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WAIVER OF LJ1I:N TO DATE
STI\TE or ILLINOIS )
) S8
COUNTY OF )
Otyfl
Blcrow /I
TO WHOM IT MAY CONCEIINI
WHERBAS 1IIe W1dmllllled hu been employed by
THE NORWOOD COMPANY
tofumi&h
tor the prllIIIlsea known 18
. . TV ofwbich FR DEVELOPMENT SERVICES.. INC. Is the owner.
THE uuderslgbed, fOl'lllld in conllderatloll of . -,5' - 'Sl -~'rL(': ~ '7.6-5. 00 )
Dollars, and other I!oo<! and valuable cOJIIlderat ,the receipt whereot Is bereby acknowledged, do(es) hereby waive and
release any and all lien or claim of, or right to,lIen, under the statutes of the Slate of PA reIallng to mllllhanial' 1I1lJ11. wIth
respect t.o and on lald above.deeQribocl pmniaes. III1d the improvements thereon, IIId 011 the material, fIxlllres, applll'll:Us or
macbinery futnl.hed, and 011 the moneys, funds or other considerations due or t.o bellOllle due ftom the owner, on lII:Coullt of all
labor services. material. f1xNl'eS, llllPlU'lUUS or machinery, fbmlshocl to this date by the undersIsned for the above.<fescribed
premilea, INCLUDING IlXTRAS.*
DATE ~-,;J/-oo COMPANYNAME ken~ G!. OE/1'c-.e7:...z;.,C .
..............""'" :t:.~~ W'. ::Oi/ts~ ,.;-+ /lPl9
OEXl'\Wl1NCLIJI)J! BUT ARIl NOT lTHO 1'0 at' Oll.DllU, M OIW. AND WI.l'M'llN. TO TIm CONTllACT.
CONTIU"'TOR'S AllFIDAVIT
STATE 0' ILUNOIS )
) SS
COUNTY OF )
TO WHOM IT MAy CONCERN: ~
TREUNDlUlSIGNED.(NAME) L O~E r::.. S6 GJ.$A. BEING DULY SWORN.
DBPOSBSANDSAYSTIMTHEO~sa:~smON) A P,"','oI.c""'" I . . ... ..OF.<COMPANY
NAME) ~G. S..:;:-~'" z:;;..c.... WHOI..S. THE. ..CO.NI'RA.'.......... .e..'.TQ.... 'R. .FVRNIBRIN...;.... . ..; G
.. .. ~ C"-.s ~c7";J--.. WORKON.s.~~YJLDJNGLOCATED
AT .,OOALLEN;RO~p.CARLlSLE.PA OWNE~ BY FIRST IMptlSWL DII.~~f~:rRE"Y'.9U
'Ibat the totallllllOUllt of the contract lncludlol! extras' IS S-=<,5.~ ~q;;). " on wltich he orIlla bat recelvecl payment
of$ a . 0 CJ . prior to this payment. that all waivers are we, oomct IUd FIIuine IIIli delivered unconditloMlly
IIId that there Is 110 claim either legal or equitable to defect the validity ot &aid waivers. ThIt the f'ollowinl! are the lIames and
eddresses of all parties who have t\1I'IIished material or labor, or both. for said work. BIId aU parties havins conuaelS or sub
QOIltrllCtll for spec:Hlc port:iOllll at &aid work or for material entering into the CODltruGtion th~f llIld the aIlIOUllt clue or to
beeome due to aach, and thet the Items melltloned included all labor and material required to clllllplete said work IICCOl'dllIa to
Iuu! and. Uiom:
MUST .rILr..IlDQtJ'r1
NAMaS....ND ADDRESS
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CONl1IACT PIUCIl
INCLDD llJC.l'MSo
nus
P....yMENT
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. Ali.W' .tNa: D . OIlXTRASO TO COMPLETE:
:' t.', are no other conll'lllltS ~:work outstandlnll, III\d there is nothins due or ,become due t.o any person
~.' o;.I.la"'_.~CJIII'!l\V!'.\iofl\D)'.'ikirid.! done ort.o bodone upon or in 1lOlll!. fJetI.. ..:.011' . ..ted,
DATE '1i~_l\!),~ T'.. .' SIGNATURIt .. .
;, 1 " .__ '" j.~ l..o..e."SG-. t;:/ e" .
SUBSCR.IHD.AIllJlS\\'OBN.~ B_FORE ME THIS ;) I DAV OF . ,.:JI"CD
',t; '~D~,'!, '0 :.' '
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NOIalial S~
'MaUssa A. Back. NoIaiy PUbflC
Carroll Twp., York County
My Commission Expires Dec. 8, 2001
Member. PennsylvaniaAssociati<>nolNolaries
NOTARY PUBLIC
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e9~6 961; 9 tL
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THE NORWOOD COMPANY
ALLENTOWN. PA
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