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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKSi1 <br />PROJECT COMPLETION AFFIDAVIT , <br />Lafayette Building,Exterior Renovations Mason <br />117-100R Division B FINAL COST $284,045.00 <br />10/18/2018 MAINTENANCE AGREEMENT ENDS <br />Restoration of mason on the exterior of the Lafayette Building <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 />fiok <br />Executed this l day of 7:�L.+J-1-'- 201 91 C&S-MasonEy Restoration, LLC. <br />Company Name <br />Signature 3725 N. Foundation Ct., Suite AB <br />Company Address <br />Printed Name <br />South Bend,„ IN 46628 <br />City, State, Zip z N <br />WITNESSESS: o a <br />Before me _,the undersigned Notary Public in and for said country and state, personally appeared m o <br />_tJ and acknowledged his/her signature to the above Project Completion Affidavit of ;°� <br />the /0 daX of 1201Le �. <br />L / Q X�. <br />Notary Signature My Commission Expires <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />Lnw <br />Q U O <br />u <br />4 <br />N <br />�a <br />Z Z� <br />E <br />�.. <br />61, <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 is acceptable fohi I approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: l <br />Construction ger <br />BOARD OF PUBLIC WORKS APPROVAL Date: <br />An (0 <br />Gary A. Gilot, President Genevieve E. Miller, Member Elizabeth A. Waradik, Mem "er <br />Therese J. au,, Mefrrl5er Laura O'Sullivan, Member i d M Martin, I rk <br />