Laserfiche WebLink
Final Waiver of Lien <br />State of Indiana, County of Elkhart 5S: <br />Eric Brown being duly sworn that President <br />Officer) <br />_... . ....,_.._��� <br />(d�arnc ofOfflcer) .._,. <br />(Title) <br />of Brown & Brown General Contractors, Inch having contracted with City of South Bend, Indiana <br />(Contractor) <br />(Owner) ..._� <br />to ihodsh certain materials andlor labor as follows; Install ADA compliant lift <br />(Descriptlon) <br />for a projectlorown as Bendix Theater Lift at Century Center <br />(Name of Project), <br />located at South Bend, IN <br />and owned by City of South Bend, IN <br />(Owner) <br />and does hereby further state on tbo behalfofthc afore►sent.iorred subcontractorlsop liar; <br />(PARTIAL WAIVBR) that there is due from the Contractor the sum of <br />Doltars ( ) <br />❑ recoipt of which is hereby acknowledged; or <br />❑ the Payment of which has been. Promised as the sole consideration for this Affidavit and Final "Walver of Lioa whtelt is given <br />solely with respect to said aneount, and which waiver shall be cffcctive only upon mtelpt ofpuynient thereof by the <br />undersigned; <br />P FINAL w at r tl'te sum of <br />wAl" that tits final ba au (lie h°orrr� It ola rs <br />our thousand one. hundred t trt our .. <br />❑ receipt of which is hereby acknowledged; or <br />® the payment of which leas been promised as trite sole consideration for this Affidavit and Final waiver of Lien which shall <br />become offeodye only upon receipt of such payment. <br />"l"l":llMl ORE, the undersigned waives mid releases unto the OwAar ofsaid premises, any and all lions or claims whal sever <br />on tiro above -described property and Improvements thereon an account of labor or material or both, furnisbcd b the undersigned <br />thorclo, subjectto limitations or conditions expressed hcrelu, if any; and, fhrthor certified that no other Marty has ally claim or right to a <br />lien on account of any work performed or material iGbrnished to the undersipecl for sold project, and within the scope of this Aftidav3t <br />and Waiver of Lien. <br />Brown & Brown General Contractors, Inc. <br />(I7hrn) (.Authorl lad Representotivo) <br />STATE OF INDIANA <br />SS: <br />ST. JOSEPH COUNTY <br />Y <br />xcoution of the foregoing Affidavit County l yappealed _Eric Brown <br />Before rue the undersigned, a rota public, In and for sold Iw.ount ' and State tersoaall <br />trod acknowledged tiao a idavit and Waiver of Lion, <br />IN Au ust name and affixed my offtoial seal on the 7th day of <br />_ 010 . <br />WITNESSll:Rl?t�l�, l have lrerermto subscribed my <br />20t1 <br />Notary Pablio Signature <br />My CommissionExpfros; 4/3/2025 <br />Residing in Marshall County, Indiana Todd A. Marek <br />_..---._.._ Notary Public Name <br />Todd A Marek <br />Notary Public <br />SEAL <br />Marshall County, State of Indiana <br />My Commission Expires April 3, 2025 <br />Commission Number: 698752 <br />