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CITY OF SOUTH BEND, INDIANA�° <br />BOARD OF PUBLIC WORKS t o° "z <br />PROJECT COMPLETION AFFIDAVIT�mv. <br />PROJECT NAME Li ht U South Bend - Riverside Lighting <br />PROJECT NO 118-011A FINAL COST $103,189.20 <br />CONTRACT SIGNED 7/24/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install new conduit and wirinq alonq Riverside Dr. for lighting LED retrofit. <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 />Exet d his day of <br />4th A riI N_ r' 2019 Martell Electric. LLC <br />�n <br />Company Name <br />Sig e e 4601 Cleveland Road <br />Jen i r Martell Company Address <br />Printed Name <br />South Bend, IN 46628 <br />City, State, Zip <br />WITNESSETS:' <br />yptjuloo, RENA BALDWIN <br />Before me, the undersigned Notary Public in and for said country and state, personally a ` N nary Public, state of Indiana <br />Jennifer Martell and acknowledged his/her signature to the above Project Co trbrr�° 11ar vl orr,t Joseph Coumy <br />the 4th day of April 201 SEA, Commission S 663664 <br />l � r `;" My Commission Expires <br />;`,�+` February 28, 2023 <br />Notary Signature My Commission Expires 02/28/2023 <br />Rena Baldwin <br />Printed Name <br />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 <br />Printed Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project i cceptable for "n approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: 1 <br />ConstruottVol oger <br />r <br />BOARD OF PUBLIC WORKS APPROVAL Date: <br />Gary A. Gilot, President r?,e F AAkj—Member Elisabeth A, Maradi , Member <br />Therese J. Dorau, Member <br />