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Nw obi r ar a,,w <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS .°` ° -ell <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Great Lakes Capital Spec Building Paving <br />PROJECT NO 118-058 FINAL COST $323,665,80 <br />CONTRACT SIGNED 10/9/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install asarklr� Poi and drivewa movements at 5545 Chet Waggoner Court. <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 tha contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend wN�iot. er part of UPke above Contract. <br />Executed th <br />Sig <br />Name <br />WITNESSESS: <br />Before me, the undersigned Notary Public in <br />L Uad Hi l= , and acknowledged <br />the 24th d y pf Lme „ . , 201 <br />Notary 0<911 l <br />Alisha Krueger <br />Printed Name <br />Walsh & Kelly, Inc. <br />Company Name <br />24358 SR 23 <br />Company Address <br />South Bend, IN 46614 <br />City, State, Zip <br />and for said country and state, personally appeared <br />is1l�§jg ornplet ton Affidavit on <br />ALISHA KRUEGf:R <br />,r�0 "-, Notary Public, State of Indiana <br />`;SEAL': ST,Joseph Counry <br />om ssi.on Expires j <br />>,c ommys�lon sslirg� <br />SIX" une 22 <br />5, 2022 <br />County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, J. Michael Schaum certify that I am Secretary of the Corporation executing this release; that <br />Dustin Hilary who signed this release on behalf of the contractor was then <br />VP of '" '-" - of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation t 1 ity of it v Ing body, and is within the scope of corporate powers: <br />ryt + m <br />Secretary° Signature <br />erporatp <br />J.J. id el Schaum <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL 0 0o,p <br />This project is acceptabl fo f w I approval and we recommend to the Board of Public Works that it be o"t alned'so <br />� Mw <br />��Date: �ts , <br />ConstructiotAymager <br />Gary A. Gilot, President <br />i�erese J. 41 rau, Me fiber <br />BOARD OF PUBLIC WORKS APPROVAL <br />Geiler/ieve E. Miller, Member <br />Date: ` /') : .,q,l °J <br />�-- <br />Efi—zabelh A. Ma adik, Member <br />da M. Martin, Clerk <br />