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WAIVER OF RIGHT TO CLAIM <br />AGAINST THE PAYMENT BOND <br />(FINAL PAYMENT) <br />The undersigned, in consideration of the Final Payment in the amount of $ 5,753.95, hereby <br />waives and releases its lien and right to claim a lien for labor, services, or material furnished to <br />Timothy Rose Contracting, on the job of <br />43'd Avenue Bridge <br />This waiver and release does not cover any retention or any labor, services, or materials <br />furnished after the date specified. <br />Dated on Ay .5 2018 <br />Lienors name: SOUTHEAST HIGHWAY GUARDRAIL <br />Address: 7760 HOOPER RD. <br />WEST PALM BEACH, FL 33411 <br />By: _&2t�—d <br />Printed Name: Connie Sinkus <br />Title VP <br />STATE OF: FLORIDA <br />COUNTY OF: PALM BEACH <br />Pernally appeared before me, this day of _�� e/ , 2018,/?i P <br />—(name), who beiZn on oath say that he/she is thei <br />(title) of {lienor) and hereby acknowledges the <br />execution of the foregoir,g-r ent f6fand on special instance and request. <br />NOTARY PUBLIC: _( <br />My commission expires: <br />susnrWeAasn <br />mycoMM =co21em <br />eats lo'm <br />43 <br />