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State oflndiana, County of <br />Final Waiver of Lien <br />St. Joseph <br />SS: <br />Jerry Halbmaier being duly sworn that he/she is the Presdient <br />(Name of Officer) (Title) <br />having contracted with <br />Of <br />Construction Ahead, Inc City of South Bend <br />_ <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: Exterior Nichiha Cladding Install <br />(Description) <br />for a project known as 320 @ the Cascade <br />(Name of Project) <br />located at 320 E Colfax Ave, South Bend IN, 46617 <br />and owned by City of South Bend <br />(Ow r) <br />and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the aura of <br />Dollars <br />❑ receipt of which is hereby acknowledged; or <br />❑ the paymont of which has been promised as the sole considoratioa for this Affidavit and Final Waiver of Lien which is given <br />solely with respect to said amount, and winch waiver shall be of ctive only upon receipt of payment thereof by the <br />undersigned; <br />(F ) that the final balance due fyom the contractor is the sum of <br />Fourteerthousand, five -hundred eighteen dollars and 191100 ($14,518.19 ) <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 shell <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 titereorn an account of labor or material or both, f3artnished b the undersigned <br />thoroto, subject to litnitations or conditions expressed herein, if any; mid further certi cd th no other party has any claim or right to a <br />land' Waiver of ofatany wont performed or material fltrrnished to the undersigned for sold o ct, and within the scope of this Affidavlt <br />Construction Ahead, Exteriors, Inc 13Y <br />(F�) uthorired Representative) <br />STATE OF iNDIANA ) <br />) SS: <br />ST. JOSEPH COUNTY ) <br />Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared <br />and acknowledged the execution ofthe foregoing Affidavit and Waiver of Lien. <br />iN WITNESS WHEREOF, f have hereunto subscribed my name and affixed my official seal on the day of <br />200 <br />Notary Public Signature <br />My Commission Expires: 6/7/2022 <br />IL LaSalleResiding in County, Notary Pubho Name <br />