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CITY OF SOUTH BEND, INDIANA ig__` <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT _ <br />PROJECT NAME Lasalle Avenue Streetscape <br />PROJECT NO 122-013R FINAL COST $6,025,155.26 <br />CONTRACT SIGNED 5/912023 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Roadway and streetscape work along Lasalle Ave. from MLK Blvd. to Eddy St. <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 rcleascd 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 ofthe City of South Bend which were a part ofthe above Contract. <br />Executed this 27th day of September 202 4 _ hftlestone Contractors North, Inc. <br />Company Name <br />Siure 24358 State Road 23 <br />Dustin P. Hilary, Director of Estimating, GriffithZouth Bend Company Address <br />Printed Name South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, pet5oga' peered ALIS1iA l(RUEOER <br />Dustin P. Hilary_, and aclmowled Aged his/her signature to the above Pro eai: �im�ssianxes <br />g gnaiur J t` pmn - A n V 2030 <br />the 27th _ ay o : Se ember , 2024 <br />C—A IMA <br />Notar. rgiature <br />My Commission Expires <br />i t CommmsbnNumber MP0653M <br />La Porte Porte CourAy <br />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 />1, Danielle Payne <br />, certify that I am Secretary of the Corporation executing this release; that <br />Dustin P. Hilary <br />_ _ __. who signed this release on behalf of the contractor was then <br />Director of Estimatin , <br />Griffith -South Bend of said Corporation: that said release was duly signed for said <br />`gLtgWH64;o <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: �`d `orti;y �tOts,�4�re <br />Secretary's Signature <br />,••'", 2 1' Lp <br />v,RPORAT� <br />�. . �tporate�Sca <br />Danielle Payne <br />ti ��A <br />Printed Name �ss - <br />DEPARTMENT OF PUBLIC WORKS APPROVAL 'e b`IVtltp����w�` <br />This project is acceptable for final approval and we recommend to the Board of Public Works that itdtllajl,�. <br />Date: 10/ 14/2024 <br />Cons coon Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: January 14, 2025 <br />