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��hcMl ttMg ��'A <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS. <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME JMS Building: Parking Lot Improvements <br />PROJECT NO 118-003R FINAL COST $85,831.00 <br />CONTRACT SIGNED 10/9/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION <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 o the above Contract. <br />Executed this day of 201 Milestone Fence, LLC <br />�m.. ITITIT <br />-M Company Name <br />psi 13399 McKmI,ey H��w <br />an _— <br />Company <br />P Y Address .. <br />� <br />Printed Name Mishawaka, IN 46545 NY, TA � W <br />................_._.__ <br />.City, State, Zip <br />V y �t,acr <br />WITNESSESS. r <br />rx <br />B f re me t e u rsigned Notary Public in and for said country and state, personally appeared <br />nd acknowledged his/her signature to the above Project Completion Affidavit onxC <br />the.df— day of 1201 7 <br />�_. <br />M11A <br />nature_ My Commission Expires <br />Icui <br />Printed Name County of Residence ' <br />I, certify that I am Secretary of the Corporation If the Contractor is a corporation, the following certificate will be executed., <br />y y executing this release; that <br />who signed this release on behalf of the contractor was then <br />of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Printed Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project acceptable ro ect is table for oA approval and we recommend to the Board of Public Works that it be ordained so„ <br />p <br />Date: <br />Construction r <br />Gary A. Gilot, President <br />Therese J D rau, Member <br />BOARD OF PUBLIC WORKS APPROVAL Date: I , Ne <br />Genevieve E. Miller, Member <br />Laura O'Sullivan, Member--°,71-inda M. Martin, <br />Member <br />