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CITY OF SOUTH BEND, INDIANA° <br />BOARD OF PUBLIC WORKS°a' <br />PROJECT COMPLETION AFFIDAVIT'""`'"" <br />PROJECT NAME Off -Street Parking Lot at Wa ne St. and St. Louis Blvd. <br />PROJECT NO 117-083B FINAL COST $382,503.18 <br />CONTRACT SIGNED 7/24/2018 MAINTENANCE AGREEMENT ENDS <br />PROJECT DESCRIPTION Construction of a new parking lot at Wayne St. and St. Louis Blvd. <br />WITNESSETH: <br />The work under the above contract between the City of South Bend and the undersigned contractor having been completed, <br />the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or <br />by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend which were a part of the above Contract. <br />Executed this day ofd2.i�-h 2019 Rieth-Riley Consruction Co., Inc. <br />Company Name <br />P Y <br />Si 25200 State Road 23 <br />G a r I& � �X- Company Address <br />Printed Naas South Bend, IN 46614 <br />City, State, Zip <br />WITNESSESS: <br />B ffore me the undersigned Notary Public in and for said country and state, personally appeared <br />rd acknowledged his/her signature to the above Project Completion Affidavit on <br />the da Y 201 q <br />Not / . Signature My Commission Expires <br />TIYI1'�° (�.t <br />Printed Name County of Residence <br />If the Cotitracto a corporation, the following certificate will be exe ed , <br />I, "v " certify that I am+ e e fry of the Corporation executing this release; that <br />t J/ 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 />�Vµw ty governing body, and is within t'' r° rs` <br />Corporation by At on" of its ove gr <br />Secretary's Signatu d $@at <br />d NMuy PUNIC • Stag M Indiana Corporate Seal <br />w k St Jouph county <br />Printed ame Commis n Expires act 2z 2022 <br />DEPARTMENT OF PUBLIC WORKS APPROVAL <br />project is acceptable <br />This p for fi proval and we recommend to the Board of Public Works that it be ordained so. <br />Date: <br />Construction Jer <br />1OARD OF PUBLIC WORKS APPROVAL <br />4 Gary A. GINoesident c �; r Jc+" Member , Pr <br />a <br />/'121-1,/`� <br />Therese J. D reu Member <br />Laura O'Sullivan, Member <br />Date: � 2 , 19 <br />Elizabeth A. Maradik, Member <br />e M. Martin, C <br />