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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />2022 Curb and Sidewalk Round 2 122-044 FINAL COST $573,021.68 PROJECT NAME PROJECT NO CONTRACT SIGNED 12/13/2022 MAINTENANCE AGREEMENT ENDS 12/13/2025 PROJECT DESCRIPTION Curb and sidewalk replacement and various locations <br />WlTNESSETH: The work under the above contract between the City of South 13end and the undersigned contractor having beencompleted, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and Stai the City of So h Bend which were a part of the above Contract. {')-H----f-H,�-,B ·1-=�J.J,J!w''------' 202 j 1/lN\tlNV\ 5e.Y1Jilt.-S Company Name <br />'1-t 2 e.i' t.hMDl'li 5l, Company Address E: l ¥-Nlrti I t,-1 4 &, 1511, City, State, Zip <br />WITNESSESS: undersigned Notary Public in and for said country and state, personally appeared <br />_._,.,.,,,_"-'-'"'--!---'-"-4''-"'",..__,__, and acknowledged his/her signature to the above Project Completion Affidavit on <br />the J9f/\ clay of 4 • .,.._....µc...,,�:,,,.., 202j__. <br />�£.?�LA_ My Commission Expires <br />Printed Name County of Residence <br />lf the Contractor is a corporation, the following certificate will be executed. <br />l, ,t,\a,y; 'ffll lL•iq , certify that I am Secretary of the Corporation executing this release; that Bu.llif Y,au,.1 who signed this release on behalf of the contractor was then <br />t'n.,nd ud-of said Corporation; that said release was duly signed for and on behalf of said of its governing body, and is within the scope of corporate powers: <br />Secretary's S • rnture Ma't Y� Corporate Seal <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: ConshT1ction Manager <br />SOUTH BEND BOARD OF PUBLIC WORKS <br />President Member <br />Member Member <br />Member Attest <br />3/18/2024 <br />March 26, 2024