Laserfiche WebLink
..a "h S• <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS =.�< <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME 2022 Community Crossings Roadway Rehabilitation <br />PROJECT NO 122-024R FINAL COST $4,566,395.74 <br />CONTRACT SIGNED 8/9/2022 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Pavement improvements on Rainbow Dr, Southlea Dr, Eastmont Dr, Hill St, and Jackson St. <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 />Exertedth•s 21 t day of_Noyember 2023 _ W_. Milestone ContractorsNorth,_Inc. <br />� Company Name <br />Signature�- 24358 State Road 23 <br />Josh .Burris Company Address <br />Printed Name <br />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 />__ _,10_§}j.Byfrl6__ _,and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 21 st day f No m , 2023 <br />ALISHA KRUEGER <br />Notary Sikmx<re My Commission Expires 5 03 .ogY nuy . . ,ission Expires <br />Alisha Krueger JnNumb 0 <br />�;• � � uile Commission Number <br />NPQ653544 W <br />Printed Name County of Residence LaPorte 'rF' a`T'' corle County <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Danielle Paine _ �, certify that I am Secretary of the Corporation executing this release, that <br />Josh Burris who signed this release on behalf of the contractor was then <br />General Superintendent of said Corporation; that said release was duly signed for and on;,q0Pfj1f4,' <br />rporation by tygoverning body, and is within the scope of corporate powers: <br />Secretary's Signature y �ORP OR` R <br />Corpsrate <br />SEAL '•nC <br />Printed Name i <br />DEPARTMENT OF PUBLIC WORKS APPROVAL �i a, b • <br />�� Nb1aN� <br />This project is acceptable for finial approval and we recommend to the Board of Public Works that it be orda�R.t l tttj�o <br />&6& , � c ry Date: 12/5/2023 <br />Conoruction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />vA�a <br />Elizabeth A. Maradik, President <br />�- --• r� Q�iil� <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Bri��4 <br />a��naa Micou, Member <br />l� <br />Attest: Theresa M. Heffner, Clerk <br />Date: December 12, 2023 <br />