Change Order No 1 Final & PCA - Mishawaka Ave Tree Replacement Proj No 118-111 - Acorn Landscaping

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) Final ( ) Partial P Payment to Follow State of Indiana, County of St. Joseph --Jeff Ritschar ,being _CIUI sworn state fiat he -is the Owner of Acorn Landscaping LLC having contracted with C to certain labor, materials, or both, furnished for or incorporated into said building by the undersigned, up to this date, Located at � //v'-)/ / Owned by And does hereby further state on behalf of the aforementioned Contractor (Partial Waiver) that there is due from the Owner the sum of receipt of which is hereby acknowledged; or the payment of which has been promised as the sole consideration of this Affidavit and the Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (Final Waiver) that there is due from the Owner the sum of $ ( ) receipt of which is hereby acknowledged; or I the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall become effective upon receipt of such payment. Therefore, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above described property and improvements thereon on account of Labor or Material, or both, furnished by the undersigned thereto, subject to the limitations or conditions expressed herein, if any; and further certified that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope for this affidavit and waiver. "1141900(„. � » �� Company: Nooz'v MDA d ��, ),Cii-ROy La:^ Ydyd di 6Eh� ytVY,l+3'IT, c Kee YI$S'o n # 629 d s By: May sWdd'tl71 MVVbk"^K ,ryr9V,i Ptl M,.W�y yy1C�pu �� 3 Y � G ., '1 9 WITNESS MY HAND AND NOTARIAL SEAL, this h/- day of X4 20, Notary My Commission Expires;