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AIA Document G706°A -1994 <br />Contractor's Affidavit of Release of Liens <br />PROJECT: (Name and address) <br />Fire Station No. 8 - S. Bend <br />2402 S. Twyckenham Dr. <br />South Bend IN 46614 <br />TO OWNER: (Name and address) <br />City of South Bend Board of Public <br />Works <br />227 W. Jefferson Blvd. <br />South Bend, IN 46601 <br />STATE OF: Indiana <br />COUNTY OF: Elkhart <br />ARCHITECT'S PROJECT NUMBER: <br />2172201870 <br />CONTRACT FOR: General <br />Construction <br />CONTRACT DATED: <br />OWNER: <br /><J <br />ARCHITECT: <br />❑ <br />CONTRACTOR: <br />❑ <br />SURETY: <br />❑ <br />OTHER: <br />❑ <br />The undersigned hereby certifies that to the best of the undersigned's knowledge, information and belief, except as listed <br />below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers of materials <br />and equipment, and all performers of Work, labor or services who have or may have liens or encumbrances or the right to <br />assert liens or encumbrances against any property of the Owner arising in any manner out of the performance of the Contract <br />referenced above. <br />EXCEPTIONS: <br />SUPPORTING DOCUMENTS ATTACHED HERETO: <br />1. Contractor's Release or Waiver Of Liens, <br />conditional upon receipt of final payment. <br />CONTRACTOR: (Name and address) <br />R. Yoder Construcrion Inc. <br />27453 CR 150 <br />Nappanee, IN 465 <br />2. Separate Releases or Waivers of Liens from BY: <br />Subcontractors and material and equipment (SignatuolKfauthorized <br />suppliers, to the extent required by the Owner, representative) <br />accompanied by a list thereof. Jason Yoder, President <br />(Printed name and title) <br />Subscribed and sworn to before me on this date: <br />den 2G, <br />Notary Public: a'LyU&1 j�1VJ(iYi/apt <br />My Commission ExpjML. May 23, 2027 <br />AIA Document G706A —1994. Copyright ®1962 and 1994. All rights reserved. "The American Institute of Architects," "American Institute of Architects;' °AIA; the <br />AIA Logo, and °AIA Contract Documents" are hademarks of The American Institute of Architects. This document was produced at 09:53:41 ET on 12/26I2024 <br />under Order No.2114509091 which expires on 02/14/2025, Is not for resale, is licensed forone-time use only, and may only be used In accordance with the AIA <br />Contract Documents®Terms of Service. To report copyright violations, a -mail doclnfoQalacontracts.com. <br />User Notes: (MMDAK) <br />