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CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME 2015 Traffic Detector Loops <br />PROJECT NO. 115-045 FINAL COST 79,171.20 <br />CONTRACT SIGNED June 2, 2015 MAINTENANCE AGREEMENT ENDS 8/2018 <br />PROJECT DESCRIPTION Installation of traffic detector loops — <br />WITNESSETH: <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 1ih day of , 23 Q- <br />9 <br />Martell Electric LLC <br />SignZttu e J Company Name <br />(yUt�W il� 4601 Cleveland Road <br />Printed Name Company Address <br />South Bend IN 46628 <br />WITNESSES <br />Before me, the undersigned Notary Public <br />and acknowledged I <br />the __ aVh day of ,rr 2iher, 200 1( <br />Not(%a7 Signature ,-Q F—J <br />0`FiN )It. L-JR i�(i+A.i4 n7 <br />Printed Name <br />City/State/Zip <br />personally appeared <br />mpletion Affidavit on <br />44"12023 <br />County of Residence -4�T - (psem <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, certify that I am Secretary of the Corporation executing this release; that <br />who signed this release on behalf of the contractor was then <br />of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Authority of its governing body, and is within the scope of corporate powers: <br />Secretary's Signature <br />Printed Name <br />Corporate Seal <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 />e Date: l • 14 <br />ConstrueldManager <br />BO RD OF PUBLIC WORKS APPROVAL Date: <br />i <br />Gary A„Gilot, Pres� avid P. Relos, Nf&nber <br />JamersiA. Mueller, Member ThereseJ. Do)rai, ember <br />au C <br />Elizabeth A. Maradik, Member <br />M. Martin, <br />