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CITY OF SOUTH BEND, INDIANA , <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Sibley Center Exterior Renovations <br />PROJECT NO 121-021 FINAL COST $228,940.00 <br />CONTRACT SIGNED 5/10/2022 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Window replacement and masonry repairs at the Sibley Center. <br />WITNESSETH: <br />The 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 />Executed this o-k '44 day of , 2023 <br />Signature <br />Printed Name <br />Slatile Roofing & Sheet Metal <br />Company, Inc. <br />Company Name <br />1703 S. Ironwood Dr. <br />Company Address <br />South Bend, IN 46613 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />CSC ,A c�1I c , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the aU ` "\ day of 202 A <br />NotarySignature My Commission Expires <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, A h/N, 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 />Pf2's 5.. 0 Filet 7— of said Corporation; that said release was duly signed for and on behalf. Df said <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />Secretary's Signatur <br />A,y k �D �G � RaT� 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 />Aal&& ,L-Uuf- Date: 4/10/2023 <br />CorL46uction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />M <br />Joseph <br />lR;. Molnar, Vice President <br />O `Fy <br />Jordan)�V. Gathers, Member <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: April 25, 2023 <br />