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PCA - Cleveland Rd & Ameritech Dr. Intersections Improvements Proj No 122-049 - Milestone
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PCA - Cleveland Rd & Ameritech Dr. Intersections Improvements Proj No 122-049 - Milestone
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4/17/2025 3:24:03 PM
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12/17/2024 1:11:54 PM
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Board of Public Works
Document Type
Projects
Document Date
12/17/2024
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P,i,SI Milestone <br />AFFIDAVIT AND WAIVER OF LIEN <br />STATE OF INDIANA ) <br />) SS: <br />COUNTY OF SAINT JOSEPH ) <br />FIN A L <br />Payment to Follow <br />Jennifer. Timmons being duly sworn states that they are the Project Accountant of Milestone Contractors <br />North, ILL C having contracted with CITY OF SOUTH BEND INDIANA to furnish certain materials and/or labor as follows: <br />ASPHALT/PIPE for a project known as COSB: CLEVELAND AND AMERITECH INTERSECTION IMPROVEMENT <br />(MCLP ]_ob# 239720) located at SOUTH BEND, IN and owned by CITY OF SOUTH BEND and does further <br />state: <br />FINAL WAIVER: <br />that the final balance due from the owner is the sum of <br />one hundred sixteen thousand nine hundred sixteen and 70 / 100 Dollars <br />the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall <br />become effective upon receipt of such payment. <br />THEREFORE, the undersigned waives and releases unto the Owner of said premises any and all lien or claim whatsoever on the <br />above -described property and improvements thereon on account of labor or material or both, furnished by the undersigned <br />thereto, and further certifies that no other party has any claim or right to a lien on account of any work performed or material <br />furnished to the undersigned for said project, and within the scope of this affidavit and waiver. <br />Milestone Contractors North, LLC <br />Jennifer. Timmons <br />Project Accountant <br />2otrgY PLe�n ~ JOHN CONWAY <br />* SEAL * Commission Number: NP0746553 <br />Q My commission Expires <br />N�9OF 0210112031 <br />Subscribed and sworn to before me this: 11 th day of December, 2024 <br />Notary Public-: ' <br />John . Conwa <br />My Commission Expires: February 1, 2031 <br />County of Residence: Laporte <br />
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