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Final Waiver of Lien <br />State of Indiana, County of St,^mT_Q_sep_„ _. _ SS: <br />being duly sworn that he/she is the President <br />(Name of Officer) (Title) <br />of B o k o (Contractor)" a s oy Inc. having contracted with 1 Cite S,0 t, e n d <br />(Owner) <br />to furnish certain materials and/or labor as follows: _QnX., __A t.a ice' . ^ a r t n t s <br />(Doscrlptlon) <br />for a project known as as ? , al—F—a��n. ten -Colfax &pa wtments <br />(Name of Project) <br />located at 617 �e��t ?�ashin.tcsn_ Stst•eotSouth Brt�d IN 466Q1 <br />and owned by 5D1It]_Ben�1 H 1 aP noun ien... no, _... _..__.. _...w_ <br />(Owner) <br />and does hereby further state on the behalf ofthe aforementioned subcontractor/suppUer. <br />(PARTIAL WAIVER) that there is due from the Contractor the sum of <br />Dollars —_ <br />) <br />❑ receipt of which is hereby aclatowledged; or <br />❑ the payment of which lies been promised as ahe sole consideration for this Affidavit and Phial "Waiver of Lien which is given <br />solely wills respect to said aniount, and which waiver shall be effective only uport receipt of payment thereof' by the <br />undersigned; <br />(FINAL WAIVER) that the final balance due from the contractor is the sum of <br />Th i r..t. . ..th. . la. —. i..Vr h3l,n . ,cents _m. o—. <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 shall <br />beconic effective only upaolt receipt ofsuch payrsiottt. <br />I'TIEREFORE$ the undersigned waives and releases )into the Owner of said promises, any and all liens or claims whatsoever <br />on tho above -described property and improvements thereon an account of labor or material or both, fisrnishod b the undersigned <br />thereto, subject to litu itations or conditions oxpressed hereia, if any; and further certified that no other party has any claim or right to a <br />lies), on account of any work performed or materialfurnished to the undersigned for said project, and within the scope of this Affidavit <br />and '' alver of'Llem <br />MAM <br />___ _ =)n „"' , ANGELA M. E(E � _ <br />STATE OF INDIANA �� Notary Public <br />SEAL A Resident of St. Joseph County, IN <br />ST. JOSEPH COUNTY Commission No. 66371 <br />Before me, the undersigna ic,IYly I <br />and acknowledged the execution of <br />)Jt(Wl"1 nMS <br />F Jhave hereunto subscribed my nar� and2I)0 <br />.. <br />appeared '. %. <br />my offiic'ial seal on <br />e. <br />y n Expires: „~ o u µ natnn . <br />g <br />M Commission p' b Z �':? <br />Residing in w .t Quist (/l _.... _��.__ yr _ __� ( Notary Fu lie rime <br />day of <br />