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SEITY s acorn <br />Notary Puellc - Sial <br />Btati of lntllini <br />Final Waiver of Lien at Josepa county <br />My Commisslpn Eaplrea Jul 22. 2oT3 <br />srata oFlndiana, cowry oY St. Joseph ss; <br />Mika Bannert baure aaly awern uacbNaM is dte Project Manager <br />p�Tama of0ffiee) (Tide) <br />pP Koontz Wagner Services having eonmao<ea wleh Cit of SoutM1 Bend <br />tcnrtra�tor) (ow er) <br />m fivralah wrmin ma(aaiala mar mbormfolmws: Misc_ electrical materials and EV charger <br />I(pmvlptloW <br />der a p[gjac[ kvuttm m <br />lecn[na at <br />and owvad by <br />EV Chargers <br />- (Noma ofPmJaotj <br />Various. locations <br />City of South Bend <br />(owmp <br />aad dom hemby 1btlLor smta on the bahalfoPtbn aPatom®tbmtl avboonRsatorJsuppliar: <br />[PARTIAL WAIVBii] dut[�ea� is duo from the Contractor the eum of <br />Dvllaas _($ <br />� rewlpt oY which la hereby aclvvowladgad: or <br />0 the lraY +wit oP hhda bee boon promised as the solo wnehtam[ba F <hia Affidavit and P1paI Waiver ofLfwwhloh>a given <br />eclat]/ wide reapeot to add araowt, aad width waiver obeli ba oIffiUiva wiy upon aocaipe oPpnyaavat theraofby the <br />ta•deralenadt <br />(FINAL WAIVER) [bat [ha Enal beleaoa dna Hom doe cor[trec[or is ties anm oP <br />($ 3222.62 ) <br />O reeetpt ofwhicb Ia l.mct y aalmowiaatsaa; or <br />® bee nee ua nR6olYva one hm been promi:ad vs the sole covsidaratiw ibr Uae Afildavi[ and I�Yuai Watvar oflAmt wbtch shad <br />ty vpvamcdpi ofauoh paymmat. <br />THEiIiBPORH, the wderaf®aad wdvae attd relamm unto dao Omer oPcaitl promiam� avy end all I(aa9 or niaima whataoaver <br />oa doe above -described paoparty avd impmvamavta daaraov av aaeotmt of Iabor or matarid or body fiviaiahvd b doe tmderai�ad <br />d:aretq aubJau to lhnita[(ova or aoaditions prmaad barely, iFavy: and Saadam mtTlfictl ShaC no od:er party hm any nidm of dghtm a <br />ltan on acwuat oPany work parlbrmed or material damia}tad to the undarafgned for saldp jeo[, and wldala the swipe ofdda AFTidavl[ <br />end Wdvar oFZlen_ <br />Koontz Wagner Services gl, MiKB BannBrt �� �"�='n'�'y"'�"' ^--� <br />sxAxa oP lNntnN.aF�) ) (Aathmlaea F.epreasvtadya) <br />) ss: <br />ST. JOSHPH COUNTY <br />Haiare ma- tlaa wdaralgned� a Notary Public, in wd !br mid County and Steta, paraonaljy appeared M - �� '�' <br />end aolmawladgad dta axawdw oPdaa foragoln6 AFYldavli and Waiver oYLien. <br />1N WiTN883 WHSItBOF� Ilaaw hareuvto aubaerlbvd tqy a atW affixed my ofY'aold aml w the ,�� dqy of <br />—�tebrvewa_� zoz 3 ` h Q <br />�` , ����_ <br />i � - � �_ _ a <br />__ _ _us a as_� <br />