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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT: <br />yr w ^�Cr <br />PROJECT NAME <br />J.C. LAUBER SITE IMPROVEMENTS BASE BID PLUS ALT. 1 & 3 <br />PROJECT NO <br />118-083B FINAL COST $416,367.38 <br />CONTRACT SIGNED <br />9/25/2018 MAINTENANCE AGREEMENT ENDS <br />Provide and install PARKING LOTS with ON SITE RETENTION & UTILITY HOOK UPS AND <br />PROJECT DESCRIPTION <br />RELATED SITE WORK & IMPROVEMENTS for the J.C. LAUBER BUILDING. <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 />15T <br />Executed this day of �G to 3 rrCL 201,_ Rieth-Riley Construction Co., Inc. <br />Company Name <br />Si " " 25200 State Road 23 <br />.lowCompany Address <br />Printed Name South Bend, Indiana, 46614 <br />City, State, Zip <br />WITNESSESS: <br />Bef re me„ I <br />Printed Name <br />Notary Public in and for said country and state, personally appeared <br />acknowledged his/her signature to the above Project Completion Affidavit on <br />C°I1A W 11 E; RMS'L( 11NG <br />k 4m0jc rtt :,flaWc, swte a:nm pmtaiii;:a <br />mnviurv° LOP00coutoy <br />rt <br />� �n-~�.��rnmrru�,���v� 6ma�w <br />ttV'4Mt+o�a�clk <br />County of Residence <br />If th ntractor a oo at" n, the following certificate will be executed. <br />I„ 1 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 />of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Authority o s governing body, and is within the scope of corporate powers: <br />L. <br />Sec etary's cg ature <br />PrintklNpke <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for :a pproval and we recommend to the Board of Public Works that it be ordained so. <br />0^ Date: I D 2 2• t °I <br />Constructio ger <br />a <br />Gary A. Gi 6t, President <br />Therese J. Dorau, Member <br />BOARD OF PUBLIC WORKS APPROVAL <br />Genevieve E. Miller <br />O'Sullivan, Member <br />Date: dl <br />Elizabeth A. Maradik, Member <br />M. Martin, <br />