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CITY OF SOUTH BEND, [ND8ANA <br />BOARD OFPUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME -Miami B i Valve <br />PROJECT NO 1 <br />CONTRACT SIGNED 1U9/2018 MAINTENANCE AGREEMENT ENDS <br />Remove plug valve and actuator and replace with the specified actuator, flow sensor, level <br />PROJECT DESCRIPTION sensor, service pole, telemetry and p|upvalve atthe ouna||ofMiami basin. <br />VVITNE8SETH <br />The work under the above contract between the City of South Bend and the undersigned contractorhaving 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 opart ofthe above Contract. <br />E d hiset V5�o b e r x 2020 Construction Co., Inc. <br />�_______— H... <br />Company Name <br />Signature 5777 Cleveland Road <br />Matthew D. Cain, President Company Address <br />Printed Name <br />South Bend, IN 46624 <br />City, State, Zip <br />WITNESSES: <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 t v Pro'ect Completion Affidavit on <br />the day of October 201 <br />0. S. Notairy Public, State of Indiana <br />-SEAQ-��! St. Joseph County <br />motj�u/gnamra MyCommimsiIM <br />r—thi 1-12phesf-p mm_ <br />Printed Ndmo County ofResidence St. Joseph <br />If the Contractor ioacorporation, the following certificate will beexecuted. <br />1 Nanry Knapik certify that |omSecretary ofthe Corporation executing this release; that <br />Matthew D. Cain - who signed this release onbehalf ofthe 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 />Corporate Seal <br />Nancy Knapik <br />Printed Name <br />DEPARTMENT OFPUBLIC 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 />Construction Manager <br />BOARD OFPUBLIC WORKS APPROVAL Date: November ` 2020 <br />BOARD OFPUBLIC WORKS <br />QL— <br />Gary A. Gilot, President <br />Therese J. Doran, Member <br />~93�' <br />Elizabeth A. Maradik, Member <br />Jordan V. Gathers, Member <br />^zTEor <br />EcAlk owlam/ <br />Joseph R- Molnar, Member <br />Linda M. Martin,m* <br />