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CITY OF SOUTH BEND, INDIANA l•• �Yi. <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME Demolition of Former YMCA Building <br />PROJECT NO 124-055 FINAL COST $1,680,800.00 <br />CONTRACT SIGNED 8/8/2024 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Demolition of Former YMCA Building <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 />Ex d is day of J ovi e , 202 Green Demolition Contractors, Inc <br />Company Name <br />gn e II 315 Brighton St. Ste. 1 <br />Mir Q e-l J ('auq Company Address <br />Printed Name LaPorte, IN 46350 <br />City, State, Zip <br />WITNESSESS: <br />Bef re me, the undersigned Notary Public in and for said country and state, personally appeared <br />U <br />J graca d acknowledged his/her signature to the above Project Completion Affidavit on <br />tt <br />the da of .,1v a 202 JANETM,DOMMER <br />Notary Public . Seal <br />JE <br />No Signature `t\ - My Commission Expires Porter County - State of Indiana <br />Jayte� -+� IMer My Commission Expires Feb 16, 2031 <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I,M11CLapd J Ca , certify that I am Secretary of the Corporation executing this release; that .+ • i <br />who signed this release on behalf of the contractor was then C . <br />44e-pecke^t of said Corporation; that said release was duly signed for and on behalf of said. <br />Co Authority of its governing body, and is within the scope of corporate powers: <br />Secreiky 's ature _ <br />CorporateSeal _ <br />MIG�geI J roua�n . <br />Printed Name V <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 />Date: 7/25/2025 <br />Coqfruction Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />M <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />dv�f <br />Murray L. Miller, Member <br />Attest: Hillary R. Horvath, Clerk <br />Date: August 12, 2025 <br />