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Final Waiver of Lien <br />State of Lidiana, County of <br />(NameofOfiScer) <br />(Contractor) <br />to ilimish certain materials and/or labor as follows; <br />for a project known as <br />located at <br />and owned by <br />being duly sworn that he/she is the <br />having contracted with <br />(Title) <br />nWk , U^C <br />(Owner) <br />O^escription) <br />/Wf Two <br />(Name of Project) <br />(Owner) <br />and does hereby further state on the behalf of the aforementioned subcontractor/suppli^: <br />(PARTIAL WAIVER) that there is due from the Contractor the sura of <br />□ receipt of which is hereby acknowledged; or <br />Dolters <br />113 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 paymrait diereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due from the contractor is the sum of <br />IB^ recei\ S r r e c e i p t o f w h i c h i s h e r e b y a c k n o w l e d g e d ; o r ^ <br />Q the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall <br />become effective only uponreceipt 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 improvmnents thereon an account of labor or material or bodi, fiirairiied b the tmdersigned <br />thereto, subject to limitations or conditi(His e^qnessed h^eln, if any; and farfiier certi^d that no other party has any claim or ri^t to alien on account of any wodc performed or material furnished to die undersigned fi>r^^ project and within die scope of diis Affidavit <br />a n d W a i v e r o f L i e m / / ^ <br />S T A T E O F I N D I A N A ) <br />) SS* <br />ST. JOSEPH COUNTY ) <br />Before me, the undersigned, a Notaiy Public, in and for said County and State, personally appeared 3*4-^ <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 offidai seal on ^ <br />AJbWUtkLf/^ 20^1 /f\ t <br />My Commission Expires; <br />c Gregory John Whrttler <br />d Notarv Public Seal State of Indiaoa— 7 — ^ ^ L a P ^ C o u m y —_ Ci- Cornrnission Nurnber NP07241^ <br />CopntVAAv Commission Expires 12/17/2027 <br />Ic Signature <br />'oblic Name