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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME 2024 Brick Spot Repair <br />PROJECT NO 124-041 FINAL COST $ 129,085.00 <br />CONTRACT SIGNED 6/11/2024 MAINTENANCE AGREEMENT ENDS <br />Perform spot repairs on brick streets and curb replacement in locations specified in the <br />PROJECT DESCRIPTION contract <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 WX <br />South Bend which wer a part of the bove Contract. <br />Execut d this da of d V 202 '� Acom Landscaping, LLC <br />Company Name <br />tgn 3680 W. Sample St. <br />atyT11 d refz /Z1 �,Om� Company Address <br />Printed Name South Bend, IN 46619 <br />City, State, Zip <br />WITNESSESS: <br />Before me t e undersigned Notary Public in and for said country and state, personally appeared <br />AvO CI 1 and acknowledged his/her signature to the above Project Completion Affidavit on <br />the d�Lk day of AiD Wipes , 2va TANYA K. CONROY <br />r— ORS 9� Notary Public <br />AL Resident of St. Joseph County, IN <br />No Signature "for "� MCommissionE� 2 <br />i /' _. _ vp <br />U 151�/1-�/a03 0 <br />Printe ame County of Residence OS <br />If the Contractor is a corpora ion, 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 /18/2024 <br />Con11ction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />�L�r7Y'!i <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />M// <br />Joseph R. Molnar, Vice President <br />Briana Micou, Member <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: November 26, 2024 <br />