Project Completion Affidavit - Century Center Convention Hall A-B New Entry Project No 115-017A - Brown & Brown

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Final Waiver of Lien Stoic of Indiana, County of Elkhart Co. SS: Eric Brown President being duly sworn that he/she is the (Name, of Officer) . ..... of Brown & Brown General Contractors, Ing, (Title) I'Lavin contracted with Cit oL..§qujt end, IN (Contractor) y (Owner) to f=ish certain materials and/or labor as follows; Addj11q_neA ntrytoconventionhall (t)",cr(pdon) for a projca itnowu as Century Center Convention Hall A-B New Entry (Name of Project) located at South Bend, IN and owned by City of South Bend, IN and does hereby hirtbor state on fire, behalfaf the aforementioned subcontractor/suppliar„ (PARTIAL WAIV1311) that there is doe from the Contractor the sum of --'8'6v--e —nTh o —us dii`d'fiVe-1Tu—n d —re d—s I Me f'rff rfd-O W1,010-- Dollars 7 5160 C1 receipt of which is hereby nolmowledged; or the PaYntent of which has been proinised as the sole consideration for this Affidavit mid Final Waiver of Lien, which 13 given solol)t with, respect to said amount, and which, waiver sball be, effective, only upon, receipt of Payment thereof by the undersigned; (FINAL WAIVER) that the final balance dtw Itom the contractor is the sum of Four thousaj��ndred sixteen and oo/1 00 B.00 13 receipt ofwhich is hereby acknowledged; or N the, payment of which has been promised as tile sole consideration foribils Affidavit and Final Waiver of Lien which shall become offiective only upon receipt of such payinent THMIFORE, the undersigned waives said releases luilo the Owner ofsaid promises, any and all liens or claims whilboaver on the above -described property, and imPrOvdMeAts thereon On account Of labor ormaterial or both, ftunishod b tbo undersigned thorolo, subject to limitations or conditions exprossed herein, if any; and flulber eartified, that no other party has any claim, or right to u lien on account of any work performed or material furnished to Cite undersigned for said pr 'cot, and the soo a of This A111davIl and Waiver of Llen� P Brown & Brown General Contractors, Inc. ............ By STATE OFINDIANA (Authorkzed Representative) SS: ST. JOSEPH COUNI'V Before me, the unrlarsigned, a Notary Public, in and for said County and Slate, personally appeared ,- Eric Brown mid acknowledged tire execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my narno and affibed nay offtilil, seal on the 9th day of 200 .3019 '�Z4No t;w—�y V bpi o—A R n a t t it �o My Commission Expires: 2/12/2027 Residing in Marshall county, Indiana Bradle �� A. Rom ine Notary Public Nettie BRADLEY ALLEN ROMINE NOTARY PUBLIC SEAL MARSHALL COUNTY, STATE OF INDIANA MY COMMISSION EXPIRES FEBRUARY 12,2027 COMMISSION NUMBER NP0718569