Project Completion Affidavit - East Bank Sewer Separation Phase V Proj No 114-062B - Walsh & Kelly Inc

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Final Waiver, of Lien State Of Indiallao County of St. Joseph SS: John Peisker being duly awom thathelshe Is the Vice President of Asphalt Operations (Name of Officer) (Title) of Walsh & Kelly, Inc. having contracted with _ Cit�outh Bend, Indiana___ (Contractor) (Owner) to furnish vottain inaterials andlor labor as follows; Asphalt Paving, Sanitary, Storm Sewer and Water 0) off on) for a project known as —East Bank Sewer Separation, Phase 5, Division B, Project No. 114-062 (Namo ofprojeot) located at Various locations jhroughout the City of South Bend, Indiana and owned by __CitY_QLSDutbJaend, —1ndJLana (owner) and dons hereby further state on the lichalf of tile a!foromontionedstiboonttiotor/suppiter: (PARTIAL WAIVER) that thero is duo from the Contractor the Bum of Dollars receipt Of winch is hereby a0knoWledged; or El the payment otw1ilch lais bcon promised as the mole consideration for this Affidavit and Final Waiver of Lion which Is given solely Will, respect to said amount, and which waivcr 8111111 be effective Only upon rocolpt of payment thereof by the undersigned; (FINAL WAIVER) that the: final balance duo Rom the contractor Is the sum of El receipt of which Is hereby acknowledged; or the, payment of which has been promised Or, the sole consideration for this Affidavit and Final Walvor of Lion which shelf become affective only vponrecoipt of such payment, T1,03REFORE, the undersigned waives mid releaseimto the Owner of Bald promises, any one, all lions or claims wilatsoever on the above-deserlbed prop" and improventantalthero6n,ail pcvbinit of labor or material or both, funrishod b the underalped thorolo, qubJ cot to limitations or conditions OXPr9 certified that no other party has any claim orright to it lien on "count of any work performed or gnat e, fished to 14MJf&Jguer[ for said projoct, And within the scope of this Affidavlt mid Waiver ofl,fon. CP Walsh & Kelly, Inc. I (Firm) SEAS ....#y 10 STAT13 OF INDIANA 00, ............ SS: 0.* '�J' IIVL) ST. JOSEPH CO1JNT`Y 111111111110 Before map the undarsigued, a Notary public, In and for said County and State, personally appeared Joh n Peisker and nolatowledged the execution of the foregoing Affidavit and Waiver of Lion, IN WITNIRS8 WIRREOP, I have hereunto subsorlbod tray namo and affixed in "'a' of -March . 200 otuy Pat, MycomnifigionExpiros, June 07, 2023 m Elizabeth Turpin Residing fit -,_JndiaML,._, County, Notary RPIN