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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS. <br />PROJECT COMPLETION AFFIDAVIT `"" IN'S <br />PROJECT NAME Lin� West and Charles Martin Sr. Dr. Improvements <br />PROJECT NO 117-072A FINAL COST $1„197,648.10 <br />CONTRACT SIGNED 6/26/2018 MAINTENANCE AGREEMENT ENDS <br />Realignment of Leland Ave with Lincoln Way; Intersection Improvments; Rebuild Lincoln Way <br />PROJECT DESCRIPTION and Scott St. Intersection <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 this 9th day of JuiY a 201 9 Selge Construction Co., Inc. <br />Company Name <br />Signature <br />Robert Kuhns, Project Engineer <br />Printed Name <br />2833 S. 11th Street <br />Company Address <br />Niles, MI 49120 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Robert Kuhns , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 9th day of l 201 9 <br />Notary Signature My Commission Expires <br />Vicki A. Priest <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />i'OTAR"Y <br />-RAC <br />J MY COMMISSION' <br />EXPIRES <br />n <br />Vicki A. Priest O,p <br />1, certify that I am Secretary of the Corporation executing this release; fftear��nrrrrii',i <br />Robert Kuhns who signed this release on behalf of the contractor was then <br />Project Engineer of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Author y of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Corporate Seal <br />Vicki A. Priest <br />Printed Name <br />07/25/2020 <br />Berrien <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable fdie fu al approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />