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Project Completion Affidavit - Wastewater Treatment Plant Riverbank Stabilization, Phase 2 - EFM Excavating, Inc.
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Project Completion Affidavit - Wastewater Treatment Plant Riverbank Stabilization, Phase 2 - EFM Excavating, Inc.
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4/8/2025 2:41:20 PM
Creation date
11/14/2019 11:05:52 AM
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Board of Public Works
Document Type
Contracts
Document Date
11/12/2019
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4' 4-n �. <br />CITY OF SOUTH BEND, ANA <br />BOARD OF PUBLIC IDS <br />PROJECT COMPLETION AFFIDAVIT , <br />M ' <br />PROJECT asteater Treatment Plant Riverbank Stabilization - Phase 2 <br />PROJECT NO. n/a FINAL $99,650.00 <br />COST <br />CONTRACT <br />SIGNED <br />PROJECT <br />DESCRIPTION <br />10/09/2018 MAINTENANCE AGREEMENT Not <br />ENDS Aplicable <br />Construction of St. Joseph Riverbank Stabilization, install well graded stone, <br />veg,�itation, trees and shrubs. Remove rubble, dead trees, and shrubs. <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,, a rlty of +✓° C7', 20—Z-F. <br />EFM Excavating, Inc, <br />Si n�tt�e� _ _ N _... <br />Company Name <br />her 0 3 aic- 20932 West lst C Road <br />Printed Name Company Address <br />Walkerton, Indiana 46574 <br />City/State/Zip <br />WITNESS <br />Before ine, me um ersigned Notary Public in and for said country and state, personally appeared <br />r'1 acknowledged his/her signature to the above Project orm�ple " <br />on the day of 201�_. R03 '61 AV sajldx3 uolsslWWOO AN <br />` <br />eue Ipul to MIS <br />y Iaatatl <br />' tve, M Commission Expires < <br />Ott°y �ttu� � ea �I_.._.� <br />Priatt1 Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, m _ _.. _ , 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 <br />said Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Corporate Seal <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: //- O4-2019 <br />Construction Manager <br />BO RD OF PUBLIC S APPROVAL Date: <br />Gary A. Gilot, President Genevieve E. Miller. Member <br />Elizabeth A. Maradik, Member Therese J. Dorau, Member <br />ra O'Sullivan;"1" einber <br />"" .�inrlau M. Martin, Clerk <br />
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