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m <br />N <br />N �N <br />g�rn <br />TO �a <br />N <br />2<cnn•& a- E <br />`Z'WYwZ' <br />vmco) =Cc <br />0 20 <br />w2 <br />m E E <br />LEEpE <br />�UUI <br />T Ip <br />uiWff y„ <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME d tialttat Center Lower Level Rest.roorn Remodel_ <br />�.. .. __.. w_ , . ...__ ` <br />_._ .m.W <br />PROJECT NO C C 8 O A 16NAL COST s2 2 eytt tz I <br />CONTRACT SIGNED 1 �0� C MAINTENANCE AGfEE E I ENDSm <br />WITNESSETH: --- <br />exa. _... enter. <br />PROJECT DESCRIPTION Remo e o I ��te existin restroom lct�tf��on tie dower �eve�ot the Centu C _n,,,,� <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 the above Contract. <br />Executed s It d of Au ust w 2 Company Name al Contractors, <br />rs, Inc. <br />y of 9 Brown & Brown General Contracto <br />Signature 124 S. Elkhart St., PO Box 487 <br />Eric Brown <br />Printed Name <br />Company Address <br />Wakarusa, IN 46573-0487 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />—Efk,Rf r 1 _ , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the � Wirth day of � Au us / <br />Notary Signature �f My Commission Expires <br />Todd A. Marek <br />Printed Name <br />County of Residence <br />4/3/2025 <br />Marshall Co.„ Indiana <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, .. Hannah M. Aitken certify that I am Secretary of the Corporation executing this release; that <br />ii <br />Eric B !Own who signed this release on behalf of the contractor was then <br />IT <br />President of said Corporation; that said release was duly signed for and on behalf of said <br />Corpy ulhority of its�governing body, and is within the scope of corporate powers: <br />,or � ratlort <br />Secretary's Signala�r Corporate Seal <br />Hannah <br />M. Aitken <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />� <br />This project is ac ceptable r f gal approval and we recornmend to the Board of Public Works that it be ordained so. <br />Date <br />Construct! nager <br />M <br />BOARD OF PUBLIC WORKS APPROVAL Date: I f <br />Gary A. Gilot, President Genevieve E. Miller, Member izabet A. Maradi ember <br />_. <br /># herese J, Cgor, u, .�. <br />M <br />emt La._ <br />ura O'Sullivan, Member ""'l.'it da M. Martin, Cler <br />