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OVEN <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVITa" <br />PROJECT NAME Small Drainage Design and Repair DivC <br />PROJECT NO 118-063 FINAL COST $72 200.00 <br />_ �.. _._ .............. ._ <br />CONTRACT SIGNED 12/20/2018 MAINTENANCE AGREEMENT ENDS <br />Provide and install various stormwater drainage improvements along and near Hawbaker <br />PROJECT DESCRIPTION Street, Olivia Circle, and Creekwater Lane including an pavement, curb, and sidewalk repair. <br />..._... .�..._.._._... � ......... <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having been completed, <br />the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or <br />by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend which were a part of the above Contract. <br />Executed ,A�of <br />A'� �0 , nWalsh 8 Kelly, Inc. <br />r <br />Company Name <br />X�24'358 SR 23 <br />Hilary, VP_ of South Bend Area Company Address <br />Printed Name South Bend„ IN 466�14 <br />City, State„ Zip_ _.._ <br />WITNESSES& <br />Before me, the undersigned Notary Public 'said" ,Pountf and state, personally appeared <br />Dustin WLaa and acknowledged h`s/hl�r sin$i� e""tag the �.bove Project Completion Affidavit on <br />the 1st dad f At t9at 201 <br />��a,N ALISHA KRUEGER <br />� Ffd� `' Mary Public, state of Indiana' ������ <br />Not gna'ture 7tnL; ap My griaaExpires <br />SI]a Krueger <br />My Commission Expires <br />Printed Name �� r„emo�° 9une O5, 2022 <br />��� 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 />who signed this release on behalf of the contractor was then <br />CorpVP f t Ar : e, - of said Corporation; that said release was duly signed for and on behalf of said <br />a tnty f p erning body, and is within the scope of corporate powers: <br />Secretary' Signature <br />Corporate Seal <br />J. Mi heel Scl-oun <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable fbr f"I approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />Construotion ger <br />BOARD OF PUBLIC WORKS APPROVAL Date: dd U 7 <br />Gary A. Gilot, President Genevieve E. Miller, Member Elizabeffi A.. Maradik, ember <br />Therese J. orau„ Menler° Laura O'Sullivan, Member Liinda M. Martin, Clerk <br />