Laserfiche WebLink
RECEIPT AND WAIVER OF MECHANIC'S LIEN RIGHTS <br />Dated: l / 11 /2024 <br />Upon receipt by the undersigned of a check from: <br />Bituminous Roadways, Inc. <br />for the sum of two thousand six hundred ten & 92/100 dollars ($2,610.92), payable to: <br />CR Fischer and Sons, Inc <br />and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document <br />shall become effective. <br />Check One Only <br />1. ❑ As partial payment for labor, skill and material furnished <br />2. ❑ As payment for all labor. skill and material furnished or to be furnished <br />(except the sum of $0.00 retainage or holdback) <br />3. 0 As full and final payment for all labor, skill and material furnished or to be furnished <br />to the following described real property: (legal description. street address or project name). <br />Arden Hills City Hall <br />Bituminous Roadways Job #221 1014 <br />and for value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens against <br />said real property for labor, skill or material furnished to said real property (only for the amount paid if Box I is <br />checked, and except fir retainage shown if Box 2 is checked). The undersigned affirms that all material furnished by <br />the undersigned has been paid for, and all subcontractors employed by the undersigned have been paid in full. <br />CI, Cher and SonsInc <br />By �Eza� J <br />Printed Name��q�L{ 06 le —ens k", <br />Title <br />Address (} 13DZ 7 7 8 <br />NOTE: If this instrument is executed by a corporation, it must he signed by (in officer, and if executed by a <br />purt►rership, it must be signed bra a partner. <br />