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<br />PARTIA~ WAIVER OF LlEN '. " ,
<br />
<br />,To AI' Who.m It May ,Concern: ,
<br />
<br />WHEREAS. the undersigned hasb~Em employed by {A}
<br />',Cit.y of 'Arden Hil~'s,
<br />
<br />to.'furnish I~bor and materials for (B}'
<br />Exte,rior Ma.sonry. Restoration
<br />
<br />work,
<br />
<br />undera contract (C). '
<br />
<br />'. .
<br />
<br />'fo.r.the improvement of the premises de~c.rjbed as {L?}
<br />Arden 'lIills Cit,y"Hal'l
<br />
<br />in the
<br />
<br />(";ry
<br />
<br />. (CitY-Vi,Hage) of A r d e'n Hi 11 s
<br />I State of
<br />
<br />, Cou nty of
<br />
<br />Ramsey
<br />
<br />Mi'nnesota
<br />
<br />. ofwhJch
<br />
<br />Ci ty of Arden. Hills
<br />
<br />IS the owner.
<br />
<br />NOW, 'THER.EFORE~ t~js 16
<br />
<br />day'. of
<br />
<br />June
<br />
<br />',' lf~ 20,0.9
<br />
<br />I _,
<br />
<br />.for and in con~ideration 'of-the ~um of tEl' $ ~ 1 , 7 5 0 . 00
<br />Dollars paid simultanequsl,y,herewith. the receipt whereof is hereby ack~ow!edg~dby the undersigned, the under:.:
<br />sigr)ed does hereby waive and rel'ease to the. exten~ ,only of the afore~aid:'amount,. a ray .lien rights ~tQ, .or claim of lien .
<br />with respect to and' o,n said abovEi-desc;ribed premises, and the im,prQvements thereon, and on the monies or other .
<br />,considerations due or to become due from the owner, by virtue of said contract, on account of labor, services,
<br />materials, fixtures,' apparatus or machine,ry furnisheq by,the ufldersigne<;i to or for the above-described premises,
<br />b.ut only to the extent of the paym~nt aforesaid.. .
<br />
<br />A. J. Spanjers 'Co.." Inc.
<br />
<br />fF} .
<br />
<br />(Name of sol~ ownership, corporation Or partnership)
<br />
<br />(SEALj
<br />
<br />(Affix corpo....ate
<br />
<br />seal here)
<br />
<br />
<br />(SEAL)
<br />
<br />TITLE: '
<br />
<br />President
<br />
<br />,jr~jSTRUCTI,ONS FOR PAiiTIAL WAfVER
<br />
<br />(A) Name person or firm with w~om 'you agreed to. furnish either labor, or services, or materials; or both,
<br />" (8) Fill in nature and extent of work; strike the word labor or the word materials if not in your contract.
<br />{C)~f,yo.u have more.tl:tan ene,contract on the same premises. describe the,eontnu:t-by number-if available, dat~ and extent ofyYork,
<br />(D) Furnish an.acc~rate enough description of the improvement and tocadon of the premises so that it can be distinguished from any otherpropetty.
<br />(E) Amount shown ~hould be the amount actually. received' on that date.
<br />(F) If waiver is f~r a corporation, corporate name should be LAsed, corporate seal affixed aod' title of officer s,igning waiver should be set forth;- if waiver is fo~ a partnership, the partnership name should be used,
<br />. . partner shooJd sign 'and designate himself as partner. '.
<br />
<br />DeSigned By The .
<br />, 'Construction Industry Affairs Commi,ttee (C1AC) ,
<br />
<br />TOPS 3459
<br />LITHo J~ V. S. A.,
<br />
<br />@ COPYRIG'~T 1973. TOPS BUSINESS FORMS. CHICAGO, ILL.
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