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AFFIDAVIT AND WAIVER OF LIEN <br />El Final 121 Partial 21 Payment to Follow <br />STATE OF: Indiana <br />COUNTY OF: St. Joseph <br />Jennifer Brown being duly sworn, deposes and says that she makes this <br />affidavit for and in behalf of MARTELL ELECTRIC, LLC which, having entered into an agreement with <br />City of South Bend ("Contractor") for the construction of Jefferson & T ckenham <br />on the premises of the owner located at <br />states that, upon receipt of payment by Martell Electric from Contractor in <br />the amount of Fifty seven thousand three hundred seventy four & 83/100 Dollars, <br />(the "Payment"), which payment has been promised by Contractor and is anticipated by Martell Electric, <br />all material and subcontract, due and payable, will have been paid and all labor paid in full to the date of <br />this affidavit EXCEPT for: <br />CONTRACT <br />RETENTION <br />Effective upon receipt by Martell Electric of the Payment, Martell Electric does waive and release unto the <br />owner of said premises, any and all lien, right of lien or claim of whatsoever kind of character on the <br />above -described building and real estate under the Statutes of the State of <br />Indiana <br />relating to Mechanic's liens, on account of any and all labor, material, or both, furnished for or <br />incorporated into said building by the undersigned, up to this date. <br />MARTELL ELECTRIC, LLC <br />BY <br />Jennifer Brown <br />(Printed Name) <br />President <br />(Title) <br />Subscribed and sworn to before me, <br />on this 6th day of November, 2018 <br />� vP P <br />RENA BALDWIN <br />r m Notary <br />Public. State of Indiana <br />42�w <br />= <br />• a� <br />St Joseph County <br />Notary Public <br />.. sEAV <br />Commission # 663664 <br />�w <br />My Commission Expires d <br />My commission expires: 2/28/2023 <br />�Pr�� <br />� <br />February 28, 2023 <br />-�-t.-_- .-.�. - .1 <br />