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CITY OF SOUTH BEND, INDIANA ; <br />BOARD OF PUBLIC WORKSm�- <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Human.. Rights Commission Office Remodel <br />PROJECT NO N/A FINAL COST $24,129,011 10 <br />CONTRACT SIGNED 4/23/2019 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Remodel of interior offices at the HRC buildin <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 part of <br />the above Contract. <br />Executed this day of gel . A201 <br />YAff �_• Premier 1 Construction <br />Company Name <br />::Signat re 105 E. Jefferson Blvd, Suite 216 <br />Company Address <br />Printed Name South Bend IN 46601 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />, and acknowledged his/her signature to the above Project Completion Affidavit on <br />th day of 201 <br />N ary nature~ w My Commission Expires <br />(Aaw <br />7C C <br />Printed ame County of Residence <br />If the Contractor is a corporation, the following certificate <br />thatl be am Secretary of the Corporation executing this I' / � Lam ' ty rY rp g release; that <br />who signed this release on behalf of the contractor was then <br />71 <br />C'or or ti b but rlt z • of said Corporation; that said release was duly signed for and on behalf of said <br />P y y f its gover ing body, and is within the scope of corporate powers: <br />Secr tary's Signd JE Notary Public - eal <br />A/ State of Indiana pora'te Seal <br />f v Count <br />t Joseph y C <br />Printed Name °� fT11SSl <br />' on f Xpires Apr 15, 2023 <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />Tho project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />Construction Manager <br />BOARD OF PUBLIC WORKS APPROVAL Date: o `' (,! <br />AEfizabe <br />Gary A. Gi ot„ President Genevieve E. Miller Member V.Ma4raik,Member <br />harass J. D43r '� .. <br />„ Me bar Laura O'Sullivan, Member Linda M. Martin, Clerk <br />