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PCA - Morris Performing Arts Center Joint Resealing – Proj No. 119-050 - Ziolkowski Construction, Inc.
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PCA - Morris Performing Arts Center Joint Resealing – Proj No. 119-050 - Ziolkowski Construction, Inc.
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4/10/2025 9:19:38 AM
Creation date
1/15/2020 10:04:44 AM
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Board of Public Works
Document Type
Projects
Document Date
1/14/2020
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Final Waiver of Lien <br />State of Indiana, Countyof St _ <br />SS: <br />......- <br />Rill Fnvnrc being duly sworn that he/she is the I;t° <br />(Name of Officer) (Title) <br />of f lkowski Construction Inc having contracted with aahGi e� <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: _Liirot l"ese all ra <br />(Description) <br />for a project known as Morris l'erforaniiro2r Arts <br />(Name of Project) <br />located at 221 North Michigan Street, South Bend, IN 46601 <br />and owned by MorrisPerforming Arts <br />(Owner) <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />I"lro�rteeiro. "' "lrocauss�rrocl °l"IroirL Nine, Dollars nd 70/100 Dollars C1.—,049.70 <br />® receipt of which is hereby acknowledged; or <br />❑ the payment of which Ims been promised as the sole consideration for this Affidavit mid Final Waiver of Lien which is given <br />solely with respect to said amount, and which waiver shall be effective only upon recelpt of payment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due from the contractor is the sum of <br />❑ receipt of which is hereby acknowledged-, or <br />[R the payment of which has been promised as the solo 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 mid releases unto tho Ownor of said promises, any and all liens or claims whatsoever <br />on the above -described property and improvements thereon im account of labor or material or both, llarnished b the undersigned <br />thereto, subject to lbuitations or conditions expressed herein, if any, .and further ccorrtlfled that no other party has any claim or rightto a <br />Don on account of any work performed or material ftrornished to the undersigned for sold project; and within the scope of this Affidavit <br />and. Waiver ofLien. <br />is rats <br />BY .., <br />(Fim) (Authorized Representative) <br />STATE OF INDIANA ) Bill Favors/President & CFO <br />SS: <br />ST. JOSEPH COUNTY } <br />Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared _ ill 1 Favors <br />and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the 18th Gay of <br />W 11120r.2D19 Mox .. <br />Notary Public SOOtur, <br />My Commission Expires: March 6 2025 <br />Residing in ._ <br />Itan D. Vinla <br />Fl��art Couniy, Iniana Notary Public Name <br />LYNN DVINING <br />Seal <br />Notary Public — State of Indiana <br />Elkhart County <br />My Commission Expires Mar 6, 2025 <br />
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