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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT -- % <br />PROJECT NAME Neighborhood Infrastructure: Ford St and Walnut St Intersection <br />PROJECT NO 121.048C FINAL COST $467,264.65 <br />CONTRACT SIGNED 12/20/2022 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Neighborhood Infrastructure <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having been <br />completed, the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever <br />arising under or by such contract, and that the contractor performed the work within the scope of the Specifications and <br />Standards of the City of South Bend which were a part of the above Contract. <br />Executed this I 27th da, of __September 2024 Milestone Contractors North, Inc. <br />Company Name <br />Signature 24358 SR 23 <br />Dustin P. Hilary, Director of Emating, Griffith -South Bend Company Address <br />sti <br />Primed Name South Bend, IN 46614 <br />City, State, zip <br />WITNESSESS: <br />Before me, the undersigned No Public in and for said coup and state, �+� .. <br />1 Y h7' (f - n 1 ALISlIA KRUEGER <br />Dustin P. Hilary _ , and acknowledged his/her signature to the above Pn� 0. tion A*rdev*.`/A►! Ex0es <br />•: SEAL -1 June 5, 2030 <br />the 27th gof sepWNber 2024 =0 _`= Comrris$ion Number NP0653W G <br />U Porte County <br />Notary ._rgnature My Commission Expires 6/5/2030 <br />Alisha Krueger <br />Printed Name County of Residence LaPorte <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, _ Danielle Paym , certify that I am Secretary of the Corporation executing this release; that <br />Dustin P. Hilary _ who signed this release on behalf of the contractor was then u <br />Direof Estimatina. GrHill South Bend of said Corporation; that said release was duly signed for and on Lyly / <br />rporation by ut�ek of its governing body, and is within the scope of corporate powers: `��� �,ontr a c»°'s <br />0100RATf <br />Secretary's Signatwe a i CorperanW ` <br />Danielle Payne y':• SEAL .r n <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL 'i', bNb' <br />This project is acceptable for final approval and we recommend to the Board of Public Works that it be ordained'Ib! <br />�I.rr Date: 11 /1 /2024 <br />Con�fuction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />vt�a Z"�-P1 <br />Elizabeth A. Maradik, President Joseph R. Molnar, Vice President <br />Gary A. Gilot, Member Briana MMiicou, Member <br />Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk <br />Date: November 12, 2024 <br />