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1 <br /> MALLEY���- <br /> NPAVINC <br /> INCORPORATED <br /> 8800 13th AVENUE EAST <br /> SHAKOPEE,MN 65379 <br /> PHONE(952)445-8615 <br /> FAX(952)445-0355 <br /> www.valloypaving.com <br /> i I <br /> I <br /> RECEIPT AND WAIVER OF MECHANIC'S LIEN RIGHTS j <br /> i <br /> Dated 18-Aug 2015 <br /> The undersigned hereby acknowledges receipt of the sum of; 1 $15,895.06 + <br /> CHECK ONLY ONE <br /> 1.) ( ) as partial payment for labor,skill and material furnished <br /> I <br /> 2.) [ ) as payment for all labor,skill and material furnished or to be furnished <br /> (except the sum of$ retainage or holdback) <br /> 3.)[Xj as full and final payment for all labor,skill and material furnished or to <br /> be furnished to the following described real property:(legal description, <br /> street address or project name) <br /> I <br /> Full Payment of$15,895.96 will be released to Stapf Concrete Construction i <br /> as Full and Final Payment for the 2015 Centerville Overlay Project when <br /> full payment Is received from the City of Centerville <br /> and for value received hereby walves all rights acquired by the undersigned to file or <br /> record mechanic's liens against said real property for labor,skill or material furnished , <br /> to said real property(only for the amount paid If Box 1 Is checked,and except for <br /> retainage shown If Box 2 Is checked). The undersigned affirms that all material I <br /> furnished by the undersigned has been paid for,and all subcontractors employed <br /> by the undersigned have been paid In full,EXCEPT: <br /> I <br /> I <br /> Sta f Concretet Construction i <br /> B <br /> i <br /> NOTE: It this Instrument Is executed by a Cp(-30.4- <br /> corporation,It must be signed by an oHtoer, (Address) i <br /> and of exectued by a partnership,it must K ��llz rS 3 3 7 I I <br /> be signed by a partner. <br /> 'TM�tS t�ao•1we.�r t5 er.tor•s�1� t:r��.4ir\�...x.'r' tpv� � � <br /> AST"F Qunw.a +a Cab riga a5 1.+J� �+N<-. f e i� o v. <br /> wt- is �onpre.A lJ� '(�lya+C-� ldlrrwj C�t�-SYto�.14 'f'o Vari� �, I <br /> Ioti,Snt:t:YCUlat[ G1..eeltr h1rS ,,,n hor.oN.,�tt Gq-t( �pMri� '$} p AVETERAN OWffEDCOMPANY <br /> Affirmative Action/Equal Opportunity Employer R L•�b'i�`1 t LZ <br /> t ' <br /> I <br /> i <br /> i <br /> 30 <br />