Laserfiche WebLink
Final Waiver of Lien <br />State oflndisins, County of St. Joseph SS: <br />Rick Cavinder being duly sworn that he/she is the President <br />(Name of Officer) (Title) <br />of Clean Air Environme <br />ntal Services Inc. having contracted with City of South Bend <br />(Contractor) (Owner) <br />to famish certain materials and/or labor as follows; Asbestos Abatement <br />(Descrlpdon) <br />for a project known as Asbestos abatement at Fire Stations 3 & 6 <br />(Name of Project) <br />located at 1605 McKinley Av & 4302 Western Av, <br />and owned by City of South Bend <br />(Owner) <br />and does hereby fiuther state on the behalf ofthe aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />Dollars$ ).. <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 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 <br />Seven Thousand Nine Huindred $7,900 , 00 <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 shall <br />become effeotive only upon receipt of such payment. <br />TBEREFORE, the undersigned waives and releases unto the Owner of said premises, an <br />claims whatsoever <br />on the above -described property and Improvements thereon an aerourtt of labor or material or bohed b the ndersigned <br />thereto, subject to limitations or conditions expressed herein, if any; and ftarthercertlfied lbatnoty has any aim o; Ight'to a <br />lien on account of any work perfonned or material furnished to the undersigned for said project,in thoscope f tlai fdidavit <br />and Waiver of Lien. <br />Clean Air Environmental Services, Inc. -� $ Rick Cavinder Preside v <br />Y <br />(Firm) (Authorized 1. vrmtt�� <br />STATE OF INDIANA ) <br />SS: <br />ST. JOSEP14 COUNTY ) � � (' __ � ► � <br />Before me, the undersigned, a Notary Public, in and for said County and Siste, personally appeared _ <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 offic] s 1' on the 21 M day of <br />February 200 20 <br />� W <br />Public Signattire <br />My Commission Expires, <br />Residing in '' � County, A _A� t n� <br />(/t K_ . �° I aS ke <br />wmr,�aar,,,a <br />'�ENA K H1 HER <br />*t'',. <br />tO' <br />Notary Pubhro Staap art India <br />;o . <br />=ZSEAL;-. <br />Elkhart County <br />Commission # 702093 <br />* < <br />My Commission Expires <br />,"10,w"' " <br />Judy 17, 2025 <br />