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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Three Twentv at the Cascade - Composite Wall Panels, Division A <br />PROJECT NO 118-074C FINAL COST $174,729.00 <br />CONTRACT SIGNED 4/9/2019 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Install Nichiha wall panels at the Three Twen!y at the Cascade proiect. <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 co Tact, and that the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South dwhich were p part of the above Contract. <br />Exec this day of ,- , 201 Construction Ahead, Inc. <br />Company Name <br />S tu� 1659 N. Lancaster Rd <br />r ® Company Address <br />Printed Name South Elgin, IL 60177 <br />City, State, Zip <br />WITNESSESS: <br />Before me, h undersigned Notary Public in and for said country and state, personally appeared <br />C , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the _._. .._. day of 201 <br />Not nature My Commission Expires <br />J. Elliot Kowalski <br />Printed Name <br />County of Residence <br />6/7/2022 <br />LaSalle <br />I is a corporationthe following certificate will be executed. <br />the Contractor r , erticertify that I am Secretary of the Corporation executing this release; t <br />t �� t r 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 <br />C por its gov r i ody, and is within the scope of corporate powers: <br />Secretary's Signature <br />6 A I <br />Printed Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable forkfi I approval and we recommend to the Board of Public Works that it be ordained so, <br />Date: <br />Consl;ructio ager Q <br />BOARD OF PUBLIC WORKS APPROVAL Date: i` <br />Gary A. Gflof msident Genev ve E. Miller, M be EfizaUX A, daradik, Member <br />Therese orau, Member ­1k, ura L. O'Sullivan,'Member b a M. Martin, Clerk <br />