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WAIVER OF LIEN <br />Final X <br />State of Indiana SS: Partial <br />County of LaPorte SS: Payment to Follow X <br />Whereas, the undersigned,LARSON-DANIELSON CONSTRUCTION CO., INC.,having been employed by <br />SOUTH BEND, CITY OF to furnish certain Material and Labor, to wit: <br />Morris Performing Arts Center - Main Level Slab Replacement Per Plans, Specs and Contract for the building owned by: <br />SOUTH BEND, CITY OF and located at: <br />211 N MICHIGAN ST C/O LARSON-DANIELSON CONST SOUTH BEND, IN 46601 <br />and does hereby further state on behalf of the aforementioned Contractor, <br />PARTIAL WAIVER that there is due the sum of <br />receipt of which is hereby acknowledged: or <br />the payment of which has been promised as the sole <br />consideration of this Partial Waiver of Lien which is given solely <br />with respect to said amount, and which waiver shall be effective <br />only upon receipt of such payment. <br />that the final balance due is the sum of <br />FINAL WAIVER I <br />forty-eight thousand seven hundred seventy-six and 78 / 100 <br />receipt of which is hereby acknowledged: or <br />4g'776.7g <br />the payment of which has been promised as the sole <br />X consideration of this Final Waiver of Lien which shall become <br />effective only upon the receipt of such payment. <br />THEREFORE, the undersigned waives and releases existing liens, rights and claims to the extent of payment <br />only for labor, material, equipment or any combination thereof, furnished to the OWNER of said premises for <br />improvements thereon. <br />Company: LARSON-DANIELSON CONST. CO. INC <br />By: <br />Patti L. O'Brien, C.F.O. <br />WITNESS MY HAND AND NOTARIAL SEAL, THIS 24 DAY OF January 2023 <br />My Commission Expires: 08/01/2030 Notary: <br />Residing in: LaPorte County Printed Name: Jennifer A. Medley <br />Notary No. NP0654434 <br />Customer: CITYS1300 <br />Job: 56-606 <br />Invoice: 56606-00008 R <br />