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��ioo7s�� <br />ATTACHMENT 2 <br />CUNTRACTOR'S SWORN STATEMENT <br />State of <br />County of <br />The undersigned, being duly sworn, on aath deposes and says that he/she is the <br />(Title) of (Business Name), that he/she has tt contract with <br />, the owner(s), to furnish labar and rnaterials for the <br />(Description of Work) on the follawing <br />described real estate in County, State of Nebraska, comrnonly known as <br />(Street Address), and legally described as <br />(Legal Description), That, for the purposes af said c4ntract, the following persons, firms and <br />corporations have been contracted r�vith, and have furnished pr are furnishin� and preparing material for, <br />and/or have done ar are doing labor on the improv�m�nts to said real estate. That there is due and to <br />becorne due to them, respectively, the exact amounts set opposite their names fnr material or labor as <br />stated. That this statement is a full, true and complete statement of all such persons, firms and <br />corparations, the amaunts paid, and the arnounts due or to become due to each. The undersigned further <br />states that all material (except any material disclosed herein) has been or will be furnished from his/her <br />own stock and has been paid for in full, and that there are no oth� contracts for material or labor <br />outstanding, The undersigned agrees to furnish Waivers of Mechanic's Lien for all labor and materials <br />under the contract, <br />4841-2135-3478,2 D-3 <br />