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PCA - Riverside Shoulder Repair Proj No 124-059 - Acorn Landscaping LLC
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PCA - Riverside Shoulder Repair Proj No 124-059 - Acorn Landscaping LLC
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Last modified
3/31/2025 8:02:28 AM
Creation date
1/14/2025 12:32:18 PM
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Board of Public Works
Document Type
Projects
Document Date
1/14/2025
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FINAL WAIVER OF LIEN <br />Jeff R.itschard being duly sworn that he/she is the OWin,er <br />(Name of Officer) (Title) <br />of Acow, La vxdscapEv,,g, LLC. having contracted with Cit Of SOuth gevLd <br />(Subcontractor/Supplier) (Contractor) <br />Remove old asphalt, replace W/ topsoU aVA seed, pour small <br />to furnish certain materials and/or labor as follows: s0ew6t0Z <br />(Description) <br />for a project known as 124-0,59 RLVersl,de SholAder 12epai r <br />(Name of Project) <br />located at ALme tzivers�de Dr. sho-older getweewJoHr'e Dr. aln,d Lathrop PL. <br />and owned by G.tl�j, Of Sou h geln,d <br />(Owner) <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplies <br />FINAL WAIVER that the final balance due from the contractor is the sum of <br />Sevewteew T-hotxsawd l=lve Huvtidred avzd sixt -N%Ine DoUcirs O°/loo <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 />ja0/ay <br />k0r-vA ✓r Z_L C By <br />(Firm) Authorized Representative) <br />STATE OF i vt d�aln a_) JoAnne Vitale <br />.SS'F <br />otary Publlc Seal Slele of lndlene <br />Memhell County <br />(pm M.- Numw,Ireer39104 <br />31B12030 <br />_St J osep h_ COUNTY) My Commission CIP <br />Before me, the undersigned, a Notary sal Coup <br />. I I J__JA.-.e.. <br />and State, personally appeared 0 <br />'A' <br />
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