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Final Waiver of Lien <br />JANEE M TOWNER <br />NOTARY PUBLIC <br />SEAL <br />ELKHART COUNTY, STATE OF INDIANA <br />MY COMMISSION EXPIRES FEBRUARY 12, 2026 <br />COMMISSION NO, 710399 <br />State oflndiana, County of SS: <br />M Qu y g,a,, being duly sworn iha he he is the V t LQ — Pyew eni <br />(Neale ofOffiear) (Title) <br />of &tlYNa_M lonQJ riiu5 Ines having contracted with D� Sotd'II germ <br />(Contractor) (Owner) <br />to flunish certain materialsand/or labor as follows; <br />£or a project known as <br />and S,, <br />ieeatedat various to ofrons <br />and owned by A-hl d (Di h !Rend <br />and does hereby further state on the behalf ofthe atom•ementiouedsubcontractor/supp4er: <br />(PARTIAL WAIVER) that there is due iiom the Contractor the sum of <br />Dollars ($ ) <br />❑ receipt of which Is hereby actntowlodged; 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 final balance due Earn the contractor is the sum oP <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 shall <br />became offeOuVe only upon receipt of such payment. <br />THEREFORE, <br />the undersigned waives and releases unto the Owner ofsaid premises, any and all liens or claims whatsoever <br />on fire above-dasoibedproperty and improvements thereon an account of tabor ormaterial or boW, furnished b the rmdexsigued <br />thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other party has any claim or right to a <br />lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this Affidavit <br />and Waiver of Lien, <br />bemlum e ry tk.Soryiu ; (nc ay <br />(Firm) (Authorized Representative) <br />STATE OF INDIANA ) <br />�fkrlflrr ) Ss: <br />-8=0911R I COUNTY ) Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared t rr 1 %� l� r <br />k K(= <br />and nolaiowledged the execution of the foregoing Affidavit and Waiver of Lien. ��-� <br />IN WITNESS WHEREOF, I Lave hereunto subscribed my name and affixed my official seal on the l _ day of <br />:] i_i ISE 2ae dL3 G t �o✓ � J ly <br />Notary public signature <br />My Commission Expires: O4 (3� I ��i L(4 <br />JAQ CC TC� IJ CPS <br />Residingin tt6 IAK�T County, TNDI AQk Notary Public Name <br />