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Final Waiver of Lien <br />State oflndiana, County of Lop r+e- SS: <br />Q Cott �e h being duly sworn that he/swis the vib e l f <br />(Name of Officer) T�- (Title) <br />-- <br />le) <br />&4,-b-*3 <br />���of Gf e eyt a ~ r4- �hSav�tng contracted with C;+..,�o u-{-r t Q <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: e w+o 1 i + `ors <br />(Description) <br />for a project Imown as OA I D-'W10 <br />located at Y et r 1'o u 3 to c ct'"r `':P n 5 <br />and owned by <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplier.- <br />(PARTIAL WAMM) that there is due from the Contractor the sum of <br />Dollars ($ 0) <br />❑ receipt of which Is hereby acknowledged; or <br />❑ 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 payment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the fpW balance ue &LT- <br />hZ-U"q(r22J <br />contractor *9 sum of o0 <br />r f�i = fwts ou3Q a fi-eI eVEH �a $ oa <br />� Tl <br />❑ receipt of which is hereby ackmowledged; or <br />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 upon receipt of such payment. <br />THSFORE, 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 improvements thereon an account of labor or material or both, Banished b the undersigned <br />thereto, subject to limitations or conditions expressed herein, if any; and farther certified that no other patty has any claim or right to a } <br />Ron on account of any work performed or material Burnished to the undersigned for said project, and within the scope of this Affidavit <br />and Waiver ofLien. # <br />t <br />e rrwio - fi'� h rQ af5C . By .r-- <br />� } (Authmized Representative) <br />STATE OF D M ANA ) <br />} SS: i <br />ST. JOSEPH COUNTY <br />Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared -JS ovl B e n h t: <br />and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />IN SS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the 21 day of <br />vot e- <br />JANET M 00 ER <br />Notary Public - Seal NO ubIie S tare <br />Porter County - State of Indiana <br />My Commission Expires: Commission Number NP0746920 i <br />p r Feb 16 2031 '-�14 Ef Oki h)Cl <br />Residing in County, Notary Public Name <br />