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PCA - Seitz Park Renovation Proj No 117-093 - Ziolkowski Construction
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PCA - Seitz Park Renovation Proj No 117-093 - Ziolkowski Construction
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8/26/2025 10:38:13 AM
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8/26/2025 10:38:02 AM
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Board of Public Works
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Projects
Document Date
8/26/2025
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FINAL WAIVER OF LIEN <br />Jason Watts <br />being duly sworn that he/she is the President <br />(Name of Officer) (Title) <br />of Ziolkowski Construction having contracted with The City of South Bend <br />(Subcontractor/Supplier) (Contractor) <br />to furnish certain materials and/or labor as follows: Renovation of Seitz Park <br />(Description) <br />for a project known as Seitz Park Renovation <br />(Name of Project) <br />located at 316 E. Colfax Ave. South Bend, IN 46617 <br />and owned by The City of South Bend <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 />Five Hundred Eleven Thousand, Seven Hundred and Ninety <br />Six Dollars and Nineteen Cents ($ 511,796.19 <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 scone of this Affidavit and Waiver of Tien <br />Ziolkowski Construction, Inc. <br />(Firm) <br />Date 08/1 Af2025 <br />By Jason Watts <br />(Authorize epresentative) <br />STATE OF Indiana ) <br />St. Joseph COUNTY ) SS: <br />Before me, the undersigned, a Notary Public, in and for said County and State, personally appeared Jason Watts <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 sea on the 41� hday of <br />August 2025 <br />My Commission Expires: 01 /28/2031 No ry Public 'gnature <br />St. Joseph County, <br />Residing in Indiana Jennifer Wiest <br />County <br />Notary Public Name <br />
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