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Change Order No 1 & PCA - 2017 Demolitions Phase 2 Project No 117-121 - Ritschard Bros Inc
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Change Order No 1 & PCA - 2017 Demolitions Phase 2 Project No 117-121 - Ritschard Bros Inc
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4/2/2025 1:22:21 PM
Creation date
6/27/2018 8:23:10 AM
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Board of Public Works
Document Type
Projects
Document Date
6/26/2018
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Final. Waiver of Lien <br />State oflndiana,Countyof St. Jose h SS; <br />Rachelle L. Dolniak being duly sworn thathelshels the President <br />(Name of Officer) (Title) <br />of Ritschard Bros., Inc, having contracted with City of South Bend <br />(Contractor) (Owner) <br />tohmishcertain.materialsfmNorlabor asfollows: Demolition <br />ODescripiion) <br />for aprojeetkaDvnas 2017 Demolitions, Phase 2 (Div. A, B, C) <br />(Name of Project) <br />located at Various Addressess <br />and ovmedby CitV of South Bend <br />(Owner) <br />and sloes hereby further stata on the behalf0fthe nforomentioned subconftactor/supplier: <br />(PARTIAL WADER) that thaw is due ftom the Contractorthe suns of <br />Dollars A j <br />El receipt of which is hereby acknowledged; or <br />❑ the payinent of which leas been promised as the sole consideration for this Affidavit and Final Waiver ofi ioa-which is given <br />solely with xespectio said amount, and which waiver shall be effective only upon receipt of payment thereof by the <br />unndelsigned; <br />(FINAL WAIVER,) that the final balance due from the contxaetor is the sum of <br />Two Hundred.Sixteen Thousand Nine Hundred Twenty-four { 216,,924160 <br />Dollars and 60/100 _,_.....,...__ <br />❑ xeceipt of wilier is hereby a0wowledgad; or <br />IMthepayiMent ofwhichhas been promised.as the sole consideration forthis Affidavit andMnal Waiver (if Lion wbich: shun <br />become effective oniyuponreceipt of such payment. <br />"ITMEFOR.E, the undersigned waives and releases unto the Owner of said promises, any and all lions or claims whatsoever <br />on lho above-deseribedproperty and improvements thereon an account of labox or material or both, furnished 6 the undersigned <br />therato, subject to limitations or conditions expressed herein, if any; and fnrthcr certified thatno other party has any olgim or rightto a <br />lien on account of any work performed or material furnished to the undo ed for saidproject; and within the scope of ft Affidavit <br />and Waiver of Lien. <br />Ritschard Bros., Inc . . lay <br />nm <br />STATE OF MIANA (Authorized epresentativa) <br />) <br />S5; <br />ST, JOSEPH COUNW ) <br />Before me, the undersigned, a Notary Public, In and for said Comity and State, personally appeared Rathe 1 q L . Dolniak <br />and acknowledged the execution of the foregoing Affidavit and Waiver of Lion. <br />IN WITNESS MMOF,1-have hums to subscribed my name and affixed my oV"-iaj"C:a� <br />the J,'znn <br />day of <br />June .fig- 2018 `�i <br />My commission Expirrs; 9 / 18 / 25 <br />Residiugin St. Joseph County, Indiana <br />rromq rumic <br />y'•2n rr <br />Robin Foa �— <br />Motary Public Xame <br />
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