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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS 4 <br />PROJECT COMPLETION AFFIDAVIT, <br />PROJECT NAME Berlin Place Site Concrete, Landscape Plantings, and Bldg. 4 Roof Pavers Division B <br />PROJECT NO 118-057 FINAL COST $+325,000.00 <br />CONTRACT SIGNED 6/26/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Site concrete work at the Berlin Place, <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 />0 South Bend whiche a part of the above Contract. a <br />Executed this w r201 / Rieth-Rile Consruction Co„ Inc. <br />Company Name <br />Signature �7-"�— 25200 State Road 23 <br />0 S e t1 Company Address <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />B f re me 0pi rsigned Notary Public in and for said country and state, personally appeared <br />f acknowledged his/her signature to the above Project Completion Affidavit on <br />the day of _ , 2.01 1 <br />a Signature My Commission Expires 4) —ba o� a <br />r <br />Printed Name County of Residence <br />,certify that I an et,a <br />�If the Co tractor is a corporat'on, the following certificate will be xe ted <br />who signed this a ry of the Corporation executing this release; that <br />+_ lease 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 AuthoMfy of its governing body, and is within the scope of corporate powers: <br />L SUE ANNE CIRA <br />T, Secretary's a Seal ioorporate Seal <br />'All <br />Notary Public - State of Indiana <br />St Joseph County <br />Printed arras Idy Commission Expires Oct 22, 2022 <br />DEPARTMENT OF <br />This project is acceptabl f f" I approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: • j <br />Constructio pager <br />Gary A. M t, President. <br />Therese J, Draw, Meg ber <br />BOARD OF PUBLIC WORKS APPROVAL Date: , A") ) t'i <br />Genevieve E. Miller, Member <br />Laura O'Sullivan, Member <br />Elizabeth A. aradik, M'em er <br />inda M. Martin, Claris <br />