Okaloosa County BOCC — December 18, 2012 — Bob Sikes Airport Taxiway A - Change Order #5, Close-out docs, Final Payment form — reading text

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AVAIXVL = LUOdUIY Sa¥IS BOB PARTIAL LIEN WAIVER AND AFFIDAVIT ESTIMATE NO: 21 (FINAL) STATE OF: FLORIDA COUNTY OF: OKALOOSA 10,396,468.68 _ Original Contract Amount -68,782.81 $ Approved Change Orders $ Adjusted Contract Amounts $ 10,327,685.87 _- Completion To Date $ 10,327,685.87 -— Retention $ 0.00 —— Total Earned (Less Retention) $ 10,327,685.87 -— Previous Payments $ 9,200,389.61 — Current Payment $ 1,127,296.26 — Contract Balance $ 0.00 The UNDERSIGNED, being duly sworn states that he is the Project Manager (title) of Anderson Columbia Co., Inc. who has a contract with Okaloosa County Board of County Commissioners for the improvements being erected on real estate located in the County of Okaloosa, State of Florida, and more particularly described as follows: BOB SIKES AIRPORT TAXIWAY A - REHABILITATION The UNDERSIGNED, for and in consideration of the sum of ONE MILLION ONE HUNDRED TWENTY-SEVEN THOUSAND TWO HUNDRED NINETY-SIX AND 26/100 DOLLARS ($1,126,296.26) and other good and valuable consideration, the receipt of which is hereby acknowledged, does Ref waive, release and quitclaim in favor of the owner (s) and each and every