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Project Completion Affidavit - McKinley Ave and Fremont Park Improvements Project No 118-072 - Walsh and Kelly Inc
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Project Completion Affidavit - McKinley Ave and Fremont Park Improvements Project No 118-072 - Walsh and Kelly Inc
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4/8/2025 2:38:39 PM
Creation date
7/24/2019 1:59:22 PM
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Board of Public Works
Document Type
Projects
Document Date
7/23/2019
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Final Waiver of Lien <br />State of Indiana, County of St. Joseph SS: <br />Dustin Hilary being duly sworn that he/she is the South Bend Area Vice President <br />(Name of Officer) (Title) <br />of Walsh & Kelly, Inc. having contracted with City of South Bend, Indiana <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows; _App Pavia_ ,Concrete, Landscape and Pipe Work <br />(Description) <br />for a project known as McKinley Avenue & Fremont Park Improvements (Division B) <br />(Name of Project) <br />located at McKinle Avenue & Fremont Park, South Bend, IN <br />and owned by City of end, Indiana 1411001/' <br />(Owner) ,...�. , <br />and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier: ;� coo 1� �� <br />" yC7� <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of SEA <br />.* .. <br />Dollars IRA. ..»....» <br />Elreceipt of which is hereby aclutowledged; or �rrt 1111111110 <br />❑ the payrnent of which has been promised as the sole consideration, for this Affidavit and Final 'lii,+"aiver of Lien which is given <br />solely with respect to said amount,, and which waiver small be of alvc 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 acknowledged; or <br />® the Payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall <br />become effective only upon receipt 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-deserlbed props ty and improvements thereon an account of labor or material or both, furnished b the undersigned <br />thoreto, subject to limitations or conditions expressed hereln, if any; and fluther certified thgt�rlo other party has any claim or right to a <br />Beta on account of any work performed or material furnished to the undersigued fora id r dct, n s tlmin the scope ofthis AftldaAt <br />and Waiver ofLlen. '° �* <br />Walsh & Kelly, Inc: By ` " <br />rized Repro <br />STATE OF 1NDIANA (Firm) ry, %u oh r tati e <br />1 drl Hila uut Bend ea se President <br />) SS: <br />ST. JOSEPH COUNTY ) <br />Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared Dustin Hilary <br />and aelmowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />IN WITNESS WHEREOF, Ihave hereunto subscribed my name and affixed mZoPu�bllo <br />onthe26th day o200 19. .'Signatut�a <br />My Commission Expires: June 7, 2023 <br />eth Turpin <br />Residing in Marshall county, Indiana Am I�lial� <br />I, Mvi II I <br />hdV,Arar �Egg'pp4 t)ira„ q :aa of Nr�s�lans <br />omnliswri Expifes <br />�W fun-"T, 2023 <br />
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