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.r^,F ly N.. <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Three Twenty at the Cascade - Exterior Insulation and Finish System <br />PROJECT NO 118-074B-R FINAL COST $561,500,00 <br />...�.�....._ ..... ........ __......... <br />CONTRACT SIGNED 3/26/2019 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Apply various exterior building finishes. <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 />Exe.put his �_ day of �M 201ok� k lane Pla tern fine <br />Company Name <br />Si nature 232 Westgate Drive <br />/ Company Address-ITITmmmmmITITIT_.. <br />Printed Name Carol Stream, IL 60188 <br />City, State, Zip <br />WITNESSESS: <br />Beft a me, the undersigned Notary Public in and for said country and state, personally appeared <br />Q( `, _0yQ,V\t_ _ and acknowledged his/her signature to the above Project Completion Affidavit on <br />he day of � 2010\ <br />Notary nature OFF10114L�+bission Exp es m _ A ........ 0 �. <br />" LUCY KONOVALCHIK <br />OF ILLINOIS <br />Prir�le Name W <br />I n, the Poll certifythat I am Secretary of th <br />If the, Contractor Is a Corp ratio � �, a Corporation 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 />Co r i Authority of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Corporate Seal <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for a pproval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />Construction Ier BOARD OF P /UBLIC WORKS APPROVAL Date: <br />A� OX�t <br />Gary A. Gilot, President Genevieve E. Miller, Member Elizabeth A. Maradik, Member <br />Therese J orau, 1 tuber <br />Laura L, O'Sullivan. Member <br />M. Martin, Clerk <br />