Laserfiche WebLink
FINAL WAIVER OF LIEN <br />Becky Yeakey being duly sworn that he/she is the President <br />(Name of Officer) (Title) <br />of Premium Concrete Services, Inc. having contracted with City of South Bend <br />(Subcontractor/Supplier) (Contractor) <br />to furnish certain materials and/or labor as follows: Curb and Sidewalk Construction <br />for a project known as 123-001 2023 Curb & Sidewallc <br />located at South Bend <br />and owned by <br />The Citv of South Bend <br />(Description) <br />(Name of Project) <br />(Owner) <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 />Three hundred twenty-three thousand, six hundred thirty-five and <br />twenty-five cents <br />(Amount Written Out) <br />323,635.25 <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 />Premium Concrete Services, Inc. By <br />(Firm) <br />STATE OFTN DI AN ) <br />SS: <br />E RA,P, 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 Waiver of Lien. <br />IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal on the <br />�ksyc bcK 20.4 <br />�h day of <br />My Commission Expires: o1I N tary Public Signature <br />Residing in CLK � A ( r.T' County JCEO, <br />JANEE M TOWNER <br />NOTARY PUBLIC <br />SEAL <br />ELKHART COUNTY, STATE OF INDIANA <br />MY COMMISSION EXPIRES FEBRUARY 12, 2026 <br />