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7 7 . 3 <br />N- ft1 rn <br />C. <br />CA) c, ri <br />e rs <br />lr`. �. <br />C,›, j c)(`) -� -J <br />W <br />State of Nebraska <br />CONSTRUCTION LIEN 2 013 0 9 9 0 4 <br />1. The real estate subject to this lien is : <br />PARCEL #400170124 MAP #3213 -00 -0- 20005 - 009 -004 CAD #0001- <br />0057 -0067 <br />CAIRO MAYFIELD VILLAGE LT 4 BLK 9 <br />2. The person against whose interest in the real estate the lien is claimed <br />is: <br />Jonathan and Roberta Schweitzer <br />204 E Kansas <br />Cairo, NE 68824 <br />3. The name and address of the claimant is : <br />NCS Equipment Inc (Phone # 308 - 472 -5077) <br />73779 Road 438 <br />Bertrand, NE 68927 <br />4. The name and address of the person with whom the claimant is <br />contracted: <br />Dave's Construction (308- 390 -6604) <br />Dave Nickel <br />1348 E Street <br />Cairo, NE 68824 <br />5. A general description of the claimant's services performed or to be <br />performed or materials furnished or to be furnished: <br />Rental of Gehl DL7 unit # 5228 <br />The total contracted price is $5,000.00 <br />_ The amount unpaid, whether due or not, to the claimant for the <br />Services or materials is $5,000.00 <br />The unpaid amount is not fixed by the contract, but a good faith <br />Estimate in the amount of $ <br />(Complete one of the following) <br />_X_ The last time services or materials were furnished was October 7, 2013 <br />The last time services or materials were furnished has not yet occurred <br />But is estimated to occur <br />Claimant: NCS EQUIPMENT mg. <br />Printed Name: AS <br />By: <br />)ss <br />County of & () S Title: P�ri�c <br />Subscribed and sworn to before me this 1 day of ,/ - 4 , 20� <br />Ty Public <br />GENERAL NOTARY-State of Nebraska <br />GAILENE ANDERSON <br />My Comm. Exp. July 25, 2016 <br />cn <br />w <br />