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% VIM , ,+ ,C f� �s � �y / f i O Pine StreetBoux 49 <br />' �allfal _ Cieci;0t, MiV Ei53f)tl-fi59h <br />is 1 +�.� � ' �W. SEUVER W/ TER Nice 763.26P-0430 <br />fax 7&3.2$2•(k1:3? <br />U-CEIPT AND WAIVER OF MRCHANICIS LIEN RIGHTS <br />Dated: <br />fire undersigned hereby acknowledges receipt of the sum of <br />CJREC�� MY Olin, <br />1) as partial payment for labor, skill and material furnished PSGf/ <br />2) El p payMnt for all labor, skill and material famished or to be furnished (except the sum of <br />$ __ retainago. or holdback) <br />3) as full and finat payment for all labor, skill and material furnished or to be furnished <br />to the following described roai property: (legal description, street address or project name) <br />and ford alue-teWved hereby waives all rights Acquired, by the undersigned to file or record meelianic's liens against <br />said ref jl property fnrlabor, skill ormaterial furnished to said neat property (only forthe amount paid if Box 1 is checked, <br />and exFpi for retainage shown if Box 2 is checked). `i'he undersigned affirms that all material furnished by the <br />understgned bps becft paid for, and all -subcontractors employed by the undersigned have been paid in full, EXCEPT: <br />NOTE;-lf this instrument- is executed by a corpora- I <br />tion, it must be signed by an officer, and if <br />' executed by a partnership, itmust be signed <br />by a parbier. o_._�...� <br />E <br />(Addreps) <br />r p, <br />i� <br />1 <br />, <br />