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Final Waiver of Lien <br />state of Mang, county of St. Joseph SS: <br />John Peisker being duly swam 9W he/she Is the Vice President of Asphalt Operations <br />(Name of Officer) (Titlo) <br />Of _ Walsh & Kelly, Inc. hoving contracted with The City of South Bend, Indiana <br />(Contractor) (Owner) <br />to fitrnlsh certain materials "or labor as follows: Concrete Work and Landscaping <br />moscripfton) <br />for a projeet known as Fellows Streetsca e, Phase 2: Project No. 116-041 B <br />(Name ofProjaot) <br />located at Broadway Street to Ewing Avenue, South Bend, IN 46601 <br />and owned by City of South Bend, Indiana ��tittat1�F�. <br />(Owner) ��o & ,4, <br />and does herbcb <br />y fiu•thor state on the bohaifofthe aforementioned subcontmotor/supptier. :., <br />(PARTIAL WAIVER) that thero is due from the Contractor the sum of <br />• <br />Dollars J� ;= _ �'` • <br />❑ receipt of which Is hereby acknowledged; or o'�i°fr +N©, tANk 100% <br />❑ the payment of which has been promised as the solo consideration for this Affidavit and Finn] Waiver of Lien -which is given <br />solely with respect to said amount, and which waiver shall be effedivo only upon reaoipt of payment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due from the contractor Is the stun of <br />Twenty Im.3housand Nine Hundred Fifteen and 151100 $22 925.1 <br />© receipt ofwhieh is hereby aolmowiedged; or <br />j� thepaymeW of which has been promised as the solo consideration for ible Affidavit and final Waiver of Liao which shall <br />become affective onlyupouraceipt o£suoh payment, <br />77IBRSPORE, the underdgnod waives sand releases unto the owner ofseid promises, any and all lions or claims whatsoever <br />on the above-doscrlbod property and improvemetms thereon as account of tabor ormatedal or both, famished b the undersigned <br />thereto, subject to limitattons or conditions expressed herein, if any; and fhrthcr certified that no other party has any olalnt orrlght to a <br />Ron on account of any work performed or material fiunished to the undersigned for said project, and wltbin scope of this Affidavit <br />and Waiver ofLim i- % / // <br />I <br />Walsh & Kelly, Inc. <br />33Y <br />(Finn) (Authorized Representative) <br />SWATS OF WDIANA ) <br />) SS: <br />ST. 30811PH COUNTY ) <br />Before me, tho undersigned, a Notary Public, In and for sold county and State, personally a arcd John Peisker <br />and aoknowlWSed the executions of the foregoing Affidavit and Waiver of Lien. <br />IN WIMSS WHBREOF, Ihavo hereunto subscribed my name and affixed my official on the 19th day of <br />January 200 18 <br />otary Public Signeturo <br />My CommissionExpir": June 07, 2023 <br />Residing in Indiana county, Marshall <br />my Elizabeth Turpin, Staff Accountant <br />Notary Pubflo Name <br />Q <br />RPIN <br />rnNota Pub'Ic, 51ate of ind!ana <br />!riarsha!I County <br />Commissionxpiras <br />June 7, 2023 <br />