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2025-157
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2025-157
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Last modified
9/11/2025 2:38:52 PM
Creation date
9/11/2025 2:37:43 PM
Metadata
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Template:
Official Documents
Official Document Type
Change Order
Approved Date
08/19/2025
Control Number
2025-157
Agenda Item Number
9.P.
Entity Name
Proctor Construction Company, LLC
Subject
Change Order No. 2 for Fire Station 11, Renovations to make final adjustments
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PARTIAL WAIVER AND RELEASE OF LIEN UPON PROGRESS PAYMENT <br />The undersigned lienor, in consideration of the sum listed below, hereby waives and releases its lien and right to claim <br />a lien for labor, services, or materials furnished through date shown below <br />Name of Claimant: <br />Name of Customer: <br />Job: <br />Owner: <br />Through Date: <br />TNA ELECTRIC LLC <br />INDIAN RIVER COUNTY <br />T -FIRE - FIRE STATION #11 REMODEL <br />Proctor Construction Company, LLC <br />06/20/2025 <br />Conditional Waiver and Release <br />This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and <br />service provided, and equipment and material delivered, to the customer on this job through the Through Date of this <br />document. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written <br />change order that has been fully executed by the parties prior to the date that this document s signed by the <br />claimant, are waived and released by this document, unless listed as an Exception below. This document is effective <br />only on the claimant's receipt of payment from the financial institution on which the following check is drawn: <br />Maker of Check: Proctor Construction Company, LLC <br />Amount of Check: 3,282.75 (three thousand, two hundred and eighty-two dollars and seventy-five <br />cents) <br />Check Number: 0000061027 <br />Check Payable to: TNA ELECTRIC LLC <br />This waiver and release does not cover any retention or labor, services, or materials furnished after the date specified. <br />Signature <br />Claimant's Signature <br />Claimant's Title: 00_-' ( r-�� <br />Date of Signature: <br />Notary: <br />ITZAYANA JACOME <br />Notary Pubbc. Stale of Flonda <br />My Comm E,Prrs Dec 12 202E <br />No HN :140497 <br />
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