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FINAL WAIVER AND RELEASE OF LIEN <br />The undersigned lienor, in consideration of the final payment in the amount of $10.00, hereby waives <br />and releases its lien and right to claim a lien for labor, services, or materials furnished to Kempfs' Site <br />Development, Inc.to the following described property: <br />Dated <br />I 3 <br />, 2014. <br />Gifford Park Baltfields <br />4715 43rd Avenue <br />Indian River County, FL <br />Lienors Name: Biueline Rentals Printed Name: <br />Address: 1449 NW Commerce Centre Pkwy. Signature: <br />City/State/Zip: Port St. Lucie, FL 34986 <br />STATE OF: <br />COUNTY OF: Lq-, CLA Cif <br />Sworn to and subscribed before me by a kictc5 �r;r%t 107 , who is either personally known to time or <br />has produced , as identification on this 1 Q' day of A� k s f , 2014. <br />1111 <br />Yd <br />• Notary Pu is State of Florida <br />Fred R Parker Jr <br />My Commission FF 008823 <br />• Expires 04/1812017 <br />My Commission Expires: <br />NOTE: This is a statutory form prescribed by 713.20 Florida Statutes (1996). Effective October 1, 1996 a person may not require Ilenor to furnish a waiver or <br />release of Ilen that Is different from the statutory form. <br />141 <br />