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Summit Construction of Vero Beach, LLC <br />2837 Flight Safety Drive <br />Vero Beach, FL 32960 <br />FINAL WAIVER AND RELEASE OF LIEN OR CLAIM AGAINST BOND <br />The undersigned, in consideration of the FINAL payment in the amount of $6,500.00 <br />hereby waives and releases its lien and right to claim a lien for labor, services or <br />materials furnished through 8/31/2014 to Summit Construction of Vero Beach, LLC to <br />the following property: <br />GIFFORD BALLFIELDS IMPROVEMENTS <br />4715 43RD AVENUE, VERO BEACH, FL 32960 <br />This waiver and release does not cover any retention of labor, services or materials <br />furnished after the date specified. <br />9-;-Z)l4 <br />Lienor's Name: E • RESS REEL GRINDING, <br />ING <br />Sign <br />Date Title <br />State of Florida <br />County of 1vl iav\ 1 _L\JeX <br />The foregoing instrument was acknowledged before me this21-4 <br />() day of -f - vv‘be,r- <br />, 2014 by -- 14 a_vvka V\ <br />following identification <br />who isfrsonally kno+euit or furnished the <br />�'�M"�•`.°`� CHRJSTYSHULHAN <br />Seal <br />* DIY COMMISSfON / FF 135252 <br />r v EXPIRES: October 21, 2018 <br />''tomos° Bonded An Budget Notary Services Notary P <br />My commission expires: <br />Note: This is a statutory form prescribed by Section 713.20, Florida Statutes (1996). Effective October 1, <br />1996, a person may not require a lienor to furnish a waiver of release that is different from the statutory <br />form. <br />136 <br />