HomeMy WebLinkAboutInv# APP 11 - Kailas Corp. - 10/13/2023 (3)WAIVER AND PARTIAL RELEASE OF LIEN
The undersigned lienor, in consideration of the progress payment in the amount of
$236,102.13 hereby waives and releases its lien and right to claim lien of labor, services or
materials fumished through 09r30n3 to Citv of Dania Beach (Owner) on the proiect SW
43 Terrace StqnnwaEr lmprovemenb atthe following propefi:
Proiect Location: SW 4:! Terrace from $W 5,{m Street to SW 48n Gourt, Dania Beach,
Broward Countyrn FL.
The waiver and release does not cover any retention of labor, services and/or materials
fumishd afterthe date specified.
Dated on lQ/ al ,204b .
Lienor's name: KAIIAS CORP.
Address: P.O BOX 552098
pAVrE. FL 39355
By: JORGE PAZ / PRESIDENT
STATE OF FLORIDA
COUNTY OF BROWARD
I hereby acknorilledge that the statements contained in the foregoing release of lien are
true and correct.
Sworn to and subscribed bfore me this e\ day of orJdcer 2s-z'3.
CI.AUDIA BERML
Notary Publlc
State of Florlda
Comm#HH200039
Eplres ILi1U2OZS
Signature:[-{qurlia Vb
Printed Name:
NotE' Thb is a statutory fom presaibed by sedion 713.2A, Florilla $tatutes (1996). Effeclive Oc*ober 1s, 1996; a person may
not rcquire a lienor to fumish a waiver or release of lien that is difrerent from the statutory form.