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Final Waiver of Lien <br />State ofIndiana, County of <br />MRA gq� §WM Mat h@/§k i§ #Ie &rs Wzvi 4- <br />- <br />(Name of"Officer) (Title) <br />Of Z on L�S'1 uv) nc C o� tau h_ &nd <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: Lrl tYtfit s ; clev •rc.\ 1<S CUr b_ 4 b/+ 2c�m� _ i oiq I Iti I i ri <br />- (Description) <br />for a project known as <br />located at <br />and owned by <br />D0-1& <br />(Name ofProject) <br />..CVOgi1 �Arccy sidcsv0.�S - - <br />(fie') <br />and does hereby further state on the behalfofthe aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due firm the Contractor the sum of <br />® receipt ofwhich is hereby acknowledged; or <br />01 the payment ofwhich has been promised as the sole consideration for this Affidavit and Final Waiver ofLienwhich is given <br />solely with respeeato said amount, and which waiver shall be effective only upon receipt offpayment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due#om the contractor. is the sum of <br />+hir3ccv� is Skylr� ��x i��icy l' r S�•l'+'i'i'�SIY+ �� _ t4--]( ttk _. <br />Q] receipt of'which is hereby acknowledged; or <br />�J the payment ofwhich has been promised as the sole consideration for this Affidavit and Final Waiver ofLien which shall <br />become effective only upon receipt ofsuch payment. <br />THEREFORE, the undersigned waives and releases unto the Owner ofsaid premises, any and all liens or claims whatsoever <br />on the above -described property and improvements thereon an account oflWnfi- or material or both, furnished b the undersigned <br />thereto, subject to limitations or conditions expressed herein, if any; and further certified that no other patty 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 ofthis Affidavit <br />and Waiver of9,ieu. <br />(Firm) (Autho ' eprasentative) <br />STATE OF INDIANA ) <br />SS: <br />ST. JOSEPH COUNTY ) �-ILe�G(�h Ylt? Z <br />Bef n me, the undersigned, a Notary Public, In and for said County and Stale, personally appeared _-- — — — — — — — — <br />and acknowledged the execution ofthe foregoing Affidavit and Waiver ofLien. <br />IN Wss WHEREOF, I have hereunto subscribed my n r a and affixed my official 1 on the oa dwof <br />tY �", <br />Notary Public Signature <br />My Conunission Exphw: 2• <br />Residing in Jb t`,\ ` County, `1(L Otiy-L 4 <br />M(A' i <br />S YA a v <br />Notary Public Name <br />r PU. MARIA RUSTMAN <br />r° 'o NOTARY PUBLIC <br />* SE& * COMMISSSON NO. MP0736M <br />eg MY COMMISSION EXPmLS <br />OFSµp�p SEPTEMBEFI a. 2029 <br />