T!JDI!iaPD 1=fa1`.fRU~TION TE~~1-51~-653-61~:-~' Tan 20'UO 1A:26 No .011 P.05
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~	DWNER
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t~	ARCHITECT	

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CONTRACT"OR	sr°• 99ry
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CONTRACT DATE: FE1~111Yt1' 8. 1499
L. J
PR:OIEC1', R~ $ RpAMFiCIQ~S T4 ~ CfY ~4~,~AAMDt
Ul..n•le, adclressl ~ 114ti1 S1tt~T ~Y~• ~ 7th
r I~ ~~ ~~ ~ CONTRACT FOR: fli45E 3 Rf1~YAT]triS
100 t#IPI S1RF~T I~RftWILEE. Y1( 78f17B
wale o}: TE7f/lS
Colnty of
The urdersi,ned, pursuant to Artic3e 9 of the General Cond;barr of the Contract for Construction, AIA Document
n.201, I-n:reby certifies that to the best of his knowledge, inlormatiarl and hehef, exrrpt as listed beivw, the Releases
or Waivers of Lien attached hereto include the Contmdor, all $vbcon tractors, all xuppliers of materials and equip-
mers, ar~d all perlarmlrs of Work, labor or services who have or may have liens against any proptrsy of the Owner
arising; in any mannM out of the performance of the Conran referenced above.
EXI.EPTb71'J'.i: (I( none, Mile "None". If required by the Owner, the GmVactnr shall furnish bond satisfactory m the
4;1wlu::r Ic~r each ezceplion.l
ARCHITECT'S PROJECT NO:
Flea annbrt ~: ?~ - 2 D '7. a ~ _
tr
Fl7E PERII~i DDYi~:
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fm,c~ ~ 2a~O37onl
6-,.g EtsA~.'.c
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SU,sP'OR'EilsC. bbCUMENTS ATTACHFO HERETO. ~1~ ~OJN NACTOR ~,~,n,; -fed Ren.Izc,IS
T. C[rnhir.:be"s Release ar Wasver of Liens, condi-
tional ugNlw receipt of Einal payment.
2. Se~.aaraLg It4feases or Wwven of Lrens fmm Sub- Address,
eemtr.rctt+rs rend material and cvquipmen! sup-
pliers. to the extent required by she Owner, ar
cclmpanied by a liss thereof. ~ ~i~~¢~e~
dye //j
""""""""^"'•"'*""•••••••«~ Subscr~laed and swum lu before me this
MERLE H. 8TEWART,+, c / , f ~L ~ ~r^JOd
* `~ * MOTMT-UBIIC STATE OF TE%0.4 ~ T ddy Of /~•~~ / -#~
~'EV MARCM t7, 2004 II r ~'
~., r....ssa>marorrrslsaa,..ws.n tJOta ry Public I~/ 'v`
~ My Car+lml55inn Cxpires: ~-- 17~ '1 ~, Il /
~~~ (,,I,UTION: Y®u should uee an arlglmal A+tA document which has thla caution printed in red.
Itst t~rigina! aesturea that c hangea will not be otucunad as mey occur whr9n daeumenta are reproduced.
{t{ Dl.ICU AxIaa'i G7taA • CDNTRACT4R'S AI'i ll){wT OF REl£ASF Of LIENS • r\1•x4 1970 EDITION ' AIAFa t1N( pAGC
b S9'0 • THE AIMERIC'AN IN 5T ITUTE OF ARCH TECTS, 5715 NEW YO Rx AVE, N\V N'Aq IING94)N, fL C. 2000n
IAygple/0: UMI®rluM phRrocu^'Ine vlele W U.B. I.+hn+snt leas YM klbgecr ro legal prvx<vUon.