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CITY OF SOUTH BEND, INDIANA v `; <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Muessel Grove Public Restroom <br />PROJECT NO 118-099R2 FINAL COST $416,803.00 <br />CONTRACT SIGNED 9/13/2022 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION <br />1►iva9041*34A9:I <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 />Exer,uted this 27th day of June 2n 91 Gibson -Lewis LLC <br />Signature <br />Robert A. Lingenfelter, President <br />Printed Name <br />Company Name <br />1001 W. 11 th St. <br />Company Address <br />Mishawaka, IN 46544 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Robert A. Lin enfelter , and acknowledged his/ signature to the above Pro ect Completion Affidavit on <br />t e 27th day of June 20 23s,►T or,,� JULI HODOWANIEC <br />y Notary Public, State of Indiana <br />:reua; St Joseph County <br />a =*: .4� <br />SEAL,: : Commission M 671269 <br />N❑ ry Signature ^'•, ; fmiAMOW20ni'es August 5, 2023 <br />...�• <br />uli Hodowaniec _ <br />Printed Name County of Residence St. Joseph <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, 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 />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 Signature <br />Printed Name <br />Corporate Seal <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: 7/6/2023 <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 />Joseph R. Molnar, Vice President <br />Ae <br />Jordan V. <br />Gathers, Member <br />Y' /� <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: July 25, 2023 <br />