PCA - 2023 Contractor Paving Round I Proj No. 123-021 - Rieth-Riley Construction

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Final Waiver of Lien State ofIndiana, County of St. Joseph SS: Ruben Alvarado being duty sworn that he/she is the Sales Manager (Name of Officer) (Title) Of Rieth-Riley Construction Co., INC having contracted with City of South Bend (Contractor) (Owner) to furnish ceitain materials and/or labor as follows; Roadwa Reconstruction description} for a project known as 123-021 2023 Contractor Paving Round 1 (Name of Project) located at Various Streets in the City of South Bend and owned by Citv of South Bend (owner) and doss hereby further state on the behalf of'the aforementioned subcontractor/supplier: (PARTIAL WAMER) that thorn is due from the Contractor the sum of Dollars $ , ❑ receipt of which is hereby acluiowledged; ,or [l the payment of which lies been promised as the sole consideration for this Affidavit and Final Waiver of'Lien-which is given solely with respect to said amount, and which waiver sball be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due from, the contractor is the sum of Fifity seven thousand two hundred fifty two 76/100 ) 57,252,.76_.Yr 0 receipt of which is hereby acknowledged; or 2 thepayment of which has been promised as the sale consideration for this Affidavit and Final Waiver of Lien which shall become effective only upon receipt 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 bath, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other puty has any claim or right to a lien on account of any work perfonned or material furnished to the undersigned for so' project, and within the scope of this Affidavit and Waiver of Lien. Rieth-Riley Construction co., INC By Erna (Authorized Representative) STATE OF IMMNA. ) } SS: ST. JOSEPH COUNTY } Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed nay official seal on the 4 day of f anuary 2024 Notary public Signature Noy Commission Expires; 10/03/30 Residing in Marshall County, Indiana Rachael Czarnecki Notary Publio Name ``\��tttu►rr��y, RACHAEL M CZARNECKI p�'0 ,- oA...� Notary Public, State of Indiana `-;SEAL -f'' Marshall County * •, ; *: ''• ••° `` Commission Number NP0744094 My Commission Expires ��nrrint�� October 03, 2030