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PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />CITY OF SOUTH BEND, INDIANA fry <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />Potawalomi Pool Demolition <br />124-023A FINAL COST $195,900.00 <br />3/1 1/2025 MAINTENANCE AGREEMENT ENDS N/A <br />Demolition of the Potawatomi Park Pool House and Pool <br />The work under the above contract between the City of South Bend and the undersigned contractor having been completed, the City of <br />South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or by such contract, and <br />that the contractor performed the work within the scope of the Specifications and Standards of the City of South Bend which were a part of <br />the above Contract. <br />E u d is day of 441 , 202 5 <br />1,7 <br />S i X <br />VC, <br />11 <br />�a e J BrovglA <br />Printed Name <br />GreeK beWldl,4(b-A a�+ge`�ors -LAC. <br />Company Name <br />Company Aqjrcss <br />L4 fo r +e , ZN 44950 <br />City, State, Zip <br />WiTNESSESS: ,, II <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared N11C Q J Oft4and <br />acknowledged his/her signature to the above Project Completion Affidavit on LJ <br />the Ae' dav of J �2026 JANET M DOMMER <br />Notary Public - Seal <br />Porter County - State of Indiana <br />Commission Number NP0746920 <br />Notary ignature My Commission Expires 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 C_6I'e t ..� r"Y4, certify that I am Secretary of the Corporation executing this release; that <br />(1C lAQ4 ( B deX11A who signed this release on behalf of the contractor was then <br />Secretary' <br />s <br />AAM "C A <br />Printed Name <br />of said Corporation; that said release was duly signed for and on behalf of said <br />ty of its governing body, and is within the scope of corporate powers: <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 />&y& �� Date: 7/25/2025 <br />ConYoction 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 />Breanr�a�M, icou, Member <br />Corporate Seal <br />Murray L. Miller, Member <br />Attest: Hillary R. Horvath, Clerk <br />Date: August 12, 2025 <br />