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Final Waiver of Lien <br />State of Indiana, County of St. Joseph SS: <br />Rachelle Dolniak <br />vp being duly sworn that he/she is the W _ President <br />or) <br />(1"itle;) <br />of Ritschard Bros.. Inc � _ having contracted with City of South Bendw <br />(Contractor) (Owner) <br />to furnish certain materials and/or labor as follows: <br />(Description) <br />for a project known as 2018 Demolitions <br />..... �..., (Name of Project) <br />t) <br />located at Various Addresses <br />and owned by C-ily of South Bend <br />(owner) <br />and does hereby further state on the behalf of the aforementioned subcontractor/supplier: <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />.s. � Dollars , <br />❑ receipt of which is hereby aclutowledged; or <br />El the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which is given <br />solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due from the contractor is the sum of <br />h r T1 wand Y;Lf on D ..;) 00 ISO .L. . _ .... _ <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 of Lien which shelf <br />become effective onlyuponreceipt of such 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 further 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 undoes" red for said project, and within the scope of this Affidavit <br />and Waiver of Lien <br />�k <br />• xn.,... <br />Rtscfnard Bros. Inc- .....�.,.�. BY w . <br />(Firm) (Authorieed Representative)_ <br />STATE OF INDIANA ) <br />SS: <br />ST. JOSEPH COUNTY ) <br />Beforet me, the undersigned, a Notary Public, in and for said County and State, personally appeared Rohe L. DoIn Qp1r <br />and acknowledged the execution of the foregoing <br />Affidavit and Waiver of Lien. <br />IN WITNESS WHEREOF, Ihave hereunto subscribed my name and affixed ray oifi a cal n the 8 t'h day of <br />hla 200 19 <br />RD <br />����gttulCr <br />r, otary Public 81gaa tro <br />My Commission Expires: 9 i 8 25 <br />Robin 1 ozo <br />. Jose h County, ...�. .�."...,�.�., h', '� '�-. <br />Residingin St "°. lotaryPubliName <br />E3L\ <br />OF 109 <br />'r rrrruof000 <br />