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<br />CD
<br />(XI -
<br />DATE:
<br />LIEN CLAIMED BY:
<br />LIEN CLAIMED AGAINST:
<br />STATE OF NEBRASKA )
<br />)ss:
<br />COUNTY OF HALL )
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<br />(XI -
<br />DATE:
<br />LIEN CLAIMED BY:
<br />LIEN CLAIMED AGAINST:
<br />STATE OF NEBRASKA )
<br />)ss:
<br />COUNTY OF HALL )
<br />CONSTRUCTION LIEN
<br />April 11, 2005
<br />Middleton Electric, Inc.
<br />2716 West Old Highway 30
<br />P.O. Box 447
<br />Grand Island, NE 68802 -0447
<br />Schafer Medical Two, L.L.C.
<br />1004 Diers Ave, Suite 140
<br />Grand Island, NE 68803
<br />e_t5d
<br />TOM MIDDLETON, duly elected President of Middleton Electric, Inc., a Nebraska
<br />corporation, being first duly sworn upon oath, deposes and says:
<br />1. He is the duly elected President of Middleton Electric, Inc., a Nebraska corporation
<br />and as said President verifies this account in writing for and on behalf of said corporation.
<br />2. Middleton Electric, Inc., by and through its duly authorized officers, entered into a
<br />contract with Shafer Development, to provide labor and materials for the electrical requirements
<br />relating to construction of a furniture store upon the real estate hereinafter described and the
<br />contract price for the improvements constructed upon such real estate by Middleton Electric, Inc.
<br />totaled Ten Thousand Two Hundred and 00/100 Dollars ($10,200.00).
<br />3. Said Shafer Development entered into this contract for and on behalf of Furniture
<br />Clearance Center.
<br />4. The materials and labor were provided upon and in respect to that real estate located at
<br />Grand Island, Nebraska, legally described as follows, to -wit:
<br />Lot Two (2), Crane Valley Fourth Subdivision, Grand Island, Hall County,
<br />Nebraska.
<br />5. The amount unpaid and due to Middleton Electric, Inc. for materials and services
<br />provided in accordance with the contract through December 22, 2004, at Five Thousand and
<br />00 /100 Dollars ($5,000.00) together with interest thereon as provided by applicable law.
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<br />CONSTRUCTION LIEN
<br />April 11, 2005
<br />Middleton Electric, Inc.
<br />2716 West Old Highway 30
<br />P.O. Box 447
<br />Grand Island, NE 68802 -0447
<br />Schafer Medical Two, L.L.C.
<br />1004 Diers Ave, Suite 140
<br />Grand Island, NE 68803
<br />e_t5d
<br />TOM MIDDLETON, duly elected President of Middleton Electric, Inc., a Nebraska
<br />corporation, being first duly sworn upon oath, deposes and says:
<br />1. He is the duly elected President of Middleton Electric, Inc., a Nebraska corporation
<br />and as said President verifies this account in writing for and on behalf of said corporation.
<br />2. Middleton Electric, Inc., by and through its duly authorized officers, entered into a
<br />contract with Shafer Development, to provide labor and materials for the electrical requirements
<br />relating to construction of a furniture store upon the real estate hereinafter described and the
<br />contract price for the improvements constructed upon such real estate by Middleton Electric, Inc.
<br />totaled Ten Thousand Two Hundred and 00/100 Dollars ($10,200.00).
<br />3. Said Shafer Development entered into this contract for and on behalf of Furniture
<br />Clearance Center.
<br />4. The materials and labor were provided upon and in respect to that real estate located at
<br />Grand Island, Nebraska, legally described as follows, to -wit:
<br />Lot Two (2), Crane Valley Fourth Subdivision, Grand Island, Hall County,
<br />Nebraska.
<br />5. The amount unpaid and due to Middleton Electric, Inc. for materials and services
<br />provided in accordance with the contract through December 22, 2004, at Five Thousand and
<br />00 /100 Dollars ($5,000.00) together with interest thereon as provided by applicable law.
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