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ASECBANIC'S iIEN WILSON COLiCR&Ti COMIPANY, Grand Island, Nebraska, has and Clai;m's a lien against GfiRALD COX, djb/a CC:t CONSTRUCTION, 4113 East Highway 3fl, Grand Island, Nebraska, for material supplied. said Gerald Cox, d/hfa Cox Construction; said materials Isere supplied said Gerald Cox, d;bja Cox Construction, up to and including August 6, 1480;. that the amount presently due and owing is Forty and 17/100 Qoilars ($40.17) as per attached Exhibit "A". 3TpTS 4P NEHRASRA ) s5. COUNTY OF :TALL ) uwyer Grimminger, attorney for ~Tilsan Concrete Company, being first duly sworn on oath, states that t!:e foregoing itemiaed accoureit caf material supplied Gerald Cox, ci/b,ja Ccax Construction, is a true and correct account of materials Supplied Gerald Cox, d/b/a Cox Construction, for use on the site set ou*_ below, for improvement on the si*_e, located on-the following described property: i,9t ~'ivg {5i, Bicx:k One (1# in Glovers Subdivision in the City saf Grand Csla.nd, Frail r'ounty, Nebraska. Affia~nt further states that said materials were furnished for, deliverard a,e and us+~ti can said pr°emises. `char the r:kt,arszes therefor are zap.. =.n=d rr~ar;anaz~l~:, that ~trers u.~ nor ~7ve cart seed account the Sum of $40.1'; that the said Wilson Concrete Company has and claims a sign on se id premises for the full amount of said account, to-wit: the sum of 540.17, together with interest thereon at the rate of nine percent Fzec annum from the 6th day of August, 1980. >nyer Grim:ni.nger, being first duly sworn, deposes and says that he i.. the attorney fr~r Wilson Concrete Company, in the above and foregoing action; that he has read the above and foregoing, knows the 'contents thereof and that the facts stated therein are true and correct as h,e ver;l~;` believes; that he is signing this Mechanic's Lien on behalf c;rf ~;i<s~~n Concrete Company, :an the taasis that Wilson Conet:ete Marry is a cooperation and that he has the necessary papers and Im€C>rmation with regard to this actican irtt his possession. ~,' , 'er` Grimminger ~, Suk~:~cr:abeti and sworn to before me this~~ day of -. !~ ~ 19£fi __ r , /.~~_ 1