Project Completion Affidavit - Charles Black Center Renovations Project No 116-073 - Gibson Lewis

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PROJECT NAME PROJECT NO CONTRACT SIGNED PROJECT DESCRIPTION WITNESSETH: %0 M'f CITY OF SOUTH BEND, INDIANA +k-ySP � BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVITrw,r„. Charles Black Center Renovations 116-073 FINAL COST $3,973,460.00 9/26/2017 MAINTENANCE AGREEMENT ENDS Interior remodel along with an addition to the Charles Black Center. The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. Exec u d is 22nd day of August 201 9 Signature Robert A. Lingenfelter, President Printed Name Gibson -Lewis LLC Company Name 1001 West 11 th Street Company Address Mishawaka, IN 46544 City, State, Zip WITNESSESS: Before me„ the undersigned Notary Public in and for said country and state, personally appeared Robert A. Lingenfelterr and acknowledged his/her signature to the above Project Completion Affidavit on the tad day of August 2019 Notary §Ignature My Commission Expires Elizabeth A. Biddle Printed Name July 10, 2024 County of Residence St. Joseph If the Contractor is a corporation, the following certificate will be executed. I, certify that I am Secretary of the Corporation executing this release; that who signed this release on behalf of the contractor was then of said Corporation; that said release was duly signed for and on behalf of said Corporation by Authority of its governing body, and is within the scope of corporate powers: Secretary's Signature Corporate Seal Printed Name DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable r al approval and we recommend to the Board of Public Works that it be ordained so. Date: Ct.- Construct" nager — BOARD OF PUBLIC WORKS APPROVAL Date: 116 /4c IY'It Qu� Gary A. Gil; Rres ant 4auraL. 11�dler; `M bar El�abe hA. Maradik, Member to rase J. Dorau, Memb r llivan, rrwbe'1 4UnaM. Martin, Clerk "