Laserfiche WebLink
Final Waiver of Lien <br />State oflndiana, County of Elkhart SS: <br />Jason Yoder being duly swom that he/she is the President <br />(Name of Officer) (Title) <br />of R. Yoder Construction having contracted with City of South Bend <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor asfollows: New Construction of Fire Station <br />(Description) <br />for a project known as Fire Station #8 Replacement <br />(Name of Project) <br />located at 2402 S. Twyckenham Dr. South Bend, IN 46614 <br />and owned by City of South Bend <br />(Owner) <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />Dollars ($ ) <br />❑ receipt of which is hereby acltowledged; or <br />❑ the payment of which lies been promised as the sole consideration for this Affidavit and Final Waiver of Licnwhich 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 from the contractor is the sum of <br />_($ 204,376.)78 <br />❑ receipt of which is hereby acknowledged; or <br />thepsyment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall <br />become offeetive only upon receipt of such payment, <br />THEREFORE, <br />the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever <br />on die above -described property and improvements thereon an account of labor• or material ar botb, ftunished b the undersigned <br />th(1reto, subject to limitations or conditions expressed herein, if any; and further cartifled that no other party has any claim or right to a <br />lien on account of any work performed or material tltmishod to the undersigned for said ct, and within the scope of this Affidavit <br />and Waiver of Lien. <br />R. Yoder Construction I'm By <br />(F�) uthorizedRe sentative) <br />STATE OF INDIANA ) <br />SS: <br />ST• JOSEPH COUNTY ) <br />Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared <br />and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the 26th day of <br />December 200 2024 . <br />�V)yYVtG(i1 <br />Notary Public Signature <br />MyCommission Expires: May 23, 2027 <br />Annette VUseman ti <br />Residing in Elkhart Cowt , Indiana aNNErr EMaN <br />tY Notary PublicNama <br />t Notary Public, State of Indiana <br />Elkhart Couray <br />Commission N NP06450 <br />4 O My cM missi 027%pires <br />