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INVESTORS TITLE INSURANCE COMPANY
Local Agent: Bankers Settlement Services Capital Region
4807 Jonestown Road
Suite 245 OS -[DO 1Y1(b <-y-~
Harrisburg, P A 17109
Tel. (717)671-4556 (877)558-8862
Fax (717)671-1859 (877)351-9238
Commonwealth of Pennsylvania, C-Qunly of Cumberland
STIPULA TIOi\'"/W AIVER OF MECHANICS' LIENS
CommitmentiPolicy No. 200402138BA
Ontms'd1,J day of ~
personally peared .C
and '
("Contractor"), to me personally known, who. being duly swom 0 their oaths. did say as follows:
WHEREAS, the undersigned Contractor entered into a contract with the O\';ner to provide materials and perform labor
necessary for construction of the follov.ing improvements:
\eS,))Q..r---\.1. o~ (
. Cd,
J 204, before me
wner of the property ("Owner"),
,General Contractor
!0\. ...)~ \\ I N Cs
located on the real property described as follows:
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J\OW, THEREFORE, it is hereby stipulated and agreed by and between the said parties as part of the said contract and
for the consideration therein set forth, that neither the Contractor, any subcontractor or materialman, nor any other person
ft:mishing labor or materials to the Contractor under this contract shall file a lien, commonly called a mechanics' lien, for
work done or materials furnished to, or in connection with, the property described above.
This stipulation is made and intended to be filed with the County Prothonotary in accordance \';ith the requirements of
Section 1402 of the Mechanics' Lien Law of 1963 of the Commonwealth of Pennsylvania.
x /wi ~~
O\\'Der
Owner
\
'"
State of \=>P"\t..) ~ \. )Clv,,'c.-\
X Il'iDMDUAL: On ' the Ad:: day of
personally appeared -.
to me (or satisfactorily proven) to be the person whose name is
executed the same for the purposes therein contained.
IY7 (lLetJ==
Ovmer
, County of eu. \f\l'-- ~ ~'\--\ ('1\1-, D
/Yl ClM ~^
. the undersigned mcer.
, knOv.TI
ent, a"d acknowledge hat ,/he
:J CORPORA no:>;: On this. the
personalty appeared
acknowledged himself to be the
day of
, 20 _, the undersigned officer,
of
, being
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authorized to do ao, executed the foregoing instrument for the pUIJloaea therein contained by sigIting the name of the corporation
by himseJfa.
In wime.s whereof, I hereunto set my hand and official seal.
\ ~<c.--,,::~ ~ _
Sigl18ture
Title Notarial Seal
. H. Anthony Adams, Notary Public
Shlppensburg Bora, <;umberland County
M ComlllL~s.,_,_,~_~es May 15, 2006
~'1el"Ji'"
General Contractor
';",'
:\"I;;'irionotNotanes
If Notary, my commission expires:
BY:
CJ2.c}~
State of P8Jt-.b'1LVANl PI
,County of C UM./:,E:.IZU" ,,-,D.
o INDIVIDUAL: On this, the _ day of , 20 , the undersigned officer,
peraonally appeared , known
to me (or satisfactorily proven) to be the person whose name ia ,ubacnbed to the within instrument, and acknowledge that s!he
executed the ,ame for the purpo,e. therein contained.
)(
CORPORATION, On this, the dfT,[)dayof Qec ~0~ ,20gL the undersigned officer,
personaUyappeared C~~ L~~l"10 V~w""<.l-'-r , Ii'd
acknowledged himself to be lhe 0'A0-1 - V P of \<1 '^-.f f .\~\~ BUdd&s,!-TlOe;ng
authorized to do '0, executed the foregoing ins\l:J!!nent ["r the pUIJl"ses therein c"n!ained by signing the name of the corporation
byhimselfas fv-..VV--C/'."-. e....r- () p .
,
In witness \V~e~of~d_"ffiCiaI seal.
Signature
~
Title
If Notary, my commission e ptres: u.' ~Ml
H Anthony Adams, Notary t'u':,iJC
Form No. PA-,t9 (312001) Shippensburg Boro. Cumberland 5C~~~~
My Commission Expires May 1 ,
M9fT'ber, pennsylVaniaAsSOClatlonotNotaneS
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