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Project Completion Affidavit - Lot 12 US 31 Industrial Park Asphalt Paving Project No 119-026 - Almac Sotebeer
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Project Completion Affidavit - Lot 12 US 31 Industrial Park Asphalt Paving Project No 119-026 - Almac Sotebeer
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4/8/2025 2:37:50 PM
Creation date
7/9/2019 2:52:39 PM
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Board of Public Works
Document Type
Projects
Document Date
7/9/2019
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State of Indiana, Elkhart County, ss: Whereas, the undersigned <br />Almac-Sotcbccr Inc., P.O. Box 1997 ElkhartIN 46515 has been heretofore <br />employed by City of South Bend/Board of Public Works 227 W. Jefferson Blvd. South <br />Bcnd 1.N 46O1 Pro°cct 11.9-026 to furnish certain material and labor, to -wit: <br />Asphalt Paving for the building owned by REW LLC / M:r. Robert Wozn / 5l 00 <br />Stratton Court / Granger, IN 46 .30-and located at 5870 Carbon. ill Drive / South <br />Bend, IN. <br />Now, Therefore, Know Ye, That the undersigned, for a good and valuable consideration, <br />Thirty-five tlaoUsand nine hundred seventy-five & 00/100 dollars � 5,975.00'l, the <br />receipt of which is hereby acknowledged, hereby and now waives and releases unto the <br />said REW,_LLC / Mr. Robert Wozn / 51500 Stratton Court / Qjqjjger IN 46530 the <br />owner of said premises, any and all lien, right of lien, or claim of whatsoever kind or <br />character on the above described building and real estate, on account of any and all labor <br />or material, or both, furnished for or incorporated into said building by the undersigned; <br />and we further certify that the consideration moving to the undersigned for executing <br />this Waiver of Lien has been mutually given and accepted as absolute cash payment and <br />not as a conditional or part payment or as security for payment. <br />Signed, sealed and delivered this 12th day of June , 2019. <br />Signji-c'sidernt <br />, <br />aa. C. So c ee <br />Personally appeared before me this 12th day of June, 2019 . John C. Sotebeer who <br />being duly sworn on oath, says: That he is President of _Almac-Sotebe r, Inc. and that <br />he hereby acknowledges the execution of the foregoing instrument for and on behalf of <br />said Corporation and at their special instance and request. <br />My Commission Expires: <br />12/28/2024 <br />Kim M. Jennings <br />Notary Public <br />Resident of Elkhart County <br />DESIGN - DEVELOPMENT m� CONSTRUCTION - LEASING - REAL ESTATE <br />3414 Co. Rd. 6 East - PO. Box 1997 - Elkhart, IN 46515 -� (574) 264-5507 - (FAX) 262-2204 <br />
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