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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />=� <br />PROJECT COMPLETION AFFIDAVIT <br />" <br />PROJECT NAME <br />McKinley Avenue & Fremont Park Improvements <br />PROJECT NO <br />118-072 Division A FINAL COST $88,533.00 <br />CONTRACT SIGNED <br />12/20/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION <br />Improve storm drainaae with new manholes and curbina. <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 w re a part of the above Contract. <br />Executed this Elf day of 201 Rieth-Riley Consruction Co., Inc. <br />Company Name <br />Signature 25200 State Road 23 <br />=,142 <br />` �Or Company Address <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSES& <br />B for me, he signed otary Public in and for said country and state, personally appeared <br />Try �' acknowledged his/her signature to the above Project Completion Affidavit on <br />the d� "_` day of 201 . / <br />itsµ ignature My Commission Expires 'A a'a- a a <br />JN n-e rvy <br />Printed Name County of Residence <br />If the Co tractor is rporat j the following certificate will be ex cuted, <br />I, vo," -J r " certify that I a dretary of the Corporation executing this release, that <br />who signed this release on behalf of the contractor was then <br />Ap- Ma <br />of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Author4 of its governing body, and is witl;ijn a c I r r._ ...,� <br />G- <br />�7 Secretary's <br />Printed Name <br />SUE ANNE CIRA <br />Seal <br />Notary Public - State of Indiana <br />St Joseph County <br />Commission Expires Oct 22, 2022 <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />Corporate Seal <br />This project is acceptable for raw approval and we recommend to the Board of Public Works that it be ordained so. <br />a Date: <br />Construction MgRger <br />Gary A. Gild „(President <br />BOARD OF PUBLIC WORKS APPROVAL <br />Genevieve E. Miller. Member <br />erese J. Ir <br />u, Mdrnber Laura O'Sullivan, Member <br />Date: ..9 <br />Eiizabeth A, aradik, Member <br />M. Martin, Clerk <br />