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CITY OF SOUTH BEND'UNDIANA50 <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Morris Theater Mezzanine Handrails <br />PROJECT NO h|118-081 FINAL COST $23525.00 <br />CONTRACT SIGNED PROJECT DESCRIPTION Installation of handrails in the mezzanine at MPAC,12/20/2018 MAINTENANCE AGREEMENT ENDS <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 />bysuch contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City <br />ofSouth Bend which were apart ofthe above Contract. <br />Executed thiday of, February 2019 Larson -Danielson <br />Company Name <br />Signature <br />Timothy F. Lar5on, President Company Address <br />Printed Name LaPorte, IN 46350 <br />City, State, Zip <br />VYD?NESSESS: <br />Before mo, the undersigned Notary public in <br />Timothy F. Larson, and acknowledged h7-X�Ojj6��m <br />Notary Sig <br />day of February -, 201 9 U1 rorj�,- <br />— <br />My <br />679923 <br />Cathy A. Sal,_e <br />Printed Name County ofResidence La Porte <br />ly appeared <br />rnpletion Affidavit on <br />If the Contractor iaacorporation, the following certificate will beexecuted. <br />| Terry ALarson <br />- Timothy F. Larson — who signed this release on behalf of the contractor was then <br />President of said Corporation; that said release was duty signed for and on behalf of said <br />CoFr oja,011,n by�Autfi�-ity of its governing body, and is within the scope of corporate powers,: <br />Terry A. Larson LARSIMMANMAGaWal <br />CONSTRUCTION CO., INC <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project Works that itboordained so. <br />