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<br /> The Northerly 82.9 feet of Lot 1 in Block 4 of Windo~h's Addition
<br /> to the City of Grand Island, Hall County Nebraska
<br /> 200905228
<br /> S~ ~6
<br /> W R AND RELE OF N
<br /> UPON FINAL P,AYWMI
<br /> (Long Form, Unconditional)
<br />
<br />
<br />
<br /> The undersigned lienor (the "Lienor"), in consideration of the final payment in the amount of 1055.00
<br /> hereby waives and releases its lien and right to claim a lien for labor, services, or material furnished to
<br /> ScotLQ lick ("Customer") on the job of Scott Glick ("Owner") the following described property: 120
<br /> i Gr Ilan N ("Project") rekAS2 6cC%3me.-~ nO. ~)>QaCo,45(,q
<br />
<br /> The Lienor certifies, under oath, that all lienors, including laborers, subcontractors, materialmen
<br /> or professionals, have been paid in full for all materials, equipment, fees, licenses, insurances, and taxes
<br /> of every description have been paid, in full, and that there are no liens , causes for liens, or claims against
<br /> the Lienor whatsoever. The Lienor certifies that Lienor will indemnify, and save harmless, the Owner
<br /> from any and all manner of claims, liens, suits, losses, costs„ expenses and damages, including, but not
<br /> limited to, reasonable attorney's fees arising out of or resulting from Lienors failure to pay for any work
<br /> performed or material supplied under the Contract, and hereby releases forever all claim, title, and interest
<br /> in the Project for the same.
<br />
<br /> The Lienor for value received does hereby release and discharge the Project from any and all
<br /> liens and claims of lien, equitable or legal, which the undersigned has or may have against the Project for
<br /> labor, services or materials, and further hereby releases and discharges any and all claims against any
<br /> Payment Bond applicable to the Project for labor, services or materials.
<br />
<br /> The Lienor warrants that no assignment of claims for payments, rights to perfect a lien against the
<br /> Project, or claims against the Payment Bond, if any, have been made, and that the undersigned has the
<br /> authority to execute this Final Waiver of Lien and has performed the labor and services and supplied the
<br /> materials required of the Lienor. The undersigned has personal knowledge that the statements made
<br /> herein are true and correct.
<br />
<br /> Dated: 6
<br /> Lienors Name: Lindell Hagood Lienors Signature
<br /> r
<br /> Lienors Address:Z ZZ ~~✓LG9~ h cc~y
<br />
<br /> GIVEN UNDER MY HAND AND SEAL OF OFFICE, THIS (~r) day of Cvea
<br /> I - Z(4 Z J1
<br />
<br /> (s' of notary public)
<br /> Notary Public in and for H ounty, Nebraska
<br />
<br /> NOTARY - Stte of
<br /> (affix Notary Seal) GENEflKATHRYN A.HILLIGAS NebrasRa
<br /> My Comm. Exp. May 2, 2010
<br />
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