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Return To: <br />Vince Mendes <br />2404 West Lincoln Hwy <br />Grand Island, NE 68803 <br />(308) 293 -1621 <br />Construction Lien <br />1. The real estate subject to this lien is: 410 w 10th st Wood River, Hall county <br />Nebracka e 1 tty,\ O r Ca tits' <br />2. The person against whose interest in the real estate the lien is calmed is: <br />Vince Mendes Sr. <br />3. The Name and address of the claimant is: <br />Vince Mendes Sr. <br />4. The Name and address of the person with whom the claimant contacted is: <br />Vince Mendes Sr 410 w 10th st Wood River. Hall county Nebracka <br />5. A general description of the claimant's service performed to materials furnished <br />for the improvement and the contract price is: Supplies. Parts and Labor. on <br />the house. property. and vehicles <br />6. (Complete one of the following) <br />X The Amount unpaid whether due or not to the claimant for the services of <br />materials is: $ 17,204.64 <br />The unpaid amount is not fixed by the contract, but a good faith estimate is <br />the amount of: $ <br />7. (Complete one of the following) <br />X The time last services or materials were furnished was: 9/19/2017 <br />_ The time the last service or materials were furnished has not yet occurred <br />but is estimated to occur: <br />State of Nebraska <br />County of Hall <br />On This c v 444 day of , ag13/ � , before me a Notary public <br />in and for said county, personally came to me known <br />to be the identical person or persons who executed the foregoing release, and <br />acknowledged the same to be his, her, or their voluntary act and deed. Witness my hand <br />and seal in said county, the day and year last written above. <br />GENERAL NOTMY - State of Nebraska <br />DENICE R. KRUSE <br />(Ay Comm. Exp. September 25, 2018 <br />201706440 <br />Company Name <br />gh e_44444_) <br />Notary Public <br />