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'wA, <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKSv�' <br />PROJECT COMPLETION AFFIDAVIT mom A <br />PROJECT NAME 2017 Lam opost Pro ram <br />PROJECT NO 117-011A FINAL COST $27,550.00 <br />CONTRACT SIGNED 9/12/2017 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Installation of IamDDosts on private residences throughout the Citv. <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 />Exeout s 7th daAfYV 201 9 Martell Electric, LLC <br />Company Name <br />Signa r 4601 Cleveland Road <br />JenniWr Martell Company Address <br />Printed Name <br />South Bend, IN 46628 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Jennifer Martell and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 7th day of May 201 9RENABALDtAIhN <br />Notar/ Public, State of Indiana <br />"(AArew St Joseph County <br />�2�28�202 4 A 5' Co« irnisbion e 663664 <br />Notary Signature My Commission Expires , <br />FurJ1Expires <br />Rena Baldwin eay28, 223 <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 <br />// Signature <br />Printed Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acce table for ;i pproval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />ConsfruAtr%n ger <br />ho-vo xl/ld� <br />Gary A. Gilot, President <br />BOARD OF PUBLIC WORKS APPROVAI <br />Genevieve E. Miller, Member <br />Therese J. D "au, M6 ber Laura O'Sullivan, Member <br />