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w�,�crsi u'�r drMw� <br />� <br />CITY OF SOUTH BEND, INDIANA�, <br />BOARD OF PUBLIC WORKS.°°�' <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME <br />Fire Station #4 <br />PROJECT NO <br />116-066 FINAL COST $3,351,062.00 <br />CONTRACT SIGNED <br />12/22/2016 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION <br />Tear down and rebuild of Fire Station #4 <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 />Execs �Iisth day of February „ 201 9 <br />Signature <br />Robert A. Lin enfelter, President <br />Printed Name <br />Gibson -Lewis, LLC <br />Company Name <br />1001 West 11th Street <br />Company Address <br />Mishawaka, IN 46544 <br />City, State, Zip <br />WITNESSES& <br />Before me„ the undersigned Notary Public in and for said country and state, personally appeared <br />Robert A: -. L �n enfelter , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the day of February <br />Notary r9 �...,.� <br />eau, nature My Commission Expires July 10, 2024 <br />Elizabeth A: Biddle <br />Printed Name County of Residence St. 'Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, 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 Corporate Seal <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This protect is acceptable forofln pproval and we recommend to the Board of Public Works that it be ordained so. <br />Date: t <br />Construction er <br />Gary A. Gilot, President <br />Therese J. Dorau, Member <br />BOARD OF PUBLIC WORKS APPROVAL <br />a yr�c r ember <br />L u a O"Suwva , em r <br />Date: <br />Elizabeth A, Maradik, Member <br />Linda M. Martin, Clerk ,' „.4 1 11 <br />