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Final Waiver of Lien <br />State oflndiana, County of 64 T L SS: <br />-"I- <br />t" ` " � being duly sworn that hafts. is the i^e3 i <br />(Name of Officer) (Title) <br />of g6kA <br />5 h `' having contracted with sty b <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: �� + ✓� Ca-'p.. - I I <br />for a project known as <br />Es <br />located at <br />and owned by <br />(Owner) <br />and does hereby further state on the behalf of the aforementioned subcontractomisupplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the aura of <br />Dollars <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 ofLienwhich is given <br />solely with respect to said amount, and which waiver sball be effective only upon receipt of payment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due kom the contractor is the sum of <br />❑ receipt ofwhich is hereby acimowledged; or <br />the payment of which has bean promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall <br />become of ootiveonlyuponreceiptofsuch payment <br />THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all liens or claims whatsoever <br />on the above -described property and Improvements thereon an account of labor or material or both, furnished b the undersigned <br />thereto, subject to limitations or conditions expressed herein, if any; and firrffier certified that no other party has any claim or right to a <br />lien on account of any work performed or material furnished to the undersigned for said projec% and within the scope of this Affidavit <br />and Waiver of Llen. <br />(firm) ( orired Representative) <br />STATE OF INDIANA ) <br />SS: <br />ST. JOSEPH COUNTY ) <br />Before me, the undersigned, a Notary Public, In and for said County and State, personally appeared w W � <br />and acknowledged the execution of the foregoing Affidavit and Waiver of Lien. <br />IN WITNESS WkWl(EOF, I have hereunto subscribed my name and affixed my 0 1 ' seal on the rV day, of <br />i3 ., " 20� 119 <br />tore Not y blCc Slgn <br />My Commission &pfres: <br />ZIZ,ZG Z p <br />Redding in I County, - 4 <br />1CF11Y M HAIC'�AUGH <br />�rd•ndr�p Notary Public <br />'St f lu'i' t <br />AIM <br />Joa <br />Q.ornrnir,„p Ir <br />ra <br />...- <br />MY Cornnrission xs rr <br />February 02, 2020 <br />