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www. RYODERCONSTRUCTION. COM <br />TEL: 574.773.3502 • FAx: 574.773.4941 <br />R., YODER CONSTRUCTION, INC. <br />27453 CR 150 • PO Box 69 • NAPPANEE, INDIANA 46550 <br />AFFIDAVIT AND WAIVER OF LIEN <br />X FINAL PARTIAL PAYMENT TO FOLLOW <br />On this date of December 19th _, 20 18 in the State of Indiana, County of Elkhart <br />Randall E. Yoder being duly sworn states that he is President <br />(Name of officer) <br />R. Yoder Construction, Inc. having contracted with The City of South Bend, IN <br />(Title) <br />Esta6Cdsh,d1978 <br />of <br />to furnish certain <br />HibberdPlaza and StreetscapeImprovements (owner) <br />321 Main Street South Bend In <br />materials and/or labor for a project known as located at r , <br />and owned by City of South Bend For the total amount of contract including extras is $ 479,998.27 of which <br />R. Yoder Construction, Inc. has received payment of $ 415,416.24 prior to this payment. <br />And does hereby further state on behalf of R. Yoder Construction, Inc.: <br />(PARTIAL WAIVER) that there is due from owner the sum of <br />Dollars ($ ) <br />( ) receipt of which is hereby acknowledged; or <br />( ) the payment of which has been promised as the sole consideration of this Affidavit of Partial Waiver of Lien which is given <br />solely with respect to said amount, and which waiver shall be effective only upon receipt of such payment. <br />(FINAL WAIVER) that the final balance due from the owner the sum of <br />Sixty four thousand Five Hundred Eighty Two dollars and 03 cents _Dollars ($ 64,582.03 ) <br />( ) receipt of which is hereby acknowledged; or <br />K) the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of Lien which shall <br />become effective only upon receipt of such payment. <br />THEREFORE, the undersigned waives and releases unto Owner of said premises any and all lien or claim whatsoever on the above <br />described property and improvements thereon the account of LABOR or material or both, furnished by the undersigned thereto, <br />subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any claim or right to a lien on <br />account to any work performed or material f the �tdersigned project, and within the scope of this affidavit and wa iver. <br />R. Yoder Construction, Inc. — By Randall E. Y der President <br />(Firm) (Authorized Representative) (Title) <br />WI S MY HAND AND NOTARIAL SEAL, this 19th— day of December <br />" 11-20-2020 <br />(Notary Public) (My Commission Expires) <br />Patricia Kay Ka for <br />(Printed name) <br />Certifled Dealer For: <br />BORKHOLIDER <br />(Corp Seal) <br />2018 <br />M <br />PAI RICIA KAY KAYLOR <br />Notary Public- Seal <br />State of Indiana <br />My Commission Expires Nov 20, 9non <br />