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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME <br />PROJECT NO. <br />CONTRACT <br />SIGNED <br />Seitz Park Renovation <br />117-093 FINAL COST $10,235,924.48 <br />December 17th, 2020 MAINTENANCE AGREEMENT ENDS 09/27/2027 <br />PROJECT Renovation of Seitz Park <br />DESCRIPTION <br />W ITNES SETH: <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 />AExtedhis 14th day of August , 2025 <br />Ziolkowski Construction, Inc. <br />Company Name <br />4050 Ralph Jones Drive <br />Printed Name Jason Watts Company Address <br />South Bend, Indiana 46628 <br />City/State/Zip <br />WITNESSES <br />Before me, the undersigned Notary Public in and for said country and state, personally <br />appeared Jason Watts , and acknowledged his/her signature to the above Project Completion <br />Idavit o the 14th(\ day of August 2025 <br />Nkary Signa re My Commission Expires 01 /28/2031 <br />Jennifer Wiest <br />Printed Name <br />County of Residence St. Joseph County, Indiana <br />If the Contractor is a corporation, the following certificate will be executed. <br />1, Robert Bash certify that I am Secretary of the Corporation executing this release; that <br />Jason Watts who signed this release on behalf of the contractor was then <br />President of said Corporation; that said release was duly signed for and on behalf of sjj4l I I I)'I <br />p rati n Autj ority of its governing body, and is within the scope of corporate powers: ``GONS r��., <br />JENNIFER WIEST <br />Secretary's Signature _`�"PY P�ec Notary Public, State of Indiana EAL� ' <br />i;SEAL = St. Joseph County �: Vc <br />Robert Bash y*. ,* Commission Number NP0883344 COr�tv�be S 1^�� IQ:. <br />p My Commission Expires = O. 9 ` <br />Printed Name p,�Npip!\`�� January28, 2031 • � <br />Dip <br />DEPARTMENT OF PUBLIC WORKS APPROVAL '.,0•• ...... X:.` <br />This project is acceptable for final approval and we recommend to the Board of Public Works that'�Ge*tl�.�` <br />ordained so. <br />/1 a& Date: <br />Construcg6n Manager <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />lut�6k <br />Elizabeth A. Maradik, President <br />ash-�it� <br />Gary A. Gilot, Member <br />Murray L. Miller, Member <br />8/14/2025 <br />�7/R <br />Joseph R. Molnar, Vice President <br />Breana Micou, Member <br />Attest: Hillary R. Horvath, Clerk <br />Date: 8126/2025 <br />