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09/14/200116:03 FAX 14024714429 NEBRASKA UCC 200109442 Q002/003 NG S.. of SiNw • UCC STL f i 9901IM232 -7 Pei: t B L 7 GROUP INC. Filed: 09/14/2001 09 :07 AM NDOL Office ofLegal Counsel STATE TAX LIEN • NEBRASKA DEPARTMENT OF LABOR P.O. Box 94600 Lincoln, NE 68509 -4600 OIUGiNAL Telephone - (402) 471 -9912 FAX - 402 471 -9917 - Employer Name: _ .B & T Group ... Inc. f /d/b /a B & T Concrete & Construction ........ ................. .................I............. ................ ............................... Address: 3842 W. Old Hwy 30, Ste A Grand Island NE 68803 -5053 NDOL Serial No.: LAB -0.173 -2001 To be filed with the Register of Deeds in the following Counties: . ............................................................................................... ............................... ............................... .......... _............................ ...... ......... ............. ............................... NDOL Employer Acct. Na.: 0280956005 Hall . ................................................:....................... ............................... ,....... ................................ . .............. ........................................ Federal ID No. / SSA No.: 47- 0874061 This State Tax Lien is issued for unpaid combined taxes (Neb. Rev. Stat. §48 -657) orpayments in lieu of contributions (Nab. Rev. Scat. §48- 660.01) pursuant to the Uniform State Tax Lien Registration & Enforcement Act (Neb. Rev. Star. §77 -3901, etseq.). Notice is given that combined taxes or payments in lieu of contributions, interest (computed at 1.5% per month), and penalties are due from this employer and remain unpaid after demand. These combined taxes or payments in lieu of contributions constitute a lien for any and all personal property and real property in the county /counties named, belonging to the employer, whether now owned or hereafter acquired. Combined Tax or Qtr. / Yr. i Date Assessed = Payment In Lieu Of Contributions Due = Penalty Interest Subtotal 4/2000 i August 29, 2001 $ 444.43 S 25.00 $ 46.01 i $ 515.44 ...... ............................... ..................... ................. a. ..................................................................... .. ............... 1.................................. �... ............................... j.. .. 0 ..................... : .00 ..................................... i....... ............................... j........................................................ ............................... .................................. i.................................. i ................ ............... I....... ' $ 0.00 ....................................:..... ..................I............ i................................. ............ . ................................ ......... j.................................. ,.. ............................... �... .......................0.00.... ...... ............................... t.................... ..................i. ........................ . ...................... . ............................. .....-.-.:......................... .....-... i....-.............................;.....,.. ............................... $ 0.00 ................................................................................................................................................................................................:.......................... ..........$.................... 0.00 .... .............................. :............ . ......................... .................. _.................................................. ................. < ............................... ...........................;.. . ..........................00.... s $ 0,00 .............................; ............................ ............................... - .............................. -........ ........................:...... .........................................................:........ ............................... $ 0.00 _ , ........ .........................:..... € $ 0.00 TOTAL Combined Tax or Payment in Lieu of Contributions Due (under this lien only): $ 515.44 I certify that the Nebraska Department of Labor has complied with the Employment Security Law of the State of Nebraska in the determination of the amount due, and the employer has failed to pay the amount due after demand. Date: September 14, 2001 RETURN FILED COPIES TO: Nebr. Dept. of Labor -LEGAL P.O. Boa 94600 Lincoln, NE 685094600 FERNANDO of W44AWr' -or- THOMAS A. UKINSKI ey Legal,Counsel Legal Counsel NEBR. DEPT. OF LABOR CHARGE ACCT. #14765