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CONTRACTOR'S LIEN STATEMENT
FOR
SALT RIVER ROOFING, INC.
OOô1.S8
Max Wade, doing business as Salt River Roofing, of Afton, Wyoming, for his
Contractor's Uen Statement, provides the following Information:
1. The name and address of the claimant seeking to enforce the lien Is:
MIIX Wade, doing business liS Salt River Roofing, 151 Circle Drive, Alton,
WY 83110.
2. The amount daimed to be due and owing Is: $30,310.00, including
retalnage.
3. The name and address of the person against whose property the lien Is
filed Is: Brandon 8ent/ey, 2615 W. 151705., 8uffd.'e, UT 84065.
4. The legal description and address of the property to be lIened Is:
.. LOT 102, Valll-Vu Golf Villas of Lincoln, County, Wyoming. The property being
lIened Is located at 102 Valll-Vu Golf Villas, Lincoln County, Wyoming.
5. An Itemized list setting forth and describing materials delivered or worked
perfonned Is attached to this lien statement In the form of a Proposal dated
9/29/08, and Invoice No. 639 dated 10/21/08, Itemizing Invoices submitted by Salt
River Roofing to Bandon Bentley, 2615 W. 15170 S, Buffdale, UT,84065.
5. The name of the person against whom the lien claim Is made are:
Brandon Bentley, 21U5 W. 15170 S, 8uffd.'e, UT 84065.
7. The date when labor was last performed or services were last rendered
Is: October 20, 2008.
RECEIVED 1/16/2009 at 2:31 PM
RECEIVING # 944724
BOOK: 713 PAGE: 188
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
8. A copy of the Contract Is attached.
0001.89
¡L/~.
DATED this LI- day of January, 2009.
/JIN R ¿J~
/Max R. Wade, dba
Salt River Roofing
VERIFICATIO~ AND ACKNOWLEDGMENT
STATE OF WYOMING
COUNTY OF )...'Y1Cð/C\
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) ss
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Max R. Wade, being first duly sworn upon his oath, deposes and states that
he has read the foregoing Contractor's Lien Statement and verifies that the
statements contained therein are true to his best knowledge, Information and
belief.
DATED this IV day of January, 2009.
~/ÆúbJ,
/ Max R. Wade
The foregoing was acknowledged before me by Max R. Wade on this 1~ day
of January, 2009.
WITNESS my hand and official seal.
(SEAL)
.....
HEIDI L. CLAYE - NOTARY PUBLIC
County of State of
Lincoln Wyoming
My Commission Expires February 15, 2010
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N ary Public
My commission explres:~-dO/Ó
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Salt River RlJ1mg '. . . ~
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ORIGINAL
~ IN u.e.A.
SaltRivcrRoo~c.
32 WyomiDs HIøhwaJ.. ,
151 Cåde~.
Alton. WY 83110'.
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Invoice
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BWTo
Ka,Coøcepa
JUchard Porter
PO Box ð09
Santequin. UT 846SS
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P.O. No. . Tenna ProjIct .
QUIftIIIJ DesaCptlOft Rate Amount
3-uak prcounc coado bun.., Asphalt IIIfDøIe 30,310.00 3D.310.oo
root
.
.
. , Total 530,310.00
p,..,
"'. -30'....5..]084
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Salt Rluer Rooftng Inc.
151 Clrdo Dr. Afton WY. 83110
Phone and Fax (307)885-3084
OOö192
Kenneth S. Cohen
Attorney
Dee 24, 2008
Dear Ken:
I 8m taking the liberw to fOIWard the infonnatiQn to send a
letter prerequisite to filing a lien. I hope you will be able to handle
the matter for us but if you cannot, please let me mow right away so
I can make other arrangements a$ it is important to get the letter sent
soon.
Please find attached the bid proposal and the invoice for the
work. The owner's name is Brandon Bentley, 2615 W 15170 S.
Bluffdale, lIT 84065. The property is lot 102, Va1li-Vu GolfVUles,
Afton, WV. The structure is a tri-p1ex, the addresses being 168, 172
and 176 Johnny Miller Drive. The last day we worked on the projed
was Oct 20.
Sincerely,
~¿)~.
Max Wade, President