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Summit Construction of Vero Beach, LLC <br />2837 Flight Safety Drive <br />Vero Beach, FL 32960 <br />PARTIAL WAIVER AND RELEASE OF LIEN OR CLAIM AGAINST BOND <br />The undersigned, in consideration of the PARTIAL payment in the amount of $7100.00 <br />hereby waives and releases its lien and right to claim a lien for labor, services or <br />materials furnished through 7/10/2014 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 />Date <br />Sql'2.U1LI <br />State of Florida <br />County of j vkL*& 4/ (2.,v0✓ <br />Lienor's Name; EXPR - ; EEL GRINDING, <br />. 416 <br />Title <br />The foregoing instrument was acknowledged before me this 15{ day of Avv,c.,y-t <br />, 2014 by Lee- t4eGLLtM6/v. who ys ersonally knoZvitof furnished the <br />following identification <br />®�� * MYCOMMISSION , FF 252 <br />Sealy to EXPIRES:Oriober2t,2ots <br />440rrice&WadArc Budget Notryservices <br />My commission expires: <br />Notary P b icy <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 />137 <br />