Laserfiche WebLink
PROJECT NAME <br />PROJECT NO <br />CONTRACT SIGNED <br />PROJECT DESCRIPTION <br />WITNESSETH: <br />Y JJI11 R/cdjJ, <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS77 <br />PROJECT COMPLETION AFFIDAVIT <br />Three Twentv at the Cascade - Site Utilities <br />118-074D (Division A&C) FINAL COST $195,222.50 <br />12/20/2018 MAINTENANCE AGREEMENT ENDS <br />Installation of water main and storm sewer. <br />The work under the above contract between the City of South Bend and the undersigned contractor having been completed, <br />the City of South Bend, its officials and agents are hereby released from all claims and demands whatsoever arising under or <br />by such contract, and that the contractor performed the work within the scope of the Specifications and Standards of the City <br />of South Bend which\uypre a part of the above Contract. <br />Executed th' day of s'" . �` 20='' Indiana Earth, Inc. <br />Company Name <br />gnature /7 10343 McKinley Highway <br />too�& 05 Lei- re-(( ` Company Address <br />Printed Name Osceola, IN 46561 <br />City, State, Zip <br />WITNESSESS: <br />Before me, the undersigned Notary Public in and for said country and state, personally appeared <br />0 vt and acknowledged his/her signature to the above Project Completion Affidavit on <br />the day of J r-�`— 20$ Amanda Lynette Johnson <br />n FNotary Public Seal State of Indiana <br />St. Joseph County <br />Commission Number NP0725748 <br />NotarySignature My Commission Expires Commission Expires03110/2028 <br />Printed Name County of Residence <br />If the Contractor is a corporation, the following certificate will be executed. <br />I, (M 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 />/��'SdOCiT of said Corporation; that said release was duly signed for and on behalf of said <br />Corpo tivyfiozritro�ts e ning body,,andis within the scope of corporate powers: <br />77t „� <br />Secretary's Signature <br />Corporate Seal <br />Printed Name <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 ordained so. <br />Date: 07/16/2020 <br />ConstructOn Manager <br />BOARD OF PUBIAC W QRKS <br />Clary A. Gilot, President <br />Elizabeth A. Maradik, Member <br />Joseph R. Molnar, Member <br />BOARD OF PUBLIC WORKS APPROVAL Date: July 28, 2020 <br />Therese J. Domia, Mein <br />Tordan V. Gathers, Member <br />Allr r: <br />o ia:;fu CPfnns <br />I i,,6 M. Martin_ Clerk <br />