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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT a•,z <br />186S <br />mm. Influent Gates I t . t v naieiits <br />PROJECT NAME Wastewater Treatment Plant Headworks .I� m <br />PROJECT NO. 117-026 FINAL $635,731.06 <br />COST <br />CONTRACT 12/12/2017 MAINTENANCE AGREEMENT 05/31/2022 <br />SIGNED ENDS <br />PROJECT Installation of Stainless Steel Isolation Gates and <br />Electric Actuators <br />DESCRIPTION <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having <br />been completed, the City of South Bend, its officials and agents are hereby released from all claims and <br />demands whatsoever arising under or by such contract, and that the contractor performed the work within the <br />scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. <br />Executed this z 0 t h day of. September- __,, 20 19 <br />HRP Construction, Inc. <br />' g¢atuac Company Name <br />Nancy K n a p i k 5777 Cleveland Road <br />Printed Name Company Address <br />South Bend, Indiana 46628-9418 <br />City/State/Zip <br />WITNESS <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />---kin„e_y��,nat�_ , and acknowledged his/her signature to the above Project Completion Affidavit <br />on <br />da. of ,. <br />l a }, 201 _0 <br />fi 8A <br />P y VAN HESTE <br />3tary S a s * rmm ission Num 812My Commission Expires 3/os/24 <br />g �Al St. Joseph County <br />Comm <br />r Commission Number 6ifes <br />Cindy t a"��u +s� , �� <br />Printed Nar a o l ,� � County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I N a n c y K n a p i k , certify that I am Secretary of the Corporation executing this release; that <br />Nan c y K n a p i k who signed this release on behalf of the contractor was then <br />_Vi.. � <br />c.e. Wps e sa. d,e.n _ m-9,e c� T„, pg §fliAgorporation; that said release was duly signed for and on behalf of <br />said Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />..... <br />Secs et�rr....�. ... - _...._ .... <br />s Signature <br />Corporate Seal <br />Nancy Knapik <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for final approval and we recommend to the Board of Public Works that it be <br />ordained so. <br />• ������ Date: <br />Construction Manager <br />BO II,1I OF P1. BLIC-W R S APPROVAL Date: <br />Gary A. ilot, <br />Genevieve E. Miller, Member <br />Laura O'Sullivan, Member <br />Elizabeth A. Maradik, Member <br />Member <br />IM <br />