HomeMy WebLinkAbout04-2617 ::' ~'"" INVESTORS TITLE Ilh'SURANCE COMPAN?" :": ':: - ' '
Local Agent: Bankers Settlement Services Capital Region
~ ...... .......... 4807 Jonestown Road
Suite 245
Harrisburg, PA 17109
Tel, (717)671-4556 (877)558-8862
Fax (717)671-1859 (877)351-9238
CoJmnonwealth of Pennsylvania, Courtly of Cumberland
STIPULATION/WAIVER OF MECHANICS' LIENS
CommlwnentfPoliey No. 200401020BA
On tNs/~L, day of ."-~-'~ ~ .20~..~, before me
personally appeared (d9 ~ ~- ~o~r ~ ~o ,X~ ~e~ep~cpe~("O~cr'),
~nd ~tc ~, ~ lie ~ ~ ,OeneralCon~aetor
("Con,actor"), to me pers~ally ~o~, who, berg ~ly sworn on ~eir oaths, did say a~ follows:
WHE~AS, the md~si~ed Con,actor ml~d into a eon~a~ wi~ ~e Om~ to prohde ~t~ials agd p~fo~ labor
necess~ for eons~efion of ~e follo~g improvements:
located on the real property described as follows:
NOW, THEREFORE, it is hereby stipulated and agreed by and be~veen the said parties as part of thc said contract and
for the consideration therein set forth, that neither the Contractor, any subcontractor or materialman, nor any other persor~
furnishing labor or materials to the Contractor under this contract shall file a lien, commonly called a mechanics' llen, for
work done or materials furnished to, or in comiecfion with, thc property described above.
This stipularion is made and intended to be isled with the County Prothonotary in accordance with the requirements of
~INDIVID/AL: On th/s, the t/J~. day cf
personally appeared ~,~e hK~ ~-L, {_.
1963 of the Commonwealth of Pennsylvania.
the undersigned officer,
to me (or satisfactorily proven) to be the p~son whose name is subscribed to the wi~in instrument, and ackmowledge that s/he
executed the same for the purposes therein contained.
[] CORPORATION: On this, thc
per~onally appeared
acknowledged himself to be the
day of ,20, , the undemgned officer,
of
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RECEIVED FROM:
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being authori;~ed to do so, executed the foregoing ir~strument for the purposes there/n contained by si~fing the name of the
corporation by hirmelf as
In winaess ~here~u.nto set my hand and official seal.
Title
Notarial Seal
H. Anthony Adams, Notary Public
Shippensburg Bore, Cumberland County
My Commi*~il>n le~plr~.~ M~V ]5 2006
~'~emDar, PonnsylvenlaA~aoelatioclOtNOtarles
If Notary, my corrmt/asion expires: __ _
to me or saris -- -- . ? ~ , ~o~
( factonly proven) m ~e p~on whose nan~ is subscribed to ~he ~tMn Ms--cut, a~ ac~owledge that s/~e
executed ~e s~e for ~e p~oses themiu c~mi~d.
121 CORPORATION: On this, the day of~ 20 , the undersigned officer
petsoaally appeared, -- -
acknowledged himself to be the
being authorized 1o do so, execu~cl the foregoing instrament for the purposes therein contained by signing the name of the
corporation by h/msel£ as
In w/mess whereof, I hereunto set my trend amd official seal
Signature
If Notary, my commission expires:
Title
Notarial Seal
H. Anthony Adams, Notary Public
gbippensburg Bore, Cumberland County
My Commission Expires May 15, 2006
t,~ernber, Pennsylvania Association et Notaries
Form No, PA-519 (3/2001)
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