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LIEN $[~(J~M~'N..~ ,r~
(Wyo. Stat.§ 29'Ji'-301)" ~ r CLERK
Robert Hill Construction, Inc., herel~y~ffe~'a lien sta~.~..~t for labor and
materials provided to Warren and Doretta Web, Iocat~'d ai"ib?~Box 402, Thayne,
WY 83127, for a job with Robert Hill Construction, Inc., and Todd Hill, who is the
President, located at P. O. Box 3018, Alpine, WY 83128.
1. Name and address of persons seekinc1 to enforce fien:
Robert Hill Construction, Inc., and Todd Hill, located at P. O. Box 3018, Alpine,
Wyoming 83128.
2. Amount claimed to be due and owing:
For services in the amount of $20,022.15, plus interest at the legal rate and attorney's
costs and fees.
3. Name and address of the person against whose property the lien
is fi/ed:
Warren and Doretta Web, of P. O. Box 402, Thayne, Wyoming 83127.
4. An itemized list setting forth and describinq materials defivered or
work performed:
SEE ATTACHED INVOICE WHICH ARE MADE PART OF THIS
DOCUMENT BY REFERENCE AND INCORPORATION, AS "EXHIBIT A."
BALANCE DUE: $ 20,022.15, plus interest and attorney fees and costs.
5. Name of persons against whom the lien claim is being made:
Warren and Doretta Web, of P. O. Box 402, Thayne, Wyoming 83127.
6. Date when labor was last performed or when services were last
rendered, or the date when the project was substantially completed:
Date of last invoice was July 18, 2004.
Lein Statement -- Page I ~I" 2
7. Legal description of the premises where the materials were
furnished or upon which the work was performed:
Unit #5, Lot #13, 25 Barberry of the Platted
Subdivision in Star Valley Ranch, Thayne, Wyoming.
A copy of the contract if available:
DATED this 21*t day of October, 2004.
ROBERT HILL CONSTRUCTION, INC.,
BY'~==T:A~,,. ~: ",9~/?.~-/ Todd Hill, President
STATE OF WYOMING )
) SS.
COUNTY OF TETON )
On this '~1¢ day of October, 2004, before me personally appeared TODD HILL, by me
first duly sworn, who did say that he is the President of ROBERT HILL CONSTRUCTION,
INC., and said instrument was signed and sealed on behalf of said TODD HILL, as President
of ROBERT HILL CONSTRUCTION, INC., and TODD HILL acknowledged said instrument
to be the free act and deed of said business in acknowledging the foregoing Lien Statement.
Witness my hand and official seal.
My Commission Expires:
NOTARY PUBEIC
~tly Commission ~pires ~
Lein Statement -- Page 2 rtl 2
~obe~ Hill Construction
Box
0517
Invoice
Date Invoice #
7/16/2004 3047
Bill To
Warren Webb
Description Amount
2 men framing labor
Dig footings and grade
Transport hoe to sw
Set and pour slab on grade
Credit for concrete
Plumbing bill for underground
Jenkins bill
Electrical materials
My labor
American express for home depot purchases
3/4 poly pipe
2,464.00
1,050.00
100.00
3,105.00
-650.00
1,500.00
1,552.51
132.87
1,125.00
9,541.97
100.80
Total
$20,022.15