Project Completion Affidavit - 2019 Small Drainage-Lathrop Project No 119-019A - Selge Construction Inc

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CITY OF SOUTH BEND, INDIANA . BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT" PROJECT NAME 2019 Small Drainage . Lathrop PROJECT NO 119-019A FINAL COST $36,808 40 CONTRACT SIGNED 4/9/2019 MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION WITNESSETH: _ ...— ............................ ___ — The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. Executed this day of J , 201 9 Sela Construction Co., Inc. I � �,,,.,.�. ' Company Name Signature 2833 S. 11th Street Company Address Printed Name Niles, MI 49120 City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared EQbUt K and acknowledged his/her signature to the above Project Completion Affidavit on th 2r;t-h day of .1201 9 M./, Notary Signature My Commission Expires 07 2S 2Q20 __ Berrien Printed Name County of Residence If the Contractor is a corporation, the following certificate will be executed,. Ia Vicki A-. Priest certify that I am Secretary of the CorporOoli`6 0 trW)q this release; that who signed this release on bet&,was then o I h� behalf of said of said Corporation; that said release w I 1 f ratio b A� c � MY COMMISSIONIC Y 9 Y, P p its vernw o an is within a scope o co ora o ' Secretary's Signature EXPIRES 1 25-202o 'W "" Corporate Seal Vicki A- prigz Printed Name" g� t✓4Q DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptab'e for al approval and we recommend to the Board of Public Works that it be ordained so. Date: Iq Constructi aaer