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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVITw,,` <br />PROJECT NAME Jackson Road Sanitary Sewer Extension <br />PROJECT NO 119-072 FINAL COST $110,987.00 <br />CONTRACT SIGNED 9/10/2019 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Installation of a sanitary sewer extension along Jackson Road. <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 />E d N d T" 2019 HRP Construction, Inc. <br />Company Name <br />.. <br />ignature _ 5777 Cleveland Road, P.O. Box 266 <br />Matthew D. Cain, President <br />Printed Name <br />Company Address <br />South Bend„ IN 46624-0266 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Matthew D. Cain , and acknowledged his/her signature to the above Project Completion Affidavit on <br />tl e 17th day of December 2019 <br />ley <br />�Nary Signature M Commission Expires 03/06/24 <br />,; CYNTHIA L. VANHESTE <br />Cynthia L Vanheste � "c b; po�/" <br />e of nn,dse p St. Joseph <br />Printed Name r St. Joseph C lVty of eside ca p <br />SEAL; <br />ar ' gmmrm N mrwbe 1 <br />If the Contractor is a corpop�t�wM ►' I � u'ted. <br />1, Nancy Knapik °'"" ao,x"'"' Md� h V �dm Se etary of the Corporation executing this release; that <br />Matthew D. Cain who signe is release on behalf of the contractor was then <br />President of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />Secreta s Signatur <br />Nancy Knapik, Secretary <br />Printed Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable for fpproval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />Construction r J/ <br />�^A MM ^17 n1..IVII I!• LALPWIP?I V A. 1'SI"5'171P11. C A I n_a_. /. //,.J. i.,�S .�..,»a"'h::.✓ <br />"Op <br />r <br />