HomeMy WebLinkAboutInv# INVOICE 3 - Kailas Corp. - 10/31/2022 (3)WAIVER AND PARTIAL RELEASE OF LIEN
The undersigned lienor, in consideration of the progress payment in the amount of
$ 14457t il_ heleby waive and rebases its lien and right to claim lien of labor,
services or materials fumished through pg lW!& to Citv of Dania Beach
(Owner).. on the project SW 37 Terrace Stormwater lmprovement at the following
property:
Pr$ect: SW 37TH TERR IMPROVEIilENTS yrC AF 5720 SW 37TH TERRACE
DANIA BEACH FL 33312
The waiver and release does not cover any rctention of labor, service anilor rnaterials
fumished afterthe date specffied.
Dated on November 10 2022 "
Lienofs name:
Address:P.O. Box 552098
Davie. FL 33355
JORGE PAZ - PRESIDENT
By:
STATE OF FLORIDA
coUNTY oF fb toqr_qrd
I hereby acknowledge that the statements contained in the foregoing release of lien are
tue and oorrd-
Swom to and subscribed before me this t o oay ot Nlur.cnther ,zoJJ
CIAI'T}IA BERT{AL
Notary Publk Signature:
State of Florld.Printed Name:
CommrHH2m39
Erplres LUL7(2O25
Nofe: This is a statutory furm prcscribed by sedion 713.20, Flodda Statutes (1996). Efuir/e October 11 1996; a person may
not require a lienor to fumish a waiver or release of lien that is different trom tle statutory form.