PCA - Century Center Water Softener Proj No. 123-041 - D.A. Dodd LLC

Home Browse Search

CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS PROJECT COMPLETION AFFIDAVIT PROJECT NAME PROJECT NO FINAL COST $ CONTRACT SIGNED MAINTENANCE AGREEMENT ENDS PROJECT DESCRIPTION WITNESSETH: Executed this ________ day of _________________, 202__________. Company Name Signature Company Address Printed Name City, State, Zip WITNESSESS: Before me, the undersigned Notary Public in and for said country and state, personally appeared _____________________, and acknowledged his/her signature to the above Project Completion Affidavit on the ________ day of _____________, 202______. Notary Signature My Commission Expires Printed Name County of Residence If the Contractor is a corporation, the following certificate will be executed. I, ____________________________________, certify that I am Secretary of the Corporation executing this release; that ___________________________________________ who signed this release on behalf of the contractor was then __________________________________ of said Corporation; that said release was duly signed for and on behalf of said Corporation by Authority of its governing body, and is within the scope of corporate powers: Corporate SealSecretary's Signature Printed Name This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained so. Date: Construction Manager President Member Member Member Member Attest The work under the above contract between the City of South Bend and the undersigned contractor having been completed, 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 Standards of the City of South Bend which were a part of the above Contract. DEPARTMENT OF PUBLIC WORKS APPROVAL SOUTH BEND BOARD OF PUBLIC WORKS _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ Century Center Water Softener 123-041 10/10/2023 Replacement of the commercial water softening system at the Century Center. March12th 4 D.A. Dodd, LLC P.O. Box 430 Jason DeMeyer Rolling Prairie, IN 46371 Jason DeMeyer 05/23/2025 Caitlin Schimmel LaPorte 12th March 4 xecuted thihis s _________dd iggnanatturere ason DeDMe er heee ________ day of ___ March 26, 2024