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Change Order No 1 & PCA - Olive Street Station Office HVAC Upgrades Proj No. 119-077A - Ideal Consolidated, Inc.
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Change Order No 1 & PCA - Olive Street Station Office HVAC Upgrades Proj No. 119-077A - Ideal Consolidated, Inc.
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4/9/2025 8:28:18 AM
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4/16/2020 2:00:17 PM
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Board of Public Works
Document Type
Projects
Document Date
4/14/2020
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State ofindiana, County of <br />Final Waiver of Lien <br />St.Joseph <br />SS: <br />Mick Rauch being dirty sworn that he/sheis the Vice -President <br />(Name ofofficer) (Title) <br />of Ideal Consolidated, Inc. having contracted with City of South Bend <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: Labor & Material for HVAC Upgrades <br />(Description) <br />for a proj ect known as Olive Street Station Office HVAC Upgrades <br />(Name of Project) <br />located at 915 S Olive St, South Bend,IN <br />and owned by City of South Bend <br />(owner) <br />and does hereby further state on the bobalf of the aforementioned subcontractor/supplier: <br />(PAR.1 AL WAIVER) that there Is due from the Contractor the slam of <br />Dollars i <br />Q receipt of which is hereby acknowledged; or <br />the payment of which has been promised as the sole consideration for this Affidavit acid Final Waiver of Lien which is given <br />solely with respect to said anxount, and which waiver shall be effective only upon receipt ofpaymentthereofby the <br />undersigned; <br />(FINAL WA VEJ+ .tj thatthe final balance due from the contractor is the sum of <br />Two thousand & 00/100 ($2000.00 1 <br />❑ receipt ofwhieh is hereby acknowledged; or <br />thepsyment of which has boon promised as the solo consideration foritds Affidavit and Final Waiver ofLien which shall <br />become offeotive only upon receipt o£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 properly and improvements thereon an account of labor or material or both, furnished b the undersigned <br />thereto, subject to limitations or conditions expressed herein, if any; and farther certified that no other party has any claim or right to a <br />lien on account of any work performed or material farnishedto the undersigned for project, within ope of this Affidavit <br />and Waiver ofLien <br />Ideal Consolidated, Inc: Ey <br />(Firm) ) AuthorizedRepresentative) <br />STATE OF IMIA14A <br />SS. <br />ST, JOSEIPH COUNTY ) <br />Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared Mick Rauch <br />and aclorowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />IN WITNESS WD EREOF, I have hereunto subscribed my name and affixed my official seal an the 31 st dray of <br />March 20 1 20 <br />Notary Public Signature <br />My Commission Expires: 02/12/26 <br />Residing in St. Joseph County, Indiana <br />Carina Cruz <br />Notary public Name <br />"„111Qj,, CARINA CRUZ <br />Pis' <br />t`�1�Y Notary <br />Public, State of Indiana <br />=: roE <br />z <br />St. Joseph County <br />* :SEAL. <br />Commission s 710398 <br />My Commission Expires <br />February 12, 2026 <br />
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