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CITY OF SOUTH BEND, INDIANA ' <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVITn <br />PROJECT NAME 116-001 South Bend One-way to Two-way Conversion <br />PROJECT NO 116-001 DIVA FINAL COST $3,477,864.79 <br />CONTRACT SIGNED 2/26/2016 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Michigan Street and Main Street from Chippewa Avenue to Ewinq Avenue <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 rArt of the above Contract. <br />E� da cif _ 201m, Rieth-Riley Construction CO., INC. <br />Company Name <br />in tore 25200 State Road 23 <br />14, 0W7 Atom Company Address <br />nted ame South Bend„ Indiana, 46614 <br />7 City, State, Zip <br />Befo a me„ tie undersigned Notary Public in and for said county and state, personally appeared <br />and acknowledged his/her signature to the above Project Completion Affidavit on <br />the�� ` -. day of _1201 . <br />k <br />Notary ignature My Commission Expires <br />Printed Name County of Residence <br />If the Con actor is e rporation, the following certificate will be xe, ted. <br />1, certify that I a retairy 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 AutNortt of its governing body, and is with tk 7Notory <br />c r ra w s: <br />UE AM CIRA <br />Secretary's Sign Sell <br />� <br />�cb upllc - SfNs of 111d1ms Corporate Seal <br />t Joaph County <br />Printed Name Msion Expires Oct 22, 2022 <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for I approval and we recommend to the Board of Public Works that it be ordained so. <br />9�1Date: <br />C¢anstructiow agar <br />130ARD OF PUBLIC WORKS APPROVAL Date. he Idd P <br />GaryA. Gilot, President Genevieve E. Miller, <br />er, Member Elizabeth A. M6rad6tt„ Member <br />Therese Dor u, Member <br />�.�.., <br />Laura O'Sullivan, Member <br />Linda M. Martin, <br />