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Final Waiver of Lien <br />r <br />State of Indiana, County of tss'IC SS: <br />being duly sworn that he/she is the U W h v— <br />atne (N of Officer (Title) <br />having contracted with <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: - -L <br />Description , <br />fora project known as t y /� .. <br />- <br />(Name of Project) <br />located at _ on <br />and owned by � � . �- , <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the suns of <br />Dollars _ <br />❑ receipt of which is hereby aclatowledged; or <br />❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien -which is given <br />solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due from the contractor is the sum of <br />❑ receipt of which is hereby aclmowledged; or <br />❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shell <br />become effective only uponreceipt of such payment. <br />THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever <br />on the above -described property and improvements thereon an account of labor or material or both, furnished b the undersigned <br />thereto, subject to limitations or conditions expressed herein, if any, and further certified that no other party has any claim or right to a <br />lien on account of any work performed or material furnished to the undersigned for sold project, and' within the scope of this Affidavit <br />and Waiver of Lien. <br />Sero —A <br />By <br />arm ' u rizedRepro ntxa "ve) <br />STATE OF INDIANA ) <br />SS: <br />ST, JOSEPH COUNTY ) <br />Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared e U -,A S�9h <br />end aclpt owledged the execution of tho foregoing Affidavit and Waiver of Lion, 7 <br />IN WITNESS WHEREOF, I have hercnnto subscribed0my name and affixed my oflMal seal on the 7 — day of <br />rtl <br />" <br />Notary 1, to Signature <br />My Commission Expires:; <br />Residing in 5° ,.�„:'47k <br />.County, /� N (i <br />M <br />._ Eugenla R. Francoeur <br />St. Joes h County <br />My Commission Expires <br />April'p , pop <br />