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PS-2011-00251_0001.tif RECEIPT & WAIVER OF MECHANIC'S LIEN RIGHTS 07/07/11 The undersigned hereby acknowledges receipt of 55.00 for PS20110251 CHECK ONLY ONE as partial payment for labor & material furnished to to Total Fire Protection. as full and final payment for all labor & material furnished or to be furnished to Total Fire Protection. For the following described real property -legal descript /street address /projec WALMART BLAIR, NE, #4568 -00 1882 HOLLY STREET BLAIR, NE 68008 and for value received hereby waives all rights acquired by the undersigned to file or record mechanic's liens against said real property for labor or materials furnished to said real property. The undersigned affirms that all material furnished by the undersigned has been paid for and all subcontractors employed by the undersigned have been paid in full, EXCEPT: CITY OF BLAIR 218 S 16TH STREET BLAIR NE 68008 By: Return to: TOTAL FIRE PROTECTION, INC. 1004 7TH AVENUE NORTH BRANDON, SD 57005 FAX: 605 - 582 -2849 OR EMAIL: apinvoice@tfpsd.com