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CITY OF SOUTH BEND, INDIANA r <br />BOARD OF PUBLIC WORKS` <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Dubail Avenue Streetscape <br />PROJECT NO 120-009 FINAL COST $1,645,315.35 <br />CONTRACT SIGNED 8/24/2021 MAINTENANCE AGREEMENT ENDS <br />Intersection drainage improvements and new curb and sidewalk from Michigan St. to Miami <br />PROJECT DESCRIPTION St. <br />WITNESSETH: <br />'fhe work under the above contract between the City of South Bend and the undersigned contractor having been <br />completed, the City of South Bend, its officials and agents are hereby released from. all claims and demands whatsoever <br />arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and <br />Standards of the City of South Bend which were a part of the above Contract. <br />Exec11't" <br />his 1 day of December 202 2 Rieth-Riley Construction Co., Inc. <br />4Z � Company Name <br />Signature 25200 State Road 23 <br />Ruben Alvarado, Sales Manager Company Address <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Ruben Alvarado , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 1 day of December 2022 <br />Notary Signature My Commission Expires October 03, 2030 <br />Rachael Czarnecki <br />Printed Name County of Residence Marshall <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Matt Hostetler <br />certify that I am Secretary of the Corporation executing this release; that <br />Ruben Alvarado <br />who signed this release on behalf of the contractor was then <br />Sales Manager <br />of said Corporation; that said release was duly signed for and on behalf of said <br />Corp ration by A441hority of its governing body, and is within the scope of corporate powers: <br />RACHAEL M CZARNECKI <br />ecr tart' s Si ture <br />�`� ��*Y : Notary Public, State of Indiana <br />a o�• tom. Corporate Seal <br />Marshall <br />=z;SEAI.;a' County <br />Matt Hostetler <br />* : *: Commleelon Number NP0744094 <br />My Commission Expires <br />Printed Name�V <br />� <br />urn,m0October03, 2030 <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: 4/11 /2023 <br />Cons . ction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Jordan V. Gathers, Member <br />41 <br />Attest: Theresa M. Heffner, Clerk <br />Date: April 25, 2023 <br />