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st,0c ut d� Cv5 <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS p, <br />PROJECT COMPLETION AFFIDAVIT tAwo " <br />PROJECT NAME Gemini at Wash in ton -Colfax Apartments Mason and Stair Repair Division A <br />PROJECT NO 118-080B FINAL COST $237,713.00 <br />CONTRACT SIGNED 10/23/2018 _ MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Re air a various mason areas at the Gemini A artments. <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 above <br />y above Contract. <br />Exec 0 d th of <br />d w41Ahich were a pad of <br />' yt - , 201 . Bokon Masonry, Inc. <br />Company Name <br />Sig Iture 56571 Pear Road <br />mpany Address <br />Pr4nted Name Nio, , <br />Si <br />WITNESSES& <br />Be me, the nd rsigned N r <br />frr <br />IT 0A and <br />day of 201 <br />VA <br />rinted <br />ANGIELA4 M. BESERRA, <br />Notary Public <br />A Resident of St. County, IN <br />Commission N6.663712 <br />th Bend„ IN 46619 <br />, State, Zip <br />,sonally appeared <br />cl Completion Affidavit on <br />c)?— <br />A <br />If th, Contract is acorporation, the following certificate will be executed. <br />........... certify that I am Secretary of the Corporation executing this release; that <br />co fed 4 ......... .. 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 />Cor=,orafion bylhlor'V of its governing body, and is within the scope of corporate powers: <br />Secreta "s Signature <br />Corporate Seal <br />Printed Name <br />atu re <br />My Commission Expires <br />County of Residence <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable o ° final approvaland we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />Constructic nager <br />BOARD OF PUBLIC WORKS APPROVAL Date: <br />w.� <br />,ary A. Gilot, rresident Geneyfqve E. Miller, Me jber 00ibM A. Maradik, Member <br />u, Member � lxaurL. O'S@Iiva , em" aer \ . - i da M. Martin, Clerk <br />