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Final Waiver of Lien <br />State ofIndiana, County of _ St. J o s e p h SS; <br />Nancy Knapik being duly swom that he/she is the SEcretary/Treasurer <br />(Name of Officer) (Title) _ <br />of HRP CONSTRUCTION INC. havingcontracted With City of South Bend, Dept, of Public Works <br />(Contractor) (Owner) <br />to furnishocitalnmaterials and/or labor asfollows: Randolph Street Basin Emergency:.Repair <br />(Description) <br />for a project known as Randolph Street Basin Emergency Repair <br />(Nams 00rojeot) <br />located at Randolph Street <br />and owned by City of South Bend, Board of Public Works <br />(Owner) <br />and does hereby fii rther state on the behalf of the aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />Dollars $ <br />Q receipt of which is hereby aolutowledged; or <br />Q the payment of which Iias been promised as the sole consideration for this Affidavit and ltitsal Waiver of Lien -which is given <br />solely with respect to said amount, and which waiver shall bu effective only upon receipt of payment thereof by the <br />undersigned; <br />FINAL WAI'VEi<t) that the final balance due &orn the eontraotor the sum of <br />Nine Thousand Two Hundred Twenty Nine Do lars and 77/100 �} 9,225.77 <br />:receipt of'which is hereby acknowledged; or <br />Q thepayment of which has been promised as the sole consideration for#his Affidavit and Final Waiver of Lien which shall <br />become effective onlyupon receipt of such payment. <br />THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and ail liens or claims whatsoever <br />on the above -described property and improvements thereon an account of labor or material or both, lttrnished b the undersigned <br />thereto, subject to limitations or conditions expressed herein, If any; and further certified that no other party has any claim or right to a <br />Iien on account of any work performed or material Airnished to the undersigned for said project, and within the scope of this Affidavit <br />and Waiver of Lion. <br />HRP CONSTRUCTION INC.' By <br />(Finn) Authorize presentative) <br />STATEOFINDIANA ) Nancy Knapik, Secretary/Treasurer <br />) SS; <br />ST. JOSEPH COUNTY ) <br />Before me, the undersigned, a Notary Public, In and for sold County and State, personally appeared <br />and admowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />IN WITNESS WIMMOF, I have hereunto subscribed my name and affixed my official seat on the 1 8 t h day of <br />May- 200 201,7 <br />Notary Public Signature <br />My Commission Expires: 3 / 6 / 2 4 <br />Cindy Uaheste <br />Residing its St. . Joseph^ County, Indiana Notary Publio Name <br />