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Project Completion Affidavit - 2017 Code Enforcement Remodel Proj No 117-117 - Ziolkowski Construction Inc
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Project Completion Affidavit - 2017 Code Enforcement Remodel Proj No 117-117 - Ziolkowski Construction Inc
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4/4/2025 10:15:53 AM
Creation date
5/9/2018 1:26:53 PM
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Board of Public Works
Document Type
Projects
Document Date
5/8/2018
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Final Waiver of Linen <br />state ofdndiana, County of St Joseph ss: <br />Bill Favors being duty 4wom th4t he/she Is the President <br />(lTWr e ofoftor) (Title) <br />Of Ziolkowski Construction, Inc. having contracted with City of South Bend <br />(Contractor) (Owner) <br />Installation of two new walls, miscellaneous electrical and painting <br />to furnish oultaltz materials ttridlor labor as follows: <br />(besorlption) <br />2017 Code Enforcement Remodel <br />for a projoctlsnowa as <br />laono of Project) <br />South Bend, Indiana <br />located at <br />City of South Bend <br />and owned by <br />('Owner) <br />and aloes hereby fertbar state on the behalf ofthe aforementioned sub 0oattactor/srappllert <br />(pARTIAL'WtI.rM) that thore is due from the CoAtMotor the sum of <br />Dollars 6� <br />Q rvoolptofwwhlehis hereby aoltnowlodged; or <br />E] the payment of which has boon proMhod us the Bola consideration for this Affidavit and Final Waiver of Lien vwhloh is glwon <br />stalely with rospeotto said amount, and. Which waiver shalt be offoctivo only upon rovelpt of payment thereof by the <br />undersigned; <br />(FINAL WAVER), that the ffnal balance doe &arra the contraetor is the Sum of <br />Three Hundred Sixteen and 951100 dollars 915'95 <br />El � 1pt Of Which Is hereby admowledged; or <br />El thepayntetat of which has boon promised as the solo consideration for this Affidavit and Final Waiver ofll Jett vwbioh shall <br />beoomo off`4otivo onlynpoarocolpt ofsuoh payment. <br />TIMM RE, the undersigned waives and rajlcases unto the owner of said promises, arty and all liens or claims whatsoever <br />on tite above-deserlbed property and improvements thereon au account of labor ortunterial or both, ftfrnishod b the undersigned <br />theretta, snblect to li mitatiotis or conditions oxpressed herein, if any, and further cortiflcdd thtrt no other Marty has any claim or right to a <br />lien on account of work pexfolimod or material fttrnishodto the undersigned for sold project, and within the scope ofthis Affidavit <br />and Waiver ofLis&. <br />Zlol'kowski construction, Inc. <br />J—'t� 2.2 <br />(Firm) (Authorized Aepresontativo) <br />STATS OF WDLVA ) <br />} Ssc <br />Before arse, the undorsigned, a notary Public, in and for sold Con* and State, personally appeared Bill Favors <br />and aololtbwlodged the execution of the foregoing A£tidavlt and Waiver of Lien. — <br />IN W17 NIRSS WNW0,11, I havo hereunto aubsorlbed my name and affixed my official soot on the �15th day of <br />April 20 10 ��(�qk& X <br />Notary Public signature <br />My L0nrirnl$3l0n)Rxpir"' March 27, 2024 <br />ll,ealdhig in Marshall County, Indiana <br />Debra L. Johnson <br />DEBRA L ,JOHNSUN <br />seal <br />Notary Public - State of Indians <br />Marshao County <br />Commission Expires Mar 27, 2004 <br />
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