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1 CU14 <br />RANGER CONSTRUCTION INDUSTRIES, INC. <br />1200 Elboc Way <br />Winter Garden, FL 34787 <br />FINAL WAIVER AND RELEASE OF LIEN <br />The undersigned lienor, in consideration of the final payment in the amount of $ 60,170.66 <br />hereby waives and releases its Iien and right to claim a lien for labor, services or materials <br />furnished to Ranger Construction Industries, Inc. on the job of Indian River County <br />Board of County Commissioners to the following described property: <br />Indian River Blvd Resurfacing (US 1 to 17th Street) <br />Indian River County <br />RPN: 3505388 <br />Dated on C l Q1) T` <br />Lienors Name: <br />By: <br />Printed Name: <br />Title: <br />STATE OF <br />FE <br />r <br />The foregoing instrument was acknowledged before me this ! day of 1r. , <br />2014 by w, P -y ,who is rsonally known to me) or (who has <br />produced l as identification),;n. who ( ) i not) take an oath. <br />COUNTY OF _dttew <br />SEAL <br />41:5-N,., MATTHEW EISERT <br />"i MY COMMISSION #FF017920 <br />A. EXPIRES May 13.2017 <br />(407) 398-0153 FloridatiOaarySery ce.ccm <br />Notary Signature: <br />Printed Notary Name: <br />Notary Public Commission Number: ,ol77ri.' <br />Notary Public Expire Date: 5�1-1 7 <br />NOTE: This is a statutory form prescribed be section 713.20, Florida Statutes (1996). Effective October 1, 1996, a <br />person may not require a lienor to furnish a waiver or release of lien that is different from the statutory form. <br />166 <br />