HomeMy WebLinkAboutInv# PAY APP 2 - MIGUEL LOPEZ JR., INC. - 06/01/2022United Rentals (North America), Inc.
10330 David Taylor Drive
Charlotte, NC 28262
Tel: 888-481-2660
UNCONDITIONAL FINAL WAIVER AND RELEASE OF LIEN
GROUND BREAKING WORKS LLC
1030 NE 140TH ST
NORTH MIAMI, FL 33161-3308
The undersigned lienor, in consideration of the final payment in the sum of $10.00, hereby waives and releases its lien
and right to claim a lien for labor, services, or materials furnished to GROUND BREAKING WORKS LLC on the job
of CITY OF DANIA BEACH to the following property:
DANIA COMMUNITY IMPROVEMENT PROJECT Job# 7
22 SE 13TH ST
DANIA BEACH, FL 33004-4329
Description of Labor and/or Materials Furnished: Rented Construction Equipment.
Dated: 9/22/2022
By:________________________________(Seal)
Mahogany Chanthaboury, Credit Associate
United Rentals (North America), Inc.
CRFS# 8753149 Waiver# 1138028
STATE OF ________________________
COUNTY OF ________________________
Subscribed and sworn to (or affirmed) before me on this _____ day of ___________________, 20_____,
by Mahogany Chanthaboury, proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
_______________________________
Notary Public
Notary Stamp
NC, MECKLENBURG
22 SEPTEMBER 22
DocuSign Envelope ID: B40B5CCB-F629-4DEF-A813-5FC2D2F4A727