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OgOt�1Tq�� <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS�'f� <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME 2022 Traffic Calming Rubberform Installation <br />PROJECT NO 122-014A FINAL COST $141,120.00 <br />CONTRACT SIGNED 9/27/2022 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Installation of Rubberform speed tables and cushions. <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 6th day of April 2M.2023 HRP Construction Inc <br />Company Name <br />Signature `��—� 5777 Cleveland Rd <br />Nancy Knapik, Vice President Company Address <br />Printed Name <br />South Bend, IN 46628 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Nancy Knapik , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 6th day of April "X 2023 % CYNTHIA L. VANHESTE <br />! — t:Y �.&e*: Notary Public, State of Indiana <br />xtSEAL�"" St. Joseph County <br />Number 68 <br />N ry Signature My Commission Expires Mar _'. * -Commission CommisSion Expires73 <br />Cynthia L. Vanheste "'of,,,, O­ March 06, gg <br />Printed Name County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Nancy Knapik certify that I am Secretary of the Corporation executing this releasq;.:that <br />Nancy Knapik who signed this release on behalf of the contractor was then' <br />Secretary 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 Sign5ture <br />Nancy Knapik Corporate Seal <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 />1'<u& .L_4�6v-- Date: 4/18/2023 <br />Coffitruction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />JosepphlR. Molnar, Vice President <br />U `l1 <br />Jordan V. Gathers, Member <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: April 25, 2023 <br />