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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 $1,725.00 <br />hereby waives and releases its lien and right to claim a lien for labor, services or <br />materials furnished through 4/30/2014 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 />State of Florida <br />County of jyga,,,,_ 12 t ✓e u" <br />Lienor's Name: THE ROOF AUTHORITY, INC. <br />-�1l�at <br />Signature <br />11.P - <br />Title <br />The foregoing instrument was acknowledged before me this 1 q day of I'VIAy <br />, 2014 by Lor.- who i <br />following identification �} <br />040 Pot,": <br />o 4 Notary Public State of Florida <br />7 c�_^, Christy Shulhan <br />t My Commission EE017647 <br />Expkes 10/21/2014 <br />My commission expires: <br />all known r furnished the <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 />145 <br />