Change Order No 4 & PCA - Miami Street Basin Drainage Improvements Project No 116-082C - HRP Construction

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T inaf Waiver of .Dien STATE OF INDIANA, as: Whereas, the undersigned HRP CONSTRUCTION INC. M has been heretofore em- ployed by City of South Bend Board of Public Works _m_ITITIT ......_mmmmmmmmmmmmm to furnish certain material and labor, to -wit: Miami Street Basin Drainage Improvements, Project No. 116-082C, St. Joseph County, Indiana for the property owned by Citv of South Bend and located on Miami Street City of South Bend , County of seph ,State of Indiana. Now THEREFOR, KNow YE, That the undersigned, for and in corn sick ration of ` _........ 27 103.00 Dollars, the receipt of which is hereby acknowledged, hereby and now waives and releases unto the said owner of said premises, any and all lien, right of lien or claim of whatsoever kind of character on the above described building and real estate, TOAN DFOR SAIDAMOUNT, on account of any and all labor material, or both, furnished for or incorporated into said building by the undersigned, up to this date, and they further certify that the consideration moving to the undersigned for executing this FINAL WAIVE OF LIEN has been mutually given and accepted as a part payment to or on account of the said Owner for said building and real estate. Signed, sealed and delivered this 1st day of oc'tobb cr Signed.w NgRcX Kna ik 20 19 Personally appeared before me this 1st day October , 20 19 Nancy Knapik ____ ___ ..... who, being duly sworn on oath, says: That he is Controller mm� _w of the HRP CONSTRUCTION INC, and that he hereby acknowledges the execution of the foregoing instrument for and on behalf of said Corporation and at their IT_.... .. r special instance and request. My Commission Expires P.3J 06 f 24 This instrument prepared by: Nancy Knapik Cynthia L. Vanheste CYNTHIA L VANHESTE ;, ., p Y Notary Public, State of Indiana "tyyhSv`,v`� My Commission Expires ,,ti. . March 06, 2024 Notary Public