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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME <br />PROJECT NO. <br />CONTRACT <br />SIGNED <br />PROJECT <br />DESCRIPTION <br />;c►V TIT kF. <br />Hi rr:ArF. y, <br />r <br />x ISfiS <br />Miami Hills TIF Project — Windows and Siding <br />122-027 FINALCOST $1,584,305.00 <br />02/28/2023 MAINTENANCE AGREEMENT ENDS N/A <br />Replace windows and install vinyl siding at Miami Hills apartment complex <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having <br />been completed, the City of South Bend, its officials and agents are hereby released from all claims and <br />demands whatsoever arising under or by such contract, and that the contractor performed the work within the <br />scope of the Specifications and Standards of the City of South Bend which were a part ofthe above Contract. <br />Executed this 26th day of July 12024 <br />Signature f <br />Issak <br />Printed Name <br />OFFICIAL SEAL <br />DAVIO HAYUT <br />NOTARY PUBLIC-GEORGIA <br />COBB COUNTY <br />My Gomm. Expires January 23, 2428 <br />H&H Renovations, Inc. <br />Company Name <br />1875 Old Alabama Road, Suite <br />765 <br />Company Address <br />Roswell, GA 30076 <br />City/State/Zip <br />WITNESSES <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Issak Hayut , and acknowledged his/her signature to the above Project Completion Affidavit on <br />the 26th day of July , 2024 <br />of Si na re My Commission Expires <br />D <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Mazal Lew , certify that I am Secretary of the Corporation executing this release; that <br />Issak Hayut who signed this release on behalf of the contractor was then <br />Owner of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Authori of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature Corporate Seat <br />Mazal Levy <br />Printed Name <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 <br />ordained so. J <br />Date: 07/30/2024 <br />Project Manager <br />BOARD OF PUBLIC WORKS APPROVAL <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />vA <br />® I' l <br />Elizabeth A. Mamdik, President <br />Joseph R. Molnm, Vice President <br />Gary A. GiloS Member <br />Briaa. Mi—, Member <br />/ <br />M—y L. Miller, Member <br />Attest Theresa M. Heffner, Clerk <br />Date, August 13, 2024 <br />