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ysKi� <br />CITY OF SOUTH BEND, INDIANA. <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Pure Green Farms Site Improvements <br />PROJECT NO 121-056 FINAL COST $314,655.50 <br />CONTRACT SIGNED 7/25/2023 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Site improvements and lot development at Pure Green Farms. <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 day of 1202 <br />nature <br />bcgar-, SItAA- <br />Printed Name <br />C&E Excavating,Inc. <br />Company Name <br />53767 CR 9 <br />Company Address <br />Elkhart, IN 46514 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />rtbir and acknowledg his/her signature to the above Project Completion Affidavit on <br />the , — day of 202 <br />N •Signal e , a-[�e My Commission Expires <br />Printed Name County of Residence <br />`ribk=pVLV� <br />If the Contractor isa 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 behalf of said <br />Corporation by A thority of its governing body, and is within the scope of corporate powers: <br />CRISTOL MELODY VALDEZ <br />l8= Notary Public, State of Indiana <br />Secretary's Signa'b re Elkhart County Co orate Seal <br />Commission # 696906 <br />-� � ^F� �c<z �—• �3ln�s Der 'LS My Commission Expires <br />Printed d am February 20, 2025 <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: 8/2/2024 <br />Co ruction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />VIL4 <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Briana Micou, Member <br />�4 <br />Attest: Theresa M. Heffner, Clerk <br />Date: August 13, 2024 <br />