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HomeMy WebLinkAboutProject Completion Affidavit - 2017 Tree and Stump Removal Project No 117-009A - K&R Tree Service LLCrw 6 1 W, IFOR Vwx IFIJF ■ '. CC L"Ar-M Lj WIMAN N "1 4 k � R W746 » !j I W PT t, 9 ff 7 Final Waiver of Lien State of Indiana, County of 1Z SS: Alevll'n M-k''enke-1 being duly sworn that he/she is the (Name of Office (TitIej of t?e c)(LO r C.Y° having contracted with ©x t..& c� (Contractor) I(Owner) to f rnish certain materials and/or labor as follows: 4',e c &m zw Pr-,c .e e,,-k l p D 1 for a project knawu as located at and owned by (Description) 0 oci (Name of Project) (owner) and does hereby Anther state on the behalf ofthe aforementioned sub ontmotor/supplier: C,"� L" ��'w.X 04 (PARTIAL WAIVER) that there is due from the Go Wwtorfhe. sum of Dollars ❑ receipt of which is hereby acltnowledged; or ❑ the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lienwhtoh Is given solely with respect to said amount and which waiver shall be effective only upon receipt of payment thereof by the undersigned; (FINAL WAIVER) that the final balance due atom, the contractor Is the sum of ❑ receipt ofwhioh is hereby acknowledged; or ❑ thepayMeat ofwltfeh has been promised as the sole consideration forthis Affidavit and Mnal Waiver of Lien which shelf become effective only upon receipt of such payment. WHEREFORE, the undersigned wolves and releases unto the Owner of said promises, any and all liens or claims whatsoever on tho above -described property and improvements thereon an account of labor or material or both, furnished b the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further cortifed that no other party has any claim or right to a lieu on Account of any work performed or materlal furnished to the undersigned for saldproject, and within the scope of this Affidavit and Waiver of Ue% (Firm) ��uthorlzedR rescntative) STATE OF INDIANA ) Ss: ST, JOSEPH COUNTY Before me, the undersigned a Notary Public, In and for sold County and State, personally appeared .Vwm We A and achowledgad the execution of the foregoing Affidavit and Waiver of Lien. IN I SS WHMOF, I have hereunto subscribed my name and affixed my official seal on the day of �0-ffty Publi S ature My Commission Expires: 7b WqE Residing in Coup o&PUh,10Name Jennifer Mroualn St, Joseph County My Commission Expires April 20, 2025