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Final Waiver of Lien <br />Slate ofludiana,Cow* of St. Joseph SSr <br />�i el L RX being duly aworn that he/she is the (20 emej Sean <br />(Name of Officer) (Title) <br />Of , le5boea "sNse has meted With City of South Bend <br />(Contractor) -- (Owner) <br />to banish certain,naterlats aftr labw as foil m: Bridge Repairs <br />{Deacrlptloarj _� <br />for a project known as East Bank Trail Over Leeper Ave. Bridge Repairs <br />(Names ofPrgeot) <br />Iocabodat E. NORTH SHORE DR &.LEEPER_AVE <br />. . <br />and owned by _ _ Cif of South Bend <br />_. (Owner) - - - <br />and does hereby l' u*cr state on the behalf of the aforemmntioned subcontractor/supplier. <br />(PARTIAL WAIMI) that thero is due from the Coruractor the sum of <br />- Dollars <br />❑ recolpt of which is hereby eok wwl u%A or <br />❑ the payment ofwhich bas been promised as the sole consideration for this Affidavit and Frost Waiver ofLk which is given <br />solely with raspeot to acid amount, and which weiver shall be effective only upon receipt of payme nt thereof by the <br />undersigned; <br />00 <br />(FINAL WAIM) that the final balance due from the contractor Is the man of <br />One Hundred Ei ht - Five Thousand five hundred <br />an:-i eighty four --... -. -- <br />❑ taceipt of which is hmeby acknowledged; or <br />® thopayment of which has been promised w the sole consideration fbr thls Afdevit and Final Waiver of Lien which shall <br />became effective only uponraeeipt of such pit. <br />TEMMORB, the undersigned waives and releases unto the Owner efseid premises, any and all lions or claims whatsoever <br />on the above -described property and improveraenta theaeou an account of labor or material or botb, famished b the undersigned <br />thereto, subject to limitations or canditiona exptrsstd herein, if any; and fluther certtlW that no other patsy has any claim or right to a <br />Lien on eoeowd of any wo* performed or material fiunished to the undersigned for said project; and within the scope of ibis Affidavit <br />and Waiver of Lien <br />Milestone Contractors North, Inc. By <br />Mim} (Authorized entative) <br />STATE OF INDiANA ) <br />SS: <br />ST.IOSEPHCOUNTY ) <br />Before me, the undersigned, a Notary Public, In and for said County and State, penonaliy. appeared Danielle L Payne <br />and arlmowledged the execution ofthe foregoing Affidavit and Waiver of Lion. 10th <br />IN WITNESS WMMEOF, shave hereunto subscribed my name andaffixed my offleiaf seal on the day of <br />November zoz 2 <br />Public Signature <br />My CommMon Expum; January 20, 2023 <br />Raddingin LaPorte county, Indiana <br />John Conway <br />Notary Public Nerne <br />;=o`.,PBni <br />John anway <br />Notary Public, State of Indiana <br />__ <br />SEAL <br />LaPorte County <br />Commission Number NP0882W <br />:HoinNP, <br />My Commission Tres <br />Janus 20 �0 3 <br />