Laserfiche WebLink
CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT; <br />PROJECT NAME Notre Dame Ave. APS <br />PROJECT NO 119-090 FINAL COST $15 200.00 <br />CONTRACT SIGNED 10/8,12019 MAINTENANCE AGREEMENT ENDS <br />Installation of APS (Accessible Pedestrian Signals) system at the intersection of Angela Blvd, <br />PROJECT DESCRIPTION and Notre Dame Ave„ <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 this 17th d of January , 20X 20 Michiana Contracting, Inc <br />Company Name <br />Sibnature 7843 Lilac Road <br />Scott Kirkpatrick Company Address <br />Printed Name Plymouth, IN 46563 <br />City, State, Zip <br />WITNESSES: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Scott Kirkpatrick _ and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 17t d7 of an gnu, 20�C 20 ANDREA JAE FISHER <br />_ .. Notary Public - Seal <br />of Indiana <br />Nry <br />i nat M Commission Expires "�: " Stata Mar 27 2022 <br />(�. g Y P ��f,�� y mission Expiresa M Com <br />✓ �:mr�mrdV�mg,�ii��� <br />Printed Name County of Residence Marshall <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Lisa Botto , certify that I am Secretary of the Corporation executing this release; that <br />Scott Kirkpatrick who signed this release on behalf of the contractor was then <br />ftPresident of said Corporation; that said release was duly signed for and on behalf of said <br />n ;Authority of its governing body, and Is within the scope of corporate powers: <br />Sacretary's Signature <br />Corporate Seal <br />Lisa Botto <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acc=,Approval and we recommend to the Board of Public Works that it be ordained so. <br />Date, Zv <br />Construotlo Wpager <br />BOARD OF PUBLICWORKS APPROVAL Date: <br />Gay A. Gllot resident -30 111 V• ��emb <br />er Elizabeth A Maradlk; Member <br />a R• o� bm r -Unda M. Martin, Clerk <br />