PCA - South Well Field Backwash Line Relocation Proj No. 117-059C - HRP Construction Inc.

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State of Indiana, County of Nancy Knapik (Name of Officer) of HRP Construction Inc. (Contractor) Final Waiver of Lien St. Joseph being duly sworn that he/she is the SS: Vice President (Title) having contracted with City of South Bend (Owner) to furnish certain materials andlor labor as follows: _ (Description) for a project known as South Well Field Backwash Line Relocation, Project No. 117-059C w (Name of Project) located at Chippewa Avenue and owned by City of South Bend (Owner) and does hereby further state on the behalf ofthe aforementioned subcontractor/supplier: (PARTIAL WAIVER) that there is due from the Contractor the sum of Dollars `($ ❑ receipt of which is hereby acknowledged; or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lienwhich is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL. WAIVER) that the final balance due from the contractor iss of Eleven Thousand Six Hundred Seventy Nine Dollars and MyUents ($11,679.50) ❑ receipt of which is hereby acknowledged; or ® the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shalt become effective only upon reccipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever on the above -described property and improvements thereon an account of labor or material or both, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other party has any claim or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this Affidavit and Waiver of Lien. HRP Construction Inc. By urn �� (Atathorized Representative) STATE OF INDIANA ) ) Nancy Knapik, Vice President SS: ST. JOSEPH COUNTY } Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared Nancy Knapik and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the 9th day of December 2022 Ala No bllc Signature My Commission Expires: Residing in St. Joseph March 6, 2024 County, Indiana NTHIA L. Vi .`qP�;•• P�/B 4� Notary Public, Stat 1r++ ft O= St. Joseph C Pu EA4*ifommission Number 68 213 My March Commission 202pires Vanheste Name