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<br /> �. 221•A—MECHANICS LILN (Revised 1962) 'fi:o Ilwii�:a� G<ner�l 5upply 14ouse, Llncolo,NeLr. ��
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<br /> ' duly rtuorn,on his oath snys that tJ�e forrgniny itemiaed accoi:ni of 2enrk.(a6or,a1:i11........................................_..... ...... �
<br /> n�aterials,and imNrovements is b:<e and corrcrt: that smse 2ar�c donc mid her�orsncd and(i�rnuhed by the�rndersiyneJ ;
<br /> • Fd Jenkins,..Personalized HQres . ........
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<br /> i ,, , on the(oflowing lot,j�iece or parcel o�Innd,tns:*......IIIt..fiettP.IlteE:Il_.(a.7.)..r...]II..S10C1C..�...�.l.�.s................... ... -- !
<br /> ; Co�tingnka.l..,C�ardens,...an.Addition..to..Grand. Zsland.c.Ha11_CountY.,..Nebraska..............----.--..----.....--.-.---i
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<br /> ; I Th¢t ut the!i»ie said coutrart:vus�nadc rrnd laGor nnd ;vntr.�ials ft�ro�ished and dcliz,errd tl�erriander...........__... �
<br /> ? � .Fd..Iet]1S].ns�-..PPxsOnd11.z2f�..I'�C&[�5,......... ................. .................. ..... ..t:,as tf�u oumcr of said prcmises'�
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<br /> _ ? � Tha! thc dale o{thc irst itcra 1urnished nnd delivrrrd :ras.............. .Jan lfi 19.7b artd thc I '_
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<br /> i :' ' I dafe of !he last itcm u�as...........�`eb�'u<"ttzj. ..1$,-1976.,...................._..._..........................._.............._.......................----............ �
<br /> _ ' � A�iant fur:hcr slates that said!¢bor was performed on, nnd vrnterials ze�re fur�iisheJ (or, defivered ui, and vsed ir. �
<br /> raid building or premises on and bct.ueen rhr riates sCeci�rd. ;
<br /> � i i That Ure prices chasged there�or are fuir enu rearonaLle, aad!lir.t tl:ere is novu duc ors said account the,ntrn o/� '
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<br /> .FLltIILE..EaEC.tr1C.._. TI.Q..................................................._..clnims a lien on thc said ,-e�aisrs ar tlte ul! amount u ! ,
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<br /> ' I aaid aetount, to-¢vit: TGe s�nn of $...1,27fi..OD-_..........................._.....tageikcr xuith f)LtETCS� t{lG7C01f at tke leg�t rate, j -
<br /> (ront the.......18.th......day of..............................•--..._...F.2b217dry..........................., t97.6......., ar,d f�arther a(j'�n! says not. i
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<br /> GENERAL NOTARY � ' +r' '
<br /> �� � l Stata ot Nebraska i �e Carlson, President. �
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<br /> ,.�,S�A� SuGscri6ed tir, »:1� resrrtcc a�id awarn fo Le ore�nc tlns i
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<br /> (See reverse side Eor instn�clians) A'otnry P,�61ic. ; �
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<br /> ' � I` STATE OF............................................................... .I Iintr��ed on numrricad index and filed fur racurd � . � � y .
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