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CITY OF SOUTH BEND, INDIANA . "r <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT " Igo <br />PROJECT NAME Main and Jefferson Earthwork <br />PROJECT NO 119-022 FINAL COST $255,250.00 <br />CONTRACT SIGNED 4/9/2019 MAINTENANCE AGREEMENT ENDS <br />Perform earthwork retention using a Soldier Pile and Lagging Earth Retention System. This <br />system shall be permanently left in place and used by the General Contractor to form the <br />PROJECT DESCRIPTION concrete foundation. <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 contra t„ and that the contractor perfrmed the work within the scope of the Specifications and Standards of the City <br />of South en which were a pa of the o Contract. <br />Exec d th` d 201 0 Hardman Construction, Inc. <br />Company Name <br />�w <br />Printed Name <br />242 South Brye Road <br />Company Address <br />Ludin ton, MI 49431 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />(gip and acknowledged his/her signature to the above Project Completion Affidavit on <br />the " day of IeHl�. <br />Notary Signature My Commission Expires <br />Printed Name County of Residence <br />If the Contractor is a <br />rporation, the following certificate will be executed, <br />, 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 />o aporporation; that said release was duly signed for and on behalf of said <br />of its e � go''ing b ,; d is within the scope of corporate powers: <br />�S6cretary's Signature <br />Corporate Seal <br />Printed NameZ <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable fdr i approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: e <br />Construction ger r <br />BOARD OF PUBLIC WORKS APPROVAL Date„ l �f <br />Ga. A. Gilot, President Gen ieve E. Miller.tentber Elizabeth . ar dik Member <br />ember u a O'Sullivan, rKber (_,Ur#M. Martin Clerk <br />