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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS'` <br />PROJECT COMPLETION AFFIDAVIT� <br />PROJECT NAME Colfax Water Works Building Repainting Base Bid & Alt.#1 <br />PROJECT NO 118-055 FINAL COST $19,153.85 <br />CONTRACT SIGNED 12/20/2018 MAINTENANCE AGREEMENT ENDS <br />Repair, clean and paint the exterior walls of the Colfax Water Works building located at 125 <br />PROJECT DESCRIPTION West Colfax Avenue, South Bend, Indiana. <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 />Executed his 01,�k day of 201 l Facelift Painting & Powerwashin <br />w: Company Name <br />Sign fore 133 S. Truesdale <br />L f S k &A �� � � Company Address <br />Printed Name <br />WITNESSESS: <br />afore me„ th undersigned Notary Public in and <br />f wand acknowledged hi <br />the day of�201 <br />Youngstown, Ohio "606 <br />City, State, Zip <br />country and state, personally appeared <br />xe to the bo a Prp�'ect Completion Affidavit on <br />�ranK $COiC <br />Notary Public, State of Ohio <br />My Commission Expires <br />J „� 6mmissio4� aii' W0MU `%�—Z0 µ. <br />Not Signature m <br />_V�L� <br />Printed Name County of Residence t <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, _ 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 of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Printed Name <br />Corporate Seal <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable f r f pproval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />Constructio liner <br />BOARD OF PUBLIC WORKS APPROVAL Date: J g' <br />Gary A.Gild. f ' Bt?PL�?�� Elrxabet <br />A„ aradik„ Member <br />harass J Dorau„ Member 1 d,a M. Martin, Clerk <br />T'' r'►'�Iv���� wthber <br />