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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />CITY OF SOUTH BEND, INDIANA Ilk <br />BOARD OF PUBLIC WORKS n <br />�: <br />PROJECT COMPLETION AFFIDAVIT � <br />Cleveland Road & Ameritech Drive Intersection Improvements <br />112-049 FINAL COST $1,463,270.49 <br />11/1/2023 MAINTENANCE AGREEMENT ENDS <br />Pavement improvements at Cleveland Road and Ameritech Dr intersection in South Bend. <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.,Ciq of Soyfh Bend which were a part of the above Contract. <br />Executed this 'both ay of C <br />Sioi f <br />>>d m P. Hilary Director of Estim <br />rinted Name <br />2024 Milestone Contractors North, INC. <br />Company Name <br />24358 SR 23 <br />Company Address <br />South Bend. IN 46614 <br />City, State, Zip <br />WITNESSES: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />Dustin P. Hilary and acknowledged his/her signature to the above Project, Cpttmgr0.,s,_,� ,r <br />the 10t day of D ember 2024 ALISHAKRUEGER <br />1:* SEAL`*=My CJune5,ion Expires <br />2030 <br />N N•. '` Commission NumberNP0653544 <br />Not ignature My Commission Expires 6/5 Q ..... La Porte County <br />Alisha Krueq <br />Printed Name <br />County of Residence LaPorte <br />If the Contractor 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 />Printed Name <br />Corporate Seal <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 />/<u1.o Date: 12/11 /2024 <br />Constru on Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />I <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />yy/.v+,,r < qv'� <br />Murray L. Miller, Member <br />WE 01 <br />Joseph R. Molnar, Vice President <br />Briana Micou, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: December 17, 2024 <br />