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08/21/2018
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08/21/2018
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2/12/2019 9:46:23 AM
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Marriage License
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Agreement No; BK1347-002 <br /> Effective(NTP)Date 7/1712018 <br /> Supplement Amount $3,498.95 <br /> Total Agreement Amount- SRC S30,454.48 <br /> IN WITNESS WHEREOF,the Parties hereby execute this Supplemental Agreement <br /> pursuant to lawful authority as of the date signed by each party. Further,the Parties, by signing <br /> this Supplemental Agreement,attest and affirm the truth of each and every certification and <br /> representation set out herein. <br /> EXECUTED by Consultant this (2 day of 'e-p c ' ....L 1.h- , 2018. <br /> FELSBURG HOLT&ULLEVIG <br /> —Kyle'A-Anderson;R.£Arny Ztcfsk'y <br /> 7 /5/4 <br /> Principal i „a••• • .,,... <br /> ,,.•�\41a1FER 36 <br /> STATE OF NEBRASKA ) %,. Noy v�•,,0 <br /> as. [ `044%, <br /> DOUGKAS COUNTY) . 0 Ex es I*: <br /> 9l' R ra 2027 <br /> t. e,„,QFNEBRP5 1/40' <br /> SUBSCRIBED AND SWORN to before me this (P day of c.�1 . 2016 <br /> I / <br /> Notary Pub c <br />• <br />• EXECUTED by LPA this Al day of c� 2018. <br /> HALL COUNTY <br /> Jane Richardson <br /> ire <br /> • air, Board •• upervi .rs <br /> Subscribed and sworn to before me thisgl( day of k-tx ttb4 , 2018. <br /> Cle <br /> STATE OF NEBRASKA <br /> DEPARTMENT OF ROADS <br /> Form of Agreement Approved for <br /> Federal Funding Eligibility: <br /> Da( <br /> Project No. BRO-7040(25) <br /> Control No.42322 <br /> Grand Island Northwest Page 3 of 3 <br /> Template T-AGR-1S Revised 3-9-16 AGREEMENT#BK1347 Sup#2 <br />
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