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.�'4Ti_8f`k <br />CITY OF SOUTH BEND, INDIANA �p <br />BOARD OF PUBLIC WORKS " �� <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Morris Performing Arts Center Carpet Replacement <br />PROJECT NO 121-029B FINAL COST $216,774.50 <br />CONTRACT SIGNED 05/24/2022 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Remove and install new carnet in the Morris Performing Arts Center. <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 />Exeout d this �. day of All 4 L 20'Q_�.�_. <br />CARPET SERVICE OUTLET INC <br />Company Name <br />Signature 1514 MISHAWAKA AVE <br />VICKI SHEPARD Company Address <br />Printed Name <br />WITNESSESS: <br />B�fo e .me the unc <br />C, �e <br />the y of <br />a Igna e <br />Printed Name <br />SOUTH BEND IN 46615 <br />City, State, Zip <br />igned Notary Public in and for said country and state, personally appeared <br />_, and acknowledged his/her signature to the above Project Completion Affidavit'on <br />201 <br />�-C-),\1 <br />Yolanda 0 Giles <br />Notary Public Seal State of Indiana <br />SLJO&eph CQUnty <br />C— mission Numbar NP06543U <br />County of Residence <br />If th-6 Contractor is a corporation, the following certificate will be executed_ <br />I, VICKI SHEPARD certify that I am Secretary of the Corporation executing this release; that <br />VICKI SHEPARD 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 Signature <br />o <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: <br />Construction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />tatLa <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />ma i <br />Joseph R. Molnar, Vice President <br />ut� aqA � <br />Alexandra Dolz-Lane, Member <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: August 22, 2023 <br />