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CITY OF SOUTH BEND, INDIANA fF <br />BOARD OF PUBLIC WORKS t, ?1 <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Lot 12 US 31 Industrial Park - Landscape Work <br />PROJECT NO 119-029 FINAL COST $52,110.00 <br />CONTRACT SIGNED 3/26/2019 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install landscaping and irrigation at Lot 12 of US 31 Industrial Park <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having been completed, <br />the Ci''ly of,South Bend, its officials and agent re.hereby released from all claims and demands whatsoever arising under or <br />by s h contract, and that the contra ® rformed the work within the scope of the Specifications and Standards of the City <br />of outh Bend which were a par the above Contract. <br />thi � d4 of <br />4... 01 <br />)A n... .. <br />Printed Name <br />Fuerbringer Landscaping and Design, <br />Inc. <br />Company Name <br />22530 Brick Road <br />Company Address <br />South Bend, IN 46628 <br />City, State, Zip <br />WITNESSESS: <br />Before r �e the undersigned Notary Public in and for said country and state, personally appeared <br />��,.. �.-k and acknowledged his/her signature to the above Project Co ? :� <br />p <br />the "u d ay of OFFICIAL SEAL <br />201 r„ ALICE M. McKINLEY <br />`i NOTARY PUBLIC - INDIANA <br />ST. JOSEPH COUNTY <br />r <br />a <br />Notary Signature My Commission Expires o , Expdr�9/2612024 <br />�" u = e Count of Residence ?, „ <br />Printed Name y£ <br />If the- Contractor Is corporation, the following certificate will be executed. <br />I, 1 i "igly�e 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 />• r Z mow, �, 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 />tu" <br />Signature Si Corporate Seal <br />Printed amd <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for f' proval and we recommend to the Board of Public Works that it be ordained so.. <br />Date: — <br />Construction er % <br />BOARD OF PUBLIC WORKS APPROVAL Date:'' 1 <br />_A <br />Gary A. Gil t"„ President Genevieve E. Miller, Member Elisabeth A. Maraclik, Member <br />Therese J. "' 6U, Member Laura O'Sullivan, Member <br />nda M. Martin, Clerk <br />