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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT �« <br />PROJECT NAME The 87, f/k/a Campus View <br />PROJECT NO DP21 -061 FINAL. COST $424,631.00 <br />AGREEMENT SIGNED 9/13/2022 MAINTENANCE AGREEMENT ENDS 1 1/12/2027 <br />PROJECT DESCRIPTION sanitary sewer and water main extensions as depicted in the approved utility extension agreement dated 9/13/22 <br />WITNESSETH: <br />The work under the above agreement between the City of South Bend and the undersigned owner having been completed, <br />the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under <br />or by such agreement, and that the owner performed the work within the scope of the Specifications and Standards of the <br />City of Soutjl Bend which were a part of the above agreement. <br />Exeg6Vd,�2; 3rd day of October 2024 UND Property Owner LLC <br />{ C Company Name <br />gnatturee 1140 Virgina Drive <br />Russell Rochestie Company Address <br />Printed Name Fart Washington, PA 19034 <br />City, State, Zip <br />WITNESSES: <br />Before m ', the underrsigned Notary Public in and for said country and state, personally appeared <br />and acknowledged his/her signature to the above Project Completion Affidavit on <br />a <br />the '; �� day of ;s t ,,"l,, , 20 '' 1.. <br />Commonwealth of Pennsylvania- Notary Seal <br />Montgomery Jacquelinery County Public <br />NotarySignatur My Commission Expires My commission expires January26,202d <br />ommlsslonnumber 14315184 <br />M yivaptA Axsoctatlon of Notaries <br />Printed Nome County of Residence,; `. <br />If the owner is a 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 Authority of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Corporate Seal <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 ordained so. <br />Date: 11 /5/2024 <br />C r truction Manag-r <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />1*1�4 <br />Elizabeth A. Maradik, President Joseph R. Molnar, Vice President <br />Gary A. Gilot, Member Briana Micou, Member <br />Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk <br />Date: November 12. 2024 <br />