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~~ <br />~~ <br />~. <br />N ~ <br />~~ <br />11~~ <br />~~ <br />~ ~~ <br />1111 <br />~~ <br />~~ <br /> <br /> <br /> C 1'~r ~:' c~ `~ Q m <br />n ~ ~ ~ ~ ~~ rv ~ <br /> ~ _ <br />~ 47 ty..... C'~ <br /> <br /> ~ f <br /> C~? ~ ~ I'T'1 ~ Z <br /> <br /> o ~ ~ <br /> <br /> --~--' ~ C~ n <br /> r <br /> <br /> ., ~ ~ ~~ <br /> .i~ <br />Construction Lien 2 010 0 5 0 01 <br />Op <br />The Real Estate subject to this lien is: _ _ _ 1517 Hope St, Grand Island , NE ~p° <br />Pleasant Home Second Sub Lots 1 &2 <br />Grand Island, Nebraska- Hatl County <br />The person (contracting owner or name of the record holder of the contracting owner's interest) <br />against whose interest in the Real Estate the lien is claimed is: <br />Bethphage Mission Inc <br />4980 S 118th St. <br />Omaha, NE 68137 <br />The name and address of the claimant is: Kelly's Carpet Ltd <br />P.O. Box 241336 <br />Omaha, NE 68124-5336 <br />The name and address of the person with whom the claimant contracted is: <br />Oakview Construction <br />1981 G Ave. <br />Red Oak, IA 51566 <br />A general ~tescription of the claimant's services performed, to be performed, or the materials <br />furnished for the improvement, and the contract price is: <br />Flooring/countertop materials and/or <br />installation labor <br />Complete one of the following: <br />X The amount unpaid, whether or not due, to the Claimant for the services or material is: <br />$ 51,016.66 <br />The unpaid amount is not fixed by the contract, but a good faith estimate in the amount: <br />Complete one of the following: <br />X The time the last services or materials were furnished was: 4!13/2010 <br />The time the last services or materials were furnished has not yet occurred, but <br />is estimated to occur <br />Signature of Claimant <br />Mark Wachter <br />_._ .___. _ _ __ _ Controller- Kelly's Carpet Ltd. <br />State of Nebraska <br />County of Douglas <br />The foregoing instrument was acknowledged before me this 14th day of <br />July, 2010 by Mark Wachter- Controller of Kelly's Carpet Ltd. - a Nebraska corporation <br />on behalf of said corporation. <br />No blic <br />IiENERAI NOTARY - State of Nebraska <br />My commission expires: ~o c~d ADENAARGERSINGER <br />MY Comm. Exp. Jug i6, 2013 <br />Return to :Kelly's Carpet Omaha - P.O. Box 241336 Omaha, NE 68124-5336 <br />