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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 $2341.90 <br />hereby waives and releases its lien and right to claim a lien for labor, services or <br />materials furnished through 8/10/2014 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. 2 <br />Lienors Nam - _ EASURE COAST <br />SPRINK <br />'i/(//(97‘Y <br />Date <br />State of Florida <br />County of 1 v'eliay. Q.,i,/2J- <br />' Signature <br />iec.5,‘,44.c7r <br />Title <br />The foregoing instrument was acknowledged before me this 1/" day of rs,i4- <br />, 2014 by U'e. SAA -A ---“A whodersonally-k idwn.3r furnished the <br />following identification <br />Seal <br />a" 't`N. CHRISTY SHUIIIAN <br />* MY COMMISSION i FF 135252 <br />EXPIRES: October 21,2018 <br />'a p Banded Thru Budget Notary services <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 />138 <br />