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I TH 8C <br />CITY OF SOUTH BEND, INDIANA U C <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT PEACE <br />., <br />x x <br />1865 <br />PROJECT NAME vjdluw oc 4c"r lS �c ` ttvl 3 <br />PROJECT NO. FINAL COST _Z-O . 00 <br />CONTRACT MAINTENANCE AGRE MENT ENDS <br />SIGNED-713oho ;-1 '7< 1 / 2-5 <br />PROJECT <br />DESCRIPTION <br />WITNESSETH: !vl7-7 V-/« t" V t <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 />Executed this t 5-eh day of t) [ , 20 2 5- <br />t <br />yj <br />6 r�Or+�► ie:�fl t��Sl Ll <br />SignatdxQj Company Name <br />Printed Name mpany Address <br />%ky* 0 G� <br />City/S a e/ ip <br />WITNESSES <br />Before me, the undersigned Notary Public in and for said country and state, personally <br />appeared -I'nkm LeCa1P,l.. , and acknowledged his/her signature to the above Project Completion <br />Affidavit on the 15"R-ay of 'S,4.k, 2005--_. <br />VALERIE MEDEMA <br />Notary Public, State of Michigan <br />Notary Signature My Commission Expires <br />�(C A.er, My Commission Expires February 2, 2030 <br />Printed Name County of Residence <br />County <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 <br />ordained so. <br />Date: 8/5/2025 <br />Congrmction 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 />j f. #rd� <br />Attest: Hillary R. Horvath, Clerk <br />Date: Auaust 12. 2025 <br />