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FINAL WAIVER OF LIEN
<br />STATE OF Indiana SS Cty #
<br />COUNTY OF LaPorte I Escrow #
<br />TO WHOM IT MAY CONCERN:
<br />WHEREAS the undersigned has been employed by Green Demolition Contractors Inc
<br />to furnish demolition services
<br />for the premises known as Potawatomi Park Improvements Pool House Demo
<br />of which City of South Bend is the owner.
<br />THE undersigned, for and in consideration of Nine -thousand seven hundred ninety-five dollars and zero cents
<br />$9,795.00 Dollars and other good and valuable considerations, the receipt whereof is hereby acknowledged, do(es)
<br />hereby waive and release any and all lien or claim of, or right to, lien under the statutes of the State of Illinois relating to mechanics' liens,
<br />with respect to and said above -described premises, and the improvements thereon, and the material, fixtures, apparatus or machinery
<br />furnished, and on the moneys, funds or other considerations due or to become due from the owner, on account of all labor, services, material,
<br />fixtures, apparatus or machinery, heretofore furnished, or which may be furnished at any time hereafter, by the undersigned for the
<br />above described premises, INCLUDING EXTRAS.*
<br />DATE June 25, 2025
<br />SIGNATURE AND TITLE
<br />*EXTRAS INCLUDE BUT ARE
<br />D TO CHANGE
<br />COMPANY NAME Green Demolition Contractors Inc
<br />ADDRESS 315 Brighton St Ste 1, LaPorte, IN 46350
<br />, BOTH ORAL AND WRITTEN, TO THE CONTRACT
<br />CONTRACTOR'S AFFIDAVIT
<br />STATE OF Indiana SS
<br />COUNTY OF LaPorte
<br />TO WHOM IT MAY CONCERN:
<br />THE UNDERSIGNED, (NAME) Michael J Brough BEING DULY SWORN, DEPOSES
<br />AND SAYS THAT HE OR SHE IS (POSITION) President OF
<br />(COMPANY NAME) Green Demolition Contractors Inc WHO IS THE
<br />CONTRACTOR FURNISHING demolition WORK ON THE BUILDING
<br />LOCATED AT Potawatomi Park Improvements Pool House Demo
<br />OWNED BY City of South Bend
<br />That the total amount of the contract including extras* is $ 195,900.00 on which he or she has received payment of
<br />$ 9,795.00 prior to this payment. That all waivers are true, correct and geniune and delivered unconditionally and that
<br />there is no claim either legal or equitable to defeat the validity of said waivers. That the following are the names and addresses of all parties
<br />who have furnished material or labor, or both, for said work and all parties having contracts or sub contracts for specific portions of said work
<br />labor and material required to complete said work according to plans and specifications:
<br />NAMES AND ADDRESSES
<br />WHAT FOR
<br />CONTRACT PRICE INCLDG
<br />EXTRAS*
<br />AMOUNT PAID
<br />THIS PAYMENT
<br />BALANCE DUE
<br />Green Demolition Contractors Inc
<br />$ 195,900.00
<br />$ 186,105.00
<br />$ 9,795.00
<br />$ -
<br />315 Brighton St Ste 1
<br />LaPorte, IN 46350
<br />All material taken from our fully paid stock and delivered to jobsite in
<br />our trucks. All benefits are paid in full. No outside rental equipment
<br />used.
<br />TOTAL LABOR AND MATERIAL INCLUDING EXTRAS* TO
<br />COMPLETE.
<br />$ 195,900.00
<br />$ 186,105.00
<br />$ 9,795.00
<br />$ -
<br />That there are no other contracts for said work outstanding, and that there is nothing due or to bec We
<br />du to any person for material, labor
<br />or other work of any kind done or to be done upon or in connection with said work other than abo t
<br />DATE: June 25, 2025 SIGNATUR j
<br />SUBSCRIBED AND SWORN TO BEFORE ME THIS A5 DAY OF f4j,e ?0;r5-
<br />*EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE
<br />ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT
<br />NOTARY PUBLIC
<br />JANET M DOMMER
<br />Notary Public - Seal
<br />Porter County - State of Indfana
<br />Commission Number NP0746920
<br />My Commission Expires Feb 16, 2031
<br />
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