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FINAL WAIVER OF LIEN <br />being duly sworn that he/she is the t5 u> ri C-V, <br />(Name of Officer) (Title) <br />of Pe5, _%C,piQ�Aptr.esdeC� having contracted with 0 SUA <br />(Subcontractor/Suppllier) (Contractor) <br />to furnish certain materials and/or labor as follows: e dQ a <br />(ides ription) <br />for a project known as i!>m .r <br />located at <br />and owned by <br />(Nameof Prdect) <br />(Owner) <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplier: <br />FINAL WAIVER that the final balance due from the contractor is the sum of <br />/ �Sy ($ <br />�• et r^cam Bert S C� f+[ �.� t Ldrt.L ivcr •— �„��,� .ajC� } <br />(Amount Written Out) <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 <br />shall become effective only upon receipt of such payment. <br />THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims <br />whatsoever on the above -described property and improvements thereon an account of labor or material or both, furnished <br />b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other <br />party has any claim or right to a lien on account of any work performed or material famished to the undersigned for said <br />project, and within the scope of this Affidavit and Waiver of Lien. <br />"5�n)j r_ <br />Date <br />�r <br />By <br />ized Representat' e} <br />STATE OF t� } <br />) SS: <br />5( �����COVNTY ) <br />Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared 41 aI o Ka? <br />and acknowledged the execution of the foregoing Waiver of Lien. <br />IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my offi al seal onthe �� day of <br />M rc In"_ 2 y . " Y_. .. _ h\ ) �. . A' A <br />My Commission Expires: NotaJy Public Signature <br />LL � _ <br />Residing in J' - . for "'Ph �� 414 I <br />LAURA D. HENSLEY Notary Public Name <br />Notary Public - Seal <br />St Joseph County - State of Indiana <br />Commission Number NP0732150 <br />My Commission Expires Mar 3, 2029 <br />