Laserfiche WebLink
202300749 <br />CONDITIONAL WAIVER AND RELEASE OF LIEN UPON FINAL PAYMENT <br />On this / S'"day of ��5iel-3gQ.Y , 20 3 , the undersigned lienor, in <br />consideration of the final payment in the amount of $ . ay O. ocD hereby <br />waives and releases his or her lien and right to claim a lien for labor, services or materials <br />furnished through /V 7t€ C Ei - )Qm . 20 to <br />7 R -EA -r )/up (customer) on the job of se e v N c e 1 -LC <br />(owner of property to the following described property: <br />C . T, .... N6 151 • N <br />A►.) -AU) iT►O/Q -T7 71-Jtc Gf3.nar, lsl,q/vo 1 )-AIL <br />Cmv..,1 , N68tAs 4A <br />sN gArsow,c6 -r ' ,,.6-rleud-,6 - -1* .2 0.:73 l88 <br />This Conditional Waiver and Release of Lien Upon Final Payment is conditioned <br />upon the undersigned receiving collected funds in the amount of $ a, UO . o0 <br />for the work described herein. Should these funds not be received within /0 days of <br />the date hereof, this Conditional Waiver and Release of Lien is void. <br />This waiver and release covers the final payment to the undersigned for all labor, <br />services, equipment, or material furnished on the job. Before any recipient of this <br />document relies on it, the party should verify evidence of payment to the undersigned. <br />State of Nebraska <br />County of A.( <br />Signature of Lien Holder <br />Q64 1, Hoose,) <br />Type or Print Name <br />2-g 43 <br />The foregoing instrument was acknowledged before me this L * d date) <br />by Q \ &i& - 2,h (name of i rson). <br />4O. 1.411fti <br />GENERAL NOTARY. State of Nebraska <br />TRACY L OVERSTREET GARTNER <br />My Comm. Exp. October 27, 2024 <br />Title or k <br />Serial Number, if any: L- 0& �1'-1-t I <br />Type or Print Name <br />Conditional Waiver and Release of Lien <br />Page 1 of 1 <br />