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CITY OF SOUTH BEND,UNDkANA <br />BOARD OPPUBLIC WORKS <br />PROJECT COMPLETION AFFIDAVIT <br />PROJECT NAME v. <br />PROJECT NO 119-004 FINAL COST $384,973.05 <br />CONTRACT SIGNED 5/28/2019 MAINTENANCE AGREEMENT END�S <br />PROJECT DESCRIPTION Remove and place concrete sidewalk, concrete curb, ~~~ compliant curb ramps, and <br />WITNESSETH: the 2019 Curb and Sidewalk Pr ---- <br />The work under the above contract between the City ofSouth Bend and the undersigned contractor having been nompleted <br />mechyofSouth Bend, dooffi�o|oand mgemoamho�byndaooad�omaUdoimnand demands who�oeve,ahaingunder <br />`r <br />oysuch ountna�.and that the contro�nrpedonnodthe work wdhinthe scope ofthe 8po�fioodonnand Gtandondoofth City <br />ofSouth Bend which f e ny <br />Ex—cuted ---- Ri <br />eth-Rilev Construction Co., Inc. <br />ompany Name <br />Si nature <br />25200 State Road 23 <br />Printed Name South Bend, Indiana, 46614 <br />iah I undersig ed Notary Public in and for said country and state, personally appeared <br />and acknowledged his/her signature to the above Project Completion Affidavit on <br />Ireday <br />---- ^~--~~—~--- ---MyCommission Expires ���x��a <br />Printed Name County ofResidence <br />AIf <br />I certify that I wn4kary of the Corporation executing this release; that <br />who signed this release on behalf of the contractor was then <br />el, n a 4C s a Wco r o a,1 o n, "thre fo"OWing certfic� <br />r of said Corporation; that said release was duly signed for and on behalf of said <br />Corporation by Auth, rity of its governing, body, and is within an <br />SecIry I s Signature Sell <br />Notary Public - State of Indiana <br />14 St Joseph County <br />Printed Name rMyMcommission Expires Oct 22,2022 <br />DEPARTMENT OFPUBLIC VVORKSAPPROVAL <br />This i |and wmrecommend tothe Board ofPublic Works that itboordained so. <br />Date: <br />ConstructionHer <br />ale <br />� x <br />GaryA. G�ilot, ie/sident <br />T 6se M�ember <br />BOARD OFPUBLIC WORKS APPROVAL <br />G onewi,�,yeE. Miller, M <br />