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WAIVER AND RELEASE OF LIEN <br />UPON FINAL PAYMENT <br />The undersigned lienor, in consideration of the final payment in the amount of $10.00, hereby <br />waives and releases its lien and right to claim a lien for labor, services or materials furnished to <br />Johnson -Davis Inc. on the Job of Indian River County BOCC (Owner), for improvements to the <br />following described project: <br />Gifford Area Stormwater Project; Bid No.: 2018045 <br />Project No.: IRC -1502 <br />Indian River County, Florida <br />Dated On r 6yr47J <br />Lienor's Name: <br />Address: <br />By: <br />Printed Name/ Title: <br />Allied Trucking od Palm Beach LLC <br />Sworn to and subscribe before me this <br />ontyll <br />moo or dr <br />V O°8a/es <br />Si?t e o l otary Public <br />Commiss ned State of Florida <br />Uig#o1 Hoaec s <br />Print Ng"4 j eq.'�v.dr �llc <br />VICTOR <br />:r MY COW/45510N t FF 899453 <br />r- �� : a EXPIRES: August 15, 2019 <br />'?A: <br />.••• u Nobly PubiclIndenwilars <br />Personall Known XX or, Produced Identification: Tht ; j /�G �'/bvyi <br />ype of Identification Produced: <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 <br />lien that is different front the statutory form_ <br />106 <br />