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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT H= <br />West Side Quiet Zone - Commercial Drive Relocation <br />120-011 FINAL COST $54,258.00 <br />12/19/2019 MAINTENANCE AGREEMENT ENDS <br />Demo structure at 1522 Ford Street and remove and replace fencing and gates to relocate <br />PROJECT DESCRIPTION commercial drive to the back of the property. <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 />r ecuted this 16th ray of October , 20 20 Ritschard Brothers, Inc. <br />uo r Company Name <br />ignature 1204 West Sample Street <br />Rachelle L. Dolniak Company Address <br />Printed Name South Bend, IN 46619 <br />City, State, Zip <br />WITNESSESS:� <br />Before me, the undersigned Notary Public in and for said county�tCrsfrpally appeared <br />Rachelle L. Dolniak ,and acknowledged his/her signature tp' e.. 6ove Proj*�S completion Affidavit on <br />he . 16th day of October , 20 ` 20 = ��: O� AR Y :� <br />4nwwb-� <br />-' <br />N tary Signature My Comraiissi6n Ift, "LX / 28 <br />Michaela Ritschard q' <br />Printed Name County of Re4dI OF ��k o\fit. Joseph <br />If the Contractor is a corp ratio the following certificate will be executed. <br />Donald Rit h d r . certify that I am Secretary of the Corporation executing this release; that <br />a e D n • k who signed this release on behalf of the contractor was then <br />Xcre <br />n of said Corporation; that said release was duly signed for and on behalf of said <br />y th its go f body, and is within the scope of corporate powers: <br />gnature <br />Corporate Seal <br />Donald Ritschard, Jr. <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 ordained so. <br />Date: 10/13/2020 <br />Construco6n Manager <br />BOARD OF PUBLIC WORKS <br />• <br />Gary A. GilAAot, Preside <br />nt n <br />Elizabeth A. Maradik, Member <br />Joseph R. Molnar, Member <br />BOARD OF PUBLIC WORKS APPROVAL Date: October 27, 2020 <br />Therese J. Damn, Member <br />Jordan V. Gathers, Member <br />ATTEST: <br />Linda OfTarna <br />Linda M. Martin, Clerk <br />