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FINAL WAIVER OF LIEN <br />being duly sworn that he/she is the _ �_-.---- <br />(Name of Officer) (Title) <br />of 5t) ,k iCP Q_5erV1tr5having contracted with <br />(Subcontractor/Supplier) (Contractor) <br />to furnish certain materials and/or labor as follows 5 u rr (�fP (il rGkt°5 <br />t :Crlptjon) <br />for a project known as V[ `1— <br />(Name of <br />located at <br />and owned by <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 />(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 furnished to the undersigned for said <br />project, and within the scope of this Affidavit and Waiver of Lien. <br />�%u1T 1\eS��G�;on �y�Gp-S <br />(Firm) <br />Date _.Z ! 4-_7- <br />By <br />STATE OF iQ ) <br />) SS: <br />Be Core me, the undersigned, a Notary Public, in and for said County and State, personally appeared Scan--l.wGK,(-)S <br />and acknowledged the execution of the foregoing Waiver of Lien. <br />1 WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on theday of <br />20 <br />My Commission Expires: �� aoa 2 Notary Pubh Signature <br />Residing in F County <br />Notary Pub 'c Name <br />�P,.•.,,g�'; Notary Public, State of Indiana <br />o' <br />Elkhart County <br />z SEAC; * ,Commission Number NP0713941 <br />My Commission Expires <br />May 30, 2121 <br />