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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME St. Joseph Street Improvements <br />PROJECT NO 118-008 FINAL COST $449,436.52 <br />CONTRACT SIGNED 9/11/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Street impovements alonq St. Joseph and Callander Streets <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 thaJAhe contractor performed the work within the scope of the Specifications and Standards of the City <br />Executed thi 1 � JBI " <br />of South Bend whic ere a part of the above Contract , <br />2019 Walsh & Kelly, Inc. <br />Company Name <br />Si'9 t 24358 State Road 23 <br />tin Hila P of South Bend Area Company Address <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Dustin HiIaN and acknowledged his/her signature to the above Pro'ect Completion Affidavit on <br />the "11th ayo JU 2019 Ilea, ALISHA KRUEGER <br />Y P& <br />Notary Public, state of Indiana <br />Notary gn ture tr Cono ssiami 5,p2�2ires a/ !' <br />Alfsha 1rueater <br />�� June <br />Printed Name County of Residence St. Jogeph <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 />stin i1a who signed this release on behalf of the contractor was there <br />VP f <br />CV Auth Its governing body, <br />t�,i th Bend Are of said Corporation; that said release was duly signed for and on bh' if1,, <br />pf <br />, and is within the scope of corporate powers: <br />Al <br />Signature <br />Corporate e <br />J�7ic"haels� �,' ,r � m <br />Schaum <br />Printed Name;r s'a <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is accepta7W" <br />approval and we recommend to the Board of Public Works that it. be ordairidd, <br />Date: Ck a <br />Constructio ager INI <br />t`BOARD OF PUBLIC WORKS APPROVAL Date: l,) <br />ht-U-1 UL U I k <br />Gary A. Gilot, Ofesident Genevieve E. Miller, Member Elizabeth A. MbradiR, I/lember <br />The�J, Dorau, <br />Member Laura L. O'Sullivan, Member .Martin, Clerk <br />