Laserfiche WebLink
WAIVER OF LIEN <br />X FINAL PARTIAL ---PAYMENT TO FOLLOW <br />STATE OF: Indiana <br />COUNTY OF: Marshall <br />David J. Delp being duly sworn, slates that he/she is the <br />Vice -President of Michiana Contracting, Inc. having contracted with <br />City of South Bend —to furnish certain materials and/or labor as follows: FUR Cameras <br />for a project known as lic FUR Caneeree at Cleveland Rd and Annentectch Dr Iodated at <br />South Bend. Indiana owned by City of South Rend <br />and does further state: <br />PARTIAL WAIVER: That the balance due from the Owner is the sum of <br />Receipt of which is hereby acknowledged, or <br />The payment of which has been promised as the sole consideration for this <br />affidavit and Partial Waiver of Lien which is given to ad said amount, effective <br />upon receipt of such payment. <br />FINAL WAIVER: That the final balance due from the Owner is the sum of <br />Forty -Thousand Four Hundred Dollars and Zero Cents Dollars ($ 40,400.00 <br />Receipt of which is hereby acknowledged, or <br />The payment of which has been promised as the sole consideration for this <br />affidavit and Final Waiver of Lien which is given to and said amount, effective <br />upon receipt of such payment. <br />Therefore: The undersigned waives and releases unto the owner of said premises any and all <br />lien or claim whatsoever on the above described property and improvements thereon on account of <br />labor or material or both, furnished by the undersigned thereto, and further certifies that no other <br />party has any claim or right to a lien on account of any work performed or material furnished to the <br />undersigned for said project, and within the scope of this affidavit and waiver. <br />Signed, sealed and delivered this 6th day of January, 2017 <br />Signed <br />Personally appreared before me this 6th day of January, 2017 <br />David J. Delp who being duly sworn on oath, says: That he/she is <br />Vice -President of the Michiana Contracting. Inc. and that he/she hereby <br />acknowledges the execution of the foregoing instrument for and on behalf of Michiana Contracting, Inc. <br />Notary Pulbjic: <br />and at his/her special instance and request. <br />Commission Expires: March 27, 20 2 Resident County: <br />Marshall <br />