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State of Indiana, County of <br />Kevin J. Kenney <br />(Name of Officer) <br />Of K&R Tree Service LLC <br />(Contractor) <br />Final Waiver of Lien <br />St. Joseph <br />to furnish certain materials and/or labor as follows; <br />being duly sworn that he/she is the <br />having contracted with <br />SS: <br />Owner <br />(Title) <br />of South Bend <br />(Owner) <br />2023 Tree & Stump Removal for Curb/Sidewalk <br />- - (Descriptlon) <br />foraprojectImawnas 2023 Tree & Stump Removal 123-002 <br />(Name of Project) <br />located at <br />and owned by <br />City of South Bend <br />(Owner) - --- <br />and does hereby hxthher state on the behalf of the aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />Dollars 0 ) <br />El receipt of which is hereby a0mowledged; or <br />❑ die payinent 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 effsotive only upon receipt of payment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due from the contractor is the sum of <br />Fifteen Thousand Five Hundred Eighty -Eight and 37/100ths Dollars $15 5gg- _ _3T ) <br />(� receipt of which is hereby acknowledged; or <br />® the payment of which has been promised as the sale consideration for this Affidavit and Final Waiver of Lien which shall <br />become affective only rpon receipt of such payment. <br />TH1MFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsncver <br />on the above described property and improvements thereon as account of labor or material or both, Mmished b the ttndersigned <br />thereto, subject to limitations or conditions expressed herein, if any; raid further cartiiied that no other party has any claim or right to a <br />Jlen on 1100ou111 of any work Performed or material ft nished to the undersigned for said project, and within the scope of this AffidavJt <br />and Waiver ofi.len. <br />K&R Tree Service LLC '� Commission on #C <br />(Finn) aft JY OMMission <br />STATE OF INDIANA e'" January 8,2 <br />ST. JOSEPH COUNTY ) <br />Before Me, the undersigned, a Notary Public, In and for said County and State, personally appeared u iY1 S �� �� <br />and. acknowledged the execution of tho foregoing Affidavit and Waiver of Lien. <br />IN WITNESS WMREOF, Ihave horcrssito subscribed my name and affixed my official seal on the 3rd day of <br />October 2023 <br />o Publio S a d" <br />My Commission Expires; Lxm <br />'Z� <br />kJL, <br />Residing in county, <br />i G�Y1�t . <br />Notary.lf�Name <br />��� �,G�h ie►.� <br />.�^� <br />