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Final Waiver of Lien <br />State ofrndiana, county of St. Joseph_ SS; <br />Hilary _ bein dui sworn that he/she is he �. <br />Dustin Hila, $ y the South Bend Area Vice President <br />(Name of Officer) (Title) <br />Of Walsh &Kelly, Inc. having contracted with City of South Bend <br />(Contractor) <br />(Owner) <br />to famish certaitimaterials "or labor as follows; Asphalt Pavement, Concrete and Marking <br />for aprojectknown as # 117-064: Marriott Hotel Site Development at Hall of Fame, Phase 3 <br />iNameof'1'rojeot) <br />located at 121 South Dr. Martin Luther King Jr. Boulevard, South Bend, IN 46601 <br />and owned by City of South Bend <br />_,�...�_. <br />,�.��__�.�.�.�...m..�(Owner) ............. _..���� _.�.... <br />and does hereby Anther state on the behalfof1he aforementioned subcontractor/supplier: <br />(PARTIAL WAWBR) that there is due from the Contractor the sum of <br />fr .... .. _._ ... __...._. Dollars <br />❑ rccolpt of which is hereby acknowledged; or <br />❑ file payment orwhich has been, promised as the sole consideration for this Affidavit and phael' Walver ofLfon.wlalcla fs given <br />solely with respect to said auaoivat, end which waiver sb011 be effective only upon receipt ofpayruent thereofbythe <br />undersigned; <br />( ER) the sum of 33,240 44 <br />(FINAL WAIVER) that the final balance due $am the contractor is <br />❑ receipt of which is hereby acimowledged; or <br />the paynaeut ofwhich has beeaa promised as the sole consideration for this Affidavit and Final Waiver ofUen which shall <br />beconic of f"ective Daly atpotaxecelpt of such payment. <br />TfUMFO", tiie undersigned waives and releases unto the Owner of said promises, any and all liens or claims whatsoever <br />oil the above-descrlbW property said hitlirovenaeiits thereon all account of labor or material or b ?dw <br />shed b the undersigned <br />thereto, subject to limitatlons or couditioras expressed here �� „ mid Rinhrr certified the f rtly has .olaim or rlgitt to a <br />Ilcn oft account of tiny work perfonned or material it i ol"t reigned forsaal pil In ope of this Af"fidaavit <br />said elver ofI len * , el <br />.rv. <br />Walsh &Kelly, Inc. C*�, yc (Aar rlxed Repre <br />sentative) <br />presentative) <br />STAT13 <br />CIIi INDIA°i A <br />i <br />%foreme, thetuiderslgned, a No Pub%, i" y mid State, personally appeared r Dustin Hilary <br />and acknowledged the execution oftlie foreg<ting Afti lr r of Lion. . <br />IN WITNESS 'II -REOF I havo hereunto ,subscrlbod my name and affixedmy oflic " seal on the 21 St day of <br />December' di_ ._. <br />Not nry Public Signature <br />My Conmaksion-Expires; June 07, 2023 <br />a C.A_. _ ....- .. Amy Elizabeth Turpin <br />Resldtngin Indiana �. aunty, Marshall � ova s�. �� _ <br />AMY ELIZABETH TURPIN <br />Nglijq Public tltate of Indiana ta�r�ia�U �tli�t}" <br />ernniisaren Expires <br />June 7, 2023 <br />