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Final Waiver of Lien <br />State of Indiana, County of St. Joseph SS: <br />Dustin Hilaryg y Area Vice President <br />heir dui sworn that he/she is the South Bend � M w�. <br />(Name of Officer) (Title) <br />of Walsh & Kelly, Inc having contracted with City of South Bend <br />(Contractor) (Owner) <br />to furnish certain meterials and/or labor as follows, Asph@ P !n, q re"t; , Sewer and Landscape <br />(Descrlption) <br />t Improvements, Project#*11-05,011ttttI <br />for a project ]mown asJoseph � <br />....�._...._.. ttreet I,� <br />(Name &- <br />of , <br />St Joseph Street, South Bend "� " CO O ` er <br />located at CityP of Sou d, IN 46628 � t�� <br />Bend, Indiana t = <br />and owned by _ . ... ..,, <br />t(Owne ) <br />and does hereby further stale on the behalf of the aforementioned subcontractor/supplier: /" `° "+••"'"`w S <br />i <br />(PARTIAL WAIVER) that there is due from the Contractor the sum ofr/ N A txr <br />__ _ .... , <br />Dollars AmM. <br />❑ receipt of which is hereby ackriowledged; 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 (� 57,217.g8 <br />❑ reeelpt of which is hereby acknowledged; or <br />Ill 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 -described property and improvements thereon an account of labor or natter th, fornisl die undersigned <br />thereto, subject to limitations or conditions expressed herein, if any; and fidlier cc M5qJ <br />its other p tas any claim or right to a <br />lien on account of any work performed or material fumishad to the undersi�l° o!Is al ect,and n the scope of Affidavit S <br />and Waiver ofLlen. <br />Walsh & Kelly, Inc <br />(Firm) (Attthoritx1 Il epresentivo) <br />STATE OF INUTANA SS: stir Hilary, <br />ilary, South Rend Area Vice President <br />ST. JOSEPH COUNTY <br />undersigned,Notary County y appearedDustin Hila <br />IN WITNESS WITNE Se WHEREOF I have hereunto subscribedrm i nape and affixed my �AtI seal on the 6th de /of <br />and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />August 200 <br />y9 y y <br />dot iy Public Signature <br />My CommissionExpires: ........ June 7, 20„23 <br />Residing in Marshall......_,..... county, Indiana <br />_.�ro�._.......�..� <br />Amy Elizabeth Tur in <br />,�...........W..... <br />Notary Public Name <br />"6Y EUZAETH *` R'P- ,(N <br />ra ory PO it x 9rp rs asr ds¢i::� <br />.,. � CttI�ITiI,�a.ti@CyMh I.,Jt,���4 <br />tuna 7, 202,� <br />