HomeMy WebLinkAboutInv# 004 - S3S Construction, Inc. - 10/04/2024WAIVER AND RELEASE OF LIEN UPON PARTIAL PAYMENT
The undersigned lienor, in consideration of the partial payment in the amount of $7,095.35
hereby waives and releases its lien and right to claim a lien for labor, services or materials
furnished to S3S Construction. Inc on the project of City of Dania Beach Building
Department Renovation_ to the following described property:
100 W. Dania Beach Boulevard, Dania Beach, FL 33004
This waiver and release is Partial.
Dated on: 8/28/2024
Lienor's Name: TIRONE ELECTRIC & DATA
Address: 3300 CORPORATE AVE, SUITE 100
WESTON, FL 33331
By: __________________________
Printed Name:
STATE OF FLORIDA
COUNTY OF ____________
The foregoing instruments was acknowledged before me by means of [how the individual appeared; check on].
physical presence or online notarization this _____ day of , 20___, by
name of person making statement).
Signature of Notary Public-State of Florida
Printed Name
Personally Known ______ OR Produced Identification _______
Type of Identification Produced_______________________________________________
NOTE: This is a statutory form prescribed by Section 713.20 Florida Statutes (1996). Effective
October 1, 1996, a person may not require a lienor to furnish a waiver or release of lien that is
different from the statutory form.
Curtiss Morgan, VP of OPS
BROWARD
X 8th October 24
Curtiss Morgan, VP of OPS
Bonnie Prat
X