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"I�pv I if1s <br />. I6 <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT la s <br />PROJECT NAME Walker Park Fieldhouse Restoration <br />PROJECT NO 120-01OR FINAL COST $74,040.00 <br />CONTRACT SIGNED 2/14/2023 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION <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 j r p��. day of 20; Acculevel Commercial Group Inc. <br />Company Name <br />Signature 8233 W State Rd 26 <br />,v 6 /., h & GGO-Z, Company Address <br />Printed Name Rossville, IN 46085 <br />City, State, Zip <br />WITNESSESS: <br />Before me, he undersigned Notary Public in and for said country and state, personally appeared <br />Nolan ec-and acknowledged his/her signature to the above Project Completion Affidavit on <br />the �] day of Cl_ 2001 <br />No ary Signature My Commission Expires <br />/ A-) AA c L.l�--e <br />Printed Name County of Residence �� ro C <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 be�h��f <br />Corporation by Authority of its governing body, and is within the scope of corporate powers:����,�� <br />Secretary's Signature Q a <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable final approval and we recommend to the Board of Public Works that it be ordained <br />X 64-)_ Date: 9/7/2023 <br />Co ruction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />r, <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Joseph R. Molnar, Vice President <br />Alexandra Dolz-Lane, Member <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: September 26, 2023 <br />