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State Indiana, County of <br />atok- Maislu"�k" <br />(Name of Officer) <br />Of <br />161 4�[ "'14 <br />(Contractor) <br />to :furnish certain materials anft <br />for a project known as <br />located at <br />mid owned by <br />Final Waiver of Lien <br />being duly sworn that be/she Is the LJ <br />(Title) <br />having contracted with <br />(0 Wn er—) <br />and does hordby fartheraato on the behalf of the Iforolnentioned 8L1br,0nttflGt0r/8U'PP1ior,' <br />(PARTIAL WAWER) that there is rice froni tile cootractor the, sum of <br />Dollars <br />El M0,001Pt Of Which is hereby aoka6wledged; or <br />the PaYMent of which has been promised as the sole consideration for this Affidftvlt and Final Waiver OtMen-which is given <br />solely With rOSP cct to said 11MOUnt, and which waiversball be effealve, <br />undersigned; . 0111Yupon receipt ofpaTnant thereof bythe <br />(FINAL WAIVER) 1:11at: the final balance due from the contractor is Ole sum of <br />dM14 <br />El receipt ofwwah is hereby acknowledged; or <br />the payment of which has been promised as the sole consideration for this AffldavU rand Final Waiver of Licit wMch shall <br />become effective onlyapon receip[ of such payment. <br />THREFORE, the undersigned waives and release-1 untO the Owner Of Said Premises, any and all lions or claims hatsor'Ver <br />on the above-dosoribed property and improvements thereon an account of labor or materia x both, Almished b the t igned <br />Marato, subject to Ihnitations or conditions expressed horain, if any; and flafthor cortified atno other Patty has any Jai or !Otto a <br />"on on 400011,ut Of any WO&PcTibrmOd OrMatorifil fumishedto the undersigood far said oject; and within the sc em s Affidavit <br />and Waiver ofLlen. <br />By <br />(Authorized Reprmescritative <br />STATE Or INDIANA <br />ST, JOSEPH COUNTY SS, -.49 <br />116fOrD me, the undersigned, a Notary Public, in and for said County and State, Personally appeared <br />and acknowledged the execution of the foregoing Affidavit and Waiver of Lien, <br />I ITNESS WMWOF, I have hereunto subscrIbed my pamo and affixed day of 01" 30"' on the <br />20 niro�ft—ubl <br />my cilinimisshmExpiros: <br />L <br />Ronidin <br />g in County, Jqr'ac <br />