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<br /> The Northerly 82.9 feet of Lot 1 in Block 4 of Windolph's Addition
<br /> to the City of Grand Tsland, Hall County Nebraska
<br />
<br />
<br />
<br /> 200905229
<br /> S, sa
<br />
<br /> WAVER AND RELEASE F LIEN
<br />
<br /> UPON FINAL PAYMENT
<br />
<br /> (Long Form, Unconditional)
<br />
<br />
<br />
<br /> The undersigned Lienor (the "Lienor"), in consideration of the final payment in the amount of 12Q3.69
<br /> hereby waives and releases its lien and right to claim a lien for labor, services, or material furnished toW
<br /> Scott Glick ("Customer") on the job of ScottGlick ("Owner" the following described
<br /> o"-~~d ~3 O
<br /> Louise Grand Islan Nebraska ("Project")re\P-"e-s 0lo v-•e tX r 0.
<br /> ,(;\e c 1~ v-e. (,-->v-& Co • 3. 09
<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 Owner
<br /> the Lienor whatsoever. The Lienor certifies that Lienor will indemnify, and save harmless,
<br /> from any and all manner of claims, liens, suits, losses, costs, expenses and damages, including, b 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 /> 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 /> 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 /> Dated: -O
<br />
<br /> Lienors Name: M S uare laesi s b Lino Mendez Lienors Signs
<br />
<br /> Lienors Address: 4/a 4' 3~ST rVA" /lS(00W/A<
<br /> ledro /
<br /> G EN UNDER MY HAND AND SEAL OF OFFICE, THIS y of(morrdi)
<br />
<br /> 4~ ~
<br /> (si l e of notary public)
<br /> Notary Public in and for Hall County, Nebraska,
<br /> prate Sal
<br /> (affix Notary Seal)
<br />
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