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4AVf A,{ <br />CITY OF SOUTH BEND. INDIANA; <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Thermoplastic Striping <br />PROJECT NO 124-025 FINAL COST $16.704.00 <br />CONTRACT SIGNED 9/24/2024 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Strinina at nortaae/lathrov and rK)rta¢e/boland round-abouts <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 />this daN of, —� ��2021. <br />Name <br />WITNESSESS: <br />e1/ _ <br />the day ofN , �. SFAS. <br />No Sianat e t <br />CE Hughes Milling, Inc., DBA The Air <br />Markina Co. <br />Company Name <br />1544 N SR 25 <br />Company Address <br />Rochester. IN 46975 <br />Notary public, State of Indiana <br />Royd Cour* <br />Commission Number NP0739934 <br />My Commission Expires <br />March 20, 2030 <br />x f Tres <br />Printed NamL County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, certiA, that I am Secretary of.the Corporation executing this release-, that <br />f''fmy,%Ai vq. vWakuS _ who signed this release on behalf of the contractor was then <br />— F itsikk+ a of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Autilprity of its governing body, and is within the scope of corporate powers: <br />�v — <br />Secretarv's Sig'nattureCorporate Seal <br />2-, W k 1� fM.'U <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 />&A Z-,' t Date: 1/9/9094 <br />Cons etum Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />Attest: Theresa M. Heffner, Clerk <br />Date: January 28, 2025 <br />