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Change Order No. 1-PCA - MPAC POTO Chandelier Support Proj No 117-034 - A&D Contractors LLC
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Change Order No. 1-PCA - MPAC POTO Chandelier Support Proj No 117-034 - A&D Contractors LLC
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4/2/2025 1:28:45 PM
Creation date
3/28/2018 2:59:24 PM
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Board of Public Works
Document Type
Projects
Document Date
3/27/2018
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Final Waiver of Lien <br />Stale of Indiana, county of Vanderburgh S5: <br />KendallWahl being duly sworn that he/she is the Controller <br />(Name of Officer) m (Title) <br />of A&D Constructors, LLC having oontracted will, City of South Bend <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows; Support Steel and Installation of Phantom of Opera Chandelier Support <br />(Description) <br />for a project known as Morris Performing Arts .Center -Phantom of the Opera Chandelier Support <br />(Name of Project) <br />located at Morris Performing Art Center - City of South Bernd <br />and owned by Board of Public Works - City of South Bend, Indiana <br />(Owner) <br />and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier. <br />(PARTIAL WAtVBR) that there is due from the Contmotorthe aura of <br />Dollars ($ -- ) <br />❑ receipt of which is limbyaciotowledged; or <br />Q the payment of which has been promised as the sole consideration for this Affidavit and final Waiver ofLienwhich Is given <br />solely with respect to said amount, and which waiver shall be effective only upon receipt ofpayment thereof by the <br />undersigned; <br />(FINAL WA1VEIQ thattho final balance due from the contractor is the sum of <br />Two Hundred Fifty Eight Thousand Forty Four Dollars and 74/100 $ 258,044.74 <br />❑ receipt of which is hereby acknowledged; or <br />the payment of which has been promised as tits sole consideration fbr this Affidavit and final Waiver of Lien which shall <br />become offeotive on yupon receipt of such payment. <br />THEk'tBFORE, the undersigned waives and releases unto the Owner ofsaid premises, any and all liars or claims whatsoever <br />on the above-desorlbed property and improvements thereon as account oflabor ormaterial or body famished b the ut,derslgned <br />thereto, subject to limitations or conditions expressed herein, if any; and further certified ihatno other party has any claim or right to a <br />lien on account of any work performed or material furnished to the undersigned for saidproject, and within the scope oftbis Affidavit <br />and WaivercfLiea <br />A&D Constructors, LLC By Kendall WahlP <br />(Firm) (Authorized Representative) <br />STATE OF INDIA'NA ) <br />SS: <br />ST. JOSEPH COUNTY ) <br />i36lbre me, the undersigned, a Notary Public, In and for sold County and State, personally appeared KendallWahl <br />and aftowIedged the execution of the foregoing Affidavit and Waiver ofLien. <br />IN WITNESS WHEREOF, Ihavo hereunto subscribed toy name and affixed my official seal on the 9th day of <br />March 200 2018 '6 <br />Nomy Public signature <br />My Commission Expires: June 23, 2023 <br />Residing in Warrick County, Indiana <br />10 <br />ALIEN DALE HANDING <br />Notary Public - Seal <br />State of Indiana <br />Warrick County <br />My Commission Expires Jun 23, 2023 <br />
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