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SpUfNg <br />CITY OF SOUTH BEND, INDIANA <br />V'On <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT } <br />PROJECT NAME Demolition of Vacant and Abandoned Houses, Phase VII Division C <br />PROJECT NO 115-117 FINAL COST $153,800.00 <br />CONTRACT SIGNED 11/27/2015 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Demolition of Vacant and Abandoned Houses, Phase VII Division C <br />W ITN ESSETH: <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 />Exec s °' y of �V ( 201 Ci Indiana Earth, Inc. <br />_ Company Name <br />ignature 10343 McKinley Hwy <br />v�� Pp� ��t�_ Company Address <br />Printed Osceola, IN 46561 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />M, K g2�� L r and acknowledged his/her signature to the above Project Completion Affidavit on <br />the day Vlr 201(�_. <br />Notary Signature My Commission Expires <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, �2 L G5LG-IZ- certify that I am Secretary of the Cc <br />�nt4lLK 031,�� who signed this release on behalf of the contractor was then <br />VI�t�3li?IT of said Corporation; that said release was duly signed for and on behalf of said <br />Co AutlF�ettt its a ing body, 0 is within the scope of corporate powers: <br />Corporate Seal <br />Printed Name <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />This project is acceptable°for inal approval and we recommend to the Board of Public Works that it be ordained so. <br />Date: '7 P- 1 t c, <br />Construction Hager .._, <br />Gary A. Gilot, President <br />Therese J. Dor u,M#mber <br />BOARD OF PUBLIC WORKS APPROVAL Date (, /-, ° J6 <br />David P. Relos, M m e6 r Elizabeth A Maradik Member <br />James A. Mueller. Member <br />Linda M. Martin, Clerk <br />