Laserfiche WebLink
PROJECT NAME <br />PROJECT NO. <br />CONTRACT <br />SIGNED <br />PROJECT <br />DESCRIPTION <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS x ,PE C";,- � <br />PROJECT COMPLETION AFFIDAVIT <br />2023 Curb and Sidewalk <br />123-001 FINAL COST $956,974.57 <br />08/22/2023 MAINTENANCE AGREEMENT ENDS <br />Curb and sidewalk construction in South Bend (Divisions A, B, C, D, E) <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having <br />been completed, the City of South Bend, its officials and agents are hereby released from all claims and <br />demands whatsoever arising under or by such contract, and that the contractor performed the work within the <br />scope of the Specifications and Standards of the City of South Bend which were a part of the above Contract. <br />E cu of NOV �� , 20 <br />Premium Concrete Services, Inc. <br />Si nature Company Name <br />Becky Yeak y 712 Richmond Street <br />Printed Name Company Address <br />Elkhart, IN 46516 <br />City/State/Zip <br />WITNESSES <br />Before me, the undersigned Notary Public in and for said country and state, personally <br />appeared b d acknowledged his/her signature to the above Project Completion <br />Affidavit on the day of VE01 <br />Not Iy Signature My Commission Expires wj 1 '�' Lau <br />Printed Name County of Residence (KflAP-7- <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, Mau yewag , certify that I am Secretary of the Corporation executing this release; that <br />gec'Lqy 00-6 L'I who signed this release on behalf of the contractor was then <br />P161 &C4 of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by A ority of its governing body, and is within the scope of corporate powers: <br />Secreta s Signature <br />Corporate Seal <br />May y>P_a2w <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />9 <br />This project is acceptable for final approval and we recommend <br />to the Board of Public Works that it <br />e <br />a a <br />ordained so. <br />CY <br />a <br />Date: 12/23/2024 <br />cc <br />o < o <br />Cons ction Manager CITY OF SOUTH BEND, INDIANA <br />Z J <br />W W <br />BOARD OF PUBLIC WORKS <br />M <br />¢ LL, O <br />2 yyyy�� <br />O <br />Elizabeth A. Maradik, President <br />Joseph R. Molnar, Vice President <br />W <br />T8Q <br />fixx- <br />�UJC�1 <br /><Z <br />voZZ <br />Gary A. Gilot, Member <br />Breana Micou, Member <br />l 05 O <br />¢tqU <br />E <br />Murray L. Miller, Member <br />Attest: Theresa M. Heffner, Clerk <br />J <br />W <br />Date: March 25, 2025 <br />> <br />