|
�wirr� P
<br />�.w O
<br />I0 -3 Forms.
<br />10 -3(a}
<br />1' The real estate subject to this lien it. Central Community
<br />4 W H 34 Y College
<br />and e. 68$01
<br />Z The person against ase �uerest in the rt,I cstatc the L1
<br />Central Comm unit Col le a dairned Is:
<br />3. The same and address cf the d
<br />almaltt Ie: Nebraska Rents -
<br />P I 126,, 1]11ox 340
<br />o han Ne. $$ 2
<br />The name and address of .
<br />_ the person with whom the daimarit contracted I4;
<br />M & R Construction
<br />RR 1 Box 44 Bloamin ton, Ne. '
<br />6$929 30$ 775 -21'12
<br />S. .l general description of the clainwes
<br />niched or to be furnished inr.the lm eet'rices Performed or to be Pm*rmed or materials fmr-
<br />and urChase pM4Ment =d the C0Wr4Ctpr#Ce h: Rent, re air
<br />lte_
<br />ui mart and su lies to do re
<br />b
<br />The total contract price is
<br />6. (Complete one of the f1Y11owin
<br />The eA+"Wt unpaid, whalher due ar not, tb the
<br />- 6 ,1$ 7.43 glut for the ecrvica or materials ist
<br />s
<br />The unpaid amount 3s not bred by the con, tract, but a good faith atlmate in the a
<br />unx
<br />�. �mplete one of the �
<br />The dme the lut cervical or materials were igraish
<br />ed wiw 04-27-05 ` r
<br />The time the last ale .
<br />• to occur �'� or mrteriais tivete fuzriiehed has not yet occurred but is vtlAtllted
<br />Subscribed Its., Dwight McDermott, Store Manager, Ne. Rents
<br />Subscribed and rwarrt to boFarr me this -
<br />"MT Of CI (,
<br />\J'C. _�.
<br />40p2kb ilc �
<br />11}8AT rE Al
<br />:UC-FFAt• RRIA,PALU S
<br />NUiAH' MY COI
<br />ti �s� SSIONEXpIRES Seplarmar, logs
<br />JUIy 24, 2007
<br />r^ti�
<br />c:s
<br />rn
<br />C:)
<br />p
<br />n
<br />V!
<br />7C
<br />=
<br />t,
<br />10 -3(a}
<br />1' The real estate subject to this lien it. Central Community
<br />4 W H 34 Y College
<br />and e. 68$01
<br />Z The person against ase �uerest in the rt,I cstatc the L1
<br />Central Comm unit Col le a dairned Is:
<br />3. The same and address cf the d
<br />almaltt Ie: Nebraska Rents -
<br />P I 126,, 1]11ox 340
<br />o han Ne. $$ 2
<br />The name and address of .
<br />_ the person with whom the daimarit contracted I4;
<br />M & R Construction
<br />RR 1 Box 44 Bloamin ton, Ne. '
<br />6$929 30$ 775 -21'12
<br />S. .l general description of the clainwes
<br />niched or to be furnished inr.the lm eet'rices Performed or to be Pm*rmed or materials fmr-
<br />and urChase pM4Ment =d the C0Wr4Ctpr#Ce h: Rent, re air
<br />lte_
<br />ui mart and su lies to do re
<br />b
<br />The total contract price is
<br />6. (Complete one of the f1Y11owin
<br />The eA+"Wt unpaid, whalher due ar not, tb the
<br />- 6 ,1$ 7.43 glut for the ecrvica or materials ist
<br />s
<br />The unpaid amount 3s not bred by the con, tract, but a good faith atlmate in the a
<br />unx
<br />�. �mplete one of the �
<br />The dme the lut cervical or materials were igraish
<br />ed wiw 04-27-05 ` r
<br />The time the last ale .
<br />• to occur �'� or mrteriais tivete fuzriiehed has not yet occurred but is vtlAtllted
<br />Subscribed Its., Dwight McDermott, Store Manager, Ne. Rents
<br />Subscribed and rwarrt to boFarr me this -
<br />"MT Of CI (,
<br />\J'C. _�.
<br />40p2kb ilc �
<br />11}8AT rE Al
<br />:UC-FFAt• RRIA,PALU S
<br />NUiAH' MY COI
<br />ti �s� SSIONEXpIRES Seplarmar, logs
<br />JUIy 24, 2007
<br />r^ti�
<br />c:s
<br />rn
<br />C:)
<br />V!
<br />N
<br />71�
<br />A
<br />C
<br />CD
<br />W
<br />C
<br />c
<br />Cr
<br />10 -3(a}
<br />1' The real estate subject to this lien it. Central Community
<br />4 W H 34 Y College
<br />and e. 68$01
<br />Z The person against ase �uerest in the rt,I cstatc the L1
<br />Central Comm unit Col le a dairned Is:
<br />3. The same and address cf the d
<br />almaltt Ie: Nebraska Rents -
<br />P I 126,, 1]11ox 340
<br />o han Ne. $$ 2
<br />The name and address of .
<br />_ the person with whom the daimarit contracted I4;
<br />M & R Construction
<br />RR 1 Box 44 Bloamin ton, Ne. '
<br />6$929 30$ 775 -21'12
<br />S. .l general description of the clainwes
<br />niched or to be furnished inr.the lm eet'rices Performed or to be Pm*rmed or materials fmr-
<br />and urChase pM4Ment =d the C0Wr4Ctpr#Ce h: Rent, re air
<br />lte_
<br />ui mart and su lies to do re
<br />b
<br />The total contract price is
<br />6. (Complete one of the f1Y11owin
<br />The eA+"Wt unpaid, whalher due ar not, tb the
<br />- 6 ,1$ 7.43 glut for the ecrvica or materials ist
<br />s
<br />The unpaid amount 3s not bred by the con, tract, but a good faith atlmate in the a
<br />unx
<br />�. �mplete one of the �
<br />The dme the lut cervical or materials were igraish
<br />ed wiw 04-27-05 ` r
<br />The time the last ale .
<br />• to occur �'� or mrteriais tivete fuzriiehed has not yet occurred but is vtlAtllted
<br />Subscribed Its., Dwight McDermott, Store Manager, Ne. Rents
<br />Subscribed and rwarrt to boFarr me this -
<br />"MT Of CI (,
<br />\J'C. _�.
<br />40p2kb ilc �
<br />11}8AT rE Al
<br />:UC-FFAt• RRIA,PALU S
<br />NUiAH' MY COI
<br />ti �s� SSIONEXpIRES Seplarmar, logs
<br />JUIy 24, 2007
<br />
|