Project Completion Affidavit - East Bank Sinkhole Repairs Project No 118-305A - Northern Indiana Construction Co Inc

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yµM47�V fiM p�. � CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT d PROJECT NAME East Bank Sinkhole Repairs Base + Alt2 PROJECT NO 118-305A FINAL COST $83,10.75 CONTRACT SIGNED ... ..... 4/23/2019 MAINTENANCE AGREEMENT ENDS Construction of repairs to city facilities including landscape and hardscape items such as sidewalk, curb, slope repair and stabilization, and other appurtenant work along the East Bank PROJECT DESCRIPTION Riverwalk within the City of South Bend, IN. 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. Northern Indiana Construction Company, V his h da f pi Inc. Company Name Signature P. 0. Box 1333 David J. Corski, President Company Address Printed Name Mishawaka, IN 46545 City, State, Zip WITNESSETS: Before me, the undersigned Notary Public in and for said country and state, personally appeared David ,T_ Walorski , and acknowledged his/her signature to the above Project Completion Affidavit on th 30th da w Julyi, 201 9 Notary Signature My Commission Expires April 16, 2025 Danisha L. Marable Printed Name County of Residence St. Joseph If the Contractor is a corporation, the following certificate will be executed. I, certify that I am Secretary of the Corporation executing this release; that David J. Wlorski who signed this release on behalf of the contractor was then of said Corporation; that said release was duly signed for and on behalf of said Corpor i by Authority of its o nng body, and is within the scope of corporate powers: .,. " Secretary's Signature Corporate O Seal Scott Fredrick Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL project p . pp Date: This ro�ect is acre tbte for nal approval and we recommend to the Board of Public Works that it be ordained so. 71. WW Constructs alter,,,._ BOARD OF PUBLIC WORKS APPROVAL Date: Gary yA. GilGilot, President Genie ve .Miller, Mesa "' l wzabe Mara,ik Memb 4. Alt, er J. Do V,,'Member U,1aura O'Sullivan, Member" `-Gr(da M. Martin, Clerk