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"SUPPLY, <br />WATERWORKS <br />FINAL WAIVER AND RELEASE OF LIEN <br />062-038819 <br />The undersigned lienor, in consideration of the final payment in the amount of $10.00 hereby waives and <br />releases its lien and right to claim a lien for labor, services or materials furnished to TIM ROSE CONTRACTING <br />on the job of INDIAN RIVER COUNTY (owner), to the following described property: <br />71ST STRE13T TO COUNTY ROAD 510, "OLD DDUE HIGHWAY RESURFACING", BOND NUMBER <br />4267231, AND FURTHER D13SCR:IBED IN BOND RECORDED IN OR BOOK 2903 PAGE 1542 PUBLIC <br />RECORDS INDIAN RIVER COUNTY, FLORIDA, <br />DATED on MAY 25, 2017 <br />Sworn to and subscribed before me this MAY 25, 2017 <br />Signature of Notary Public <br />Commissioned State of Florida <br />Personally Known XX OR, Produced Identification <br />Type of Identification Produced <br />H D SUPPLY WATERWORKS LTD <br />1830 CRAIG PARK COURT <br />SAINT LOUIS MO 63146 <br />CREDIT MANAGER <br />VERONICA A SCHINN <br />(11DITIX <br />MY COMMISSION #FF051385 <br />EXPIRES December 20, 2017 <br />40 39841b3 FlorldeNot senAee.wm <br />Print, Type or Stamp <br />Name ofNotary Public <br />NIA <br />N/A <br />NOTE: This is a statutory form prescribed by section 713.20, Florida Statutes (1996) <br />Effective October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is <br />different from the statutory form. <br />