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L11 1N1 ►` �� <br />® Siemens Building Technologies, Inc. <br />Our Project # <br />440P-106011 <br />CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT <br />Upon receipt by the undersigned of a check from <br />County Of Indian River <br />in the sum of $27,570.00 <br />payable to SIEMENS BUILDING TECHNOLOGIES INC. and when the check has been properly endorsed and has been <br />paid by the bank upon which it is drawn, this document shall become effective to release any mechanic's lien, stop notice, or <br />bond right the undersigned has on the job of the <br />Indian River County Jail Fire Alarm located at <br />4550 41st Street Verao Beach, FL to the following extent. This release <br />covers the final payment to the undersigned for all labor, services, equipment, or material furnished on the job, except for disputed <br />claims for additional work in the amount of <br />the party should verify evidence of payment to the undersigned. <br />State of Georgia <br />County Of Gwinnett <br />$0.00 Before any recipient of this document relies on it, <br />SIEMENS Industry, Inc. <br />1745 Corporate Dnve Suite 240 <br />Norcross, GA 30093 <br />Dated this <br />13th <br />I /I �i <br />Angela LiI9 Field Accounting Supervisor <br />day of January 2014 <br />BEFORE ME, the undersigned authority, on this day, personally appeared Angela Liles of Siemens <br />Industry, Inc subscribed to the foregoing instrument, and acknowledged to me that he executed the same for the purposes <br />and considered therein expressed, in the capacity therein stated and as the act and deed of said corporation. <br />GIVEN UNDER MY HAND AND SEAL OF OFFICE, this 13th day of July 6, 1905 2013 <br />____ frt_A—fir ---* atAktilP <br />Notary Public in and for the State of Georgia <br />CONNIE M CANTRELL <br />NOTARY PUBLIC GWINNETT COUNTY, GEORGIA <br />IJY COMMISSION EXPIRES 12/0112014 <br />My commission expires: <br />• <br />3°`43°2-1-1`f <br />57 <br />