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oF�� eFG <br />CITY OF SOUTH BEND, INDIANA . <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Gemini at Colfax Exterior Renovations, Masonry <br />PROJECT NO 119-103 (Div B) FINAL COST $368,128.00 <br />CONTRACT SIGNED 4/14/2020 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Masonry repairs at the Gemini apartments. <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 whic were a part of the above Contract. <br />xecute this d of r 202-C Slatile Roofing and Sheet Metal <br />LI �, Company Name <br />''% <br />Signature \��`� �'% 1703 S. Ironwood Dr. <br />(�(""' Z- Company Address <br />Printed Name - ~ �� - South Bend, IN 46613 <br />- — - <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in'and 11drgsa'6d country and state, personally appeared <br />, and acknowledged his%i 60rsignature to the above Project Completion Affidavit on <br />the-3 day 0 of CC'-. 20A- <br />oJa-i` &COl <br />Notary Signature My Commission Expires f / / g AF 7 <br />LCOL <br />Printed Name County of Residence 54-J0,5SQ1n <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 gnature <br />I �Corporate Seal <br />ANN <br />Printed Name [��opol— <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 ordained so. <br />Z�Date: 10/19/2020 <br />Constructi Manager <br />BOARD OF PUBLIC WORKS APPROVAL Date: October 27, 2020 <br />BOARD OF PUBLIC WORKS <br />Gary A. Gilot, President <br />Elizabeth A. Maradik, Member <br />Joseph R. Molnar, Member <br />Therese J. Dorau, Member <br />7�s <br />Jordan V. Gathers, Member <br />ATTEST: <br />c2Lrcta C(Trutni <br />Linda M. Martin, Clerk <br />