in and for said country and state, persona I Pe. d St. JOesph County <br />T � A and acknowledged his/her signature to the above Project CA! MoaGowiission Expires <br />the day of A 2n, <br />„ 2o1g April 26, 2026 <br />. _ <br />Notary Sign ture My Commission Expires �. .:2° <br />N ; Q F� j c co eu-r <br />Printed Name County of Residence 157.�°- <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, 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 />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 acceptable Tor ai approval and we recommend to the Board of Public Works that it be ordained so. <br />_ Date: all <br />Constructio manager <br />BOARD OF/)PUBLIC WORKS APPROVAL <br />Therese J. Dorau, Member <br />I -At A d-Ylky—i o'ember <br />