Change Order No.2(final)-PCA - Demo of Vacant & Abandoned Houses, Phase IX Proj No 116-074B - Green Demolition Contractors, Inc.

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FINAL WAIVER OF LIEN STATE OF: Indiana SS COUNTY OF: St. Joseph TO WHOM IT MAY CONCERN: WHEREAS the undersigned has been employed by to furnish for the premises known as of which owner. THE undersigned, for and in consideration of Nine Thousand Eight Hundred Forty Two Dollars and 85/100------ —--------- ------------------------- $ 9,842.85 Dollars and other good and valuable considerations, the receipt whereof is hereby acknowledged, do(es) hereby waive and release any and all lien or claim of, or right to, lien under the statutes of the State of Indiana. relating to mechanics' liens, with respect to and said above -described premises, and the improvements thereon, and the material, fixtures, apparatus or machinery furnished, and on the moneys, funds or other considerations due or to become due from the owner, on account of all labor, services, material, fixtures, apparatus or machinery, heretofore furnished, or which may be furnished at any time hereafter, by the undersigned for the above described premises, INCLUDING EXTRAS.' DATE November 24, 2016 SIGNATURE AND TITLE 'EXTRAS INCLUDE BUT ARE CONTRACTOR'S AFFIDAVIT STATE OF IN SS COUNTY OF St. Joseph TO WHOM IT MAY CONCERN: THE UNDERSIGNED, (NAME) AND SAYS THAT HE OR SHE IS (POSITION) (COMPANY NAME) CONTRACTOR FURNISHING LOCATED AT OWNED BY Green Demoltiion Contractors Inc. 1427 West Dickens Chicago, II 60614 BEING DULY SWORN, DEPOSES OF WHO IS THE WORK ON THE BUILDING B Phase IX That the total amount of the contract including extras' is $ 196,857.00 on which he or she has received payment of $ 187,014.15 prior to this payment. That all waivers are true, correct and geniune and delivered unconditionally and that there is no claim either legal or equitable to defeat the validity of said waivers. That the following are the names and addresses of all parties who have furnished material or labor, or both, for said work and all parties having contracts or sub contracts for specific portions of said work labor and material required to complete said work according to plans and specifications: NAMES AND ADDRESSES WHAT FOR CONTRACT PRICE INCLDG EXTRAS` AMOUNT PAID THIS PAYMENT BALANCE DUE Green Demolition Contractors, Inc. Demolition $ 196,857.00 1 $187,014.15 1 $ 9,842.85 $ - 1427 West Dickens Chicago, If 60614 TOTAL LABOR AND MATERIAL INCLUDING EXTRAS` TO COMPLETE. $ 196,857.00 $187,01in ji $ 9,642.85 $ - That there are no other contracts for said work outstanding, and that there is nothing due or to becc or other work of any kind done or to be done upon or in connection with said work other than above DATE: November 24, 2016 SUBSCRIBED AND SWORN TO BEFORE ME THIS 24th SIGNATURE: DAY OF for KELLY ANN LANG NOTARY PUBLIC — OFFICIAL SEAL