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Final Waiver of Lien <br />State ofhadtana, County of St Joseph SSt <br />Bill Favors being duly swom that he/she is the President <br />(Name of Officer) (Title) <br />Of Ziolkowski Construction„ inc. Having contracted with City of Soth Beni <br />(Contractor) (Owner) <br />to iiurlish certain materials and/or labor as follows: Demolish existing kitchen and install now cabinets, countertop„ water cooler and plumb fixtures <br />(I)e�erlpdon) <br />2017 Engineering Remodel <br />for a projeot%town as <br />(Name ofAmject) <br />located at South Benxi, Indiana <br />and owned by City of South Bend <br />(Owner) <br />and does hereby "or state on the behalf ofthe atforornentioned suboontnotor/supplier., <br />(PA.RVAL WAMR) thatthom is due froin the CoAtrootor the sum of <br />Dollars ( ) <br />d rccelpt of which is hereby acluiowleaigod or <br />0 the payeaneaat of which has been prouslsed as; the sole consideratlon for this Affidavit and Flunl Waiver ofLienwhich is given <br />solely with ruspuutto said amoont, anal which we Ivor shall be effective only upon reoelpt of payment thereof by the <br />undowigned; <br />(FINAL' AIV tJ thatthe fival balance due from tho contractor is the sum of <br />** Twe Thousorrd Four Hundred Three and 351100 *` ($ 2,403,35 <br />( recelpt oft Bich is hereby acllartowlecdpad, or <br />d thepaymentot'Whj0hhas boon prcWiodfistiiteSolo consideration for this A davitand.FilialWaiverofLitnr,whichshall <br />boorm o otl'cotivo onlytapoill.xeocipt ofauola payment, <br />TIMWORB, the underolgnud waives and releases unto the Civmor of said premises, any and all lions or claims whatsoever <br />on tho abovic-deserlbcd prepexty and improvements thereon an atzrmt rs(labor ar m�terlal or both, lilrnislaud ly the utadersig>�ed <br />thereto, subject to limitations crr conditions oapressed herons, ifany, and fhrther certlFAW thatno ether patty has any cloittt or rightto u. <br />lion on acconlnt of'any work pertirrrrnaed or material Mmished to the undorslguetl for ealdpr�oot, and wIthin the scope of this Affidavit <br />said Waiver of Llest. <br />Ziolkowski Construction, Inc, " <br />(Firm) (Autborixedliopmso °^V <br />y <br />trm ntivo) <br />STATE OF MIA` 4A ) <br />} SS; <br />ST, 30SEPH COUNTY Bill Favors <br />Before me, the undersigned, a'Nvtov Publio, in and for said County and State, personally appoared <br />and afaowledged the execution of the foregoing Affidavit and Walvoar of Lion, <br />IN WI'1`l' B aS 'WXR OF,1 havo hereunto subscribed my name and of xS ed any official seal on the 1 t th day of <br />April 20 18 s <br />Nowt' Publio Signature <br />MyC'vmaat3ssipnM fret': March 27,2024 <br />Debra L. Johnson <br />Residing irk Marshall County, Indiana �,�. ,13EJ <br />NSONte of Indianaountyes filar 27, 2024 <br />