HomeMy WebLinkAboutInv# Pay App 7 - VERCETTI ENTERPRISES LLC - 08/31/2024 (5)Conditional Waiver and Release Upon Progress Payment
State of Florida
County of Miami Dade
The undersigned, in consideration of the sum of $ hereby waives and releases its lien
and right to claim a lien for labor, services, or materials furnished through on the following
described property. As well as releases any and all claims against City of Dania Beach, Florida and Suntex
Harbour Towne Marina. This release is contingent upon payment of said amounts on pay application
7 in cleared funds.
This waiver and release does not cover any retention or labor, services, or materials furnished after the
date specified.
Owner: City of Dania Beach, Florida
Property: 901 NE 3rd St Dania Beach, FL 33004
Folio No. 50-423-516-0010
Company: VERCETTI ENTERPRISES, LLC
Address: 7296 SW 48th Street, Miami, FL 33155
Sign: ____________________________
Print: ____________________________
Title: ____________________________
Sworn to and subscribed before me this ____ day of _____________, 20___, by ___________________.
Personally Known ____ OR Produced Identification ____
Type of Identification Produced_____________________
Signature of Notary Public - State of Florida
Print or Stamp Commissioned Name of Notary Public