HomeMy WebLinkAboutInv# 005 - S3S Construction, Inc. - 11/12/2024 (2)WAIVER AND RELEASE OF LIEN UPON PARTIAL PAYMENT
The undersigned lienor, in consideration of the partial payment in the amount of $52,316.86
hereby waives and releases its lien and right to claim a lien for labor, services or materials
furnished to City of Dania Beach 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: 9/30/2024
Lienor's Name:
Address:
0
Printed Name:
STATE OF FLORIDA
COUNTY OF Broward
S3S Construction, Inc.
7320 Griffin Rd., Ste 222
Davie, FL 33325
Reena Maragh
The foregoing instruments was acknowledged before me by means of [how the individual appeared; check on].
physical presence or ❑ online notarizatjon this �_ day of 0l �}� , 20 (, by
t).
Si atAo_fNoT;Uy Public -State o lorida
6
Printed Name �0A s� MOLINA BONHOMME
' Notary Public, State of Florida
Personally Known OR Produced Identification Commission# HH 277882
r—� My comm. expires June 19, 2026
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.