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Change Order No. 1-PCA - Demolition of Vacant and Abandoned Houses, Phase VII - Div C - Proj No 115-128C - Torok
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Change Order No. 1-PCA - Demolition of Vacant and Abandoned Houses, Phase VII - Div C - Proj No 115-128C - Torok
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3/28/2025 1:39:50 PM
Creation date
8/30/2016 1:45:09 PM
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Board of Public Works
Document Type
Projects
Document Date
8/23/2016
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wazvER of LIEN <br />FINAL <br />of Indiana, St, �o L t1 <br />is .County, ss: <br />Whereas, the undersigned —FO t-0K Eicea vW}:A <br />k7t� ' 1 has been heretofore em- <br />eloyed by Ct+y. 0.9 SduiH. ..at;Kt rYrAi <br />. . ..to furnish certain material and labor. <br />r. I to-rci <br />for the building owned by C14y OF Soitch Uet iil Sn, _ and located on .. .. <br />Qew�oi;�i�� ea Va4ewK� � Rloai�doneo l�taiJse'i l�hns�.Vl[l.- Di✓tslarl �. <br />Sa��lh. �3end ,..�w• tis- Ixg <br />Now, Therefore, Know Ye, That the undersigned, for a good and taluable considenra�tion. the receipt of which ., <br />threw .. tlt Urn. + <br />y acknowledged, hereby and nou waives and releases unto the saM A-j� ar <br />the owner of said premises, any and all lien, right of lien, or claim of whatsn'ever kind or character on the above described <br />building and real estate, on acrnuot of any and all labor or material, or both, furnished for or incorporated into said building <br />by the undersigned; and further certify that the consideration moving to the undersigned for executing this <br />Waiver of Lien has been mutually given and accepted as absolute cash payment and not as a conditional or part payment or <br />as security for payment - <br />Signed, Signed, sea!ed and delivered this. oZ9 day of it, ..i9.2U1(a <br />i <br />__ Signed aVtQl1te�Rt !/lQty1 _ <br />Personally appealed before me this.. _.. %-9.. day of <br />Wi �'+kin .L 6,&. IL is DYCS.C4en ..�' _-.. "o--' --- iwho being duly sumrn an oath, sa <br />ys: That he <br />fthe onpw- rc*uc97.Ki and that he hereby <br />acknoudedges the execution of the foregoing instrument for and on behalf of said.... .T41-G (C E.A'CRU14�iHQ <br />...and at ...... ....� special instance and re est. tl <br />.WY Commission Expires <br />........ _. .....�./. ...C�t `�...,...... ...... Notary Public. <br />W <br />This instrument prepared by: I <br />_. , il+hH T6lie IL <br />
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