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(NORTHWEST <br />NORTHWEST ASPHALT, INC <br />1451 Stagecoach Road * Shakopee, MN 55379 <br />Phone 952-445-1003 * Fax 952-445-1056 <br />Receipt and Waiver of Lien and Bond Claim Riehts <br />The undersigned, CASTLE ROCK CONTRACTING acknowledges receipt of payment <br />from Northwest Asphalt, Inc. or its subcontractor (if applicable) in the amount of <br />'% Oa'{-G <br />$ PA,Ai U— L/ INAL ayment for all labor, materials, equipment <br />and services provided by the undersigned through the date hereof for the completion <br />of project listed: <br />NATURES EDGE BUSINESS CENTER ** <br />NWA JOB # 1255 <br />To induce Northwest Asphalt, Inc. or its subcontractor to make this payment, the <br />undersigned represents and warrants to Northwest Asphalt, Inc. and its subcontractor <br />that the undersigned has fully paid any and all of its laborers, suppliers and <br />subcontractors for labor, materials, equipment and services provided for the Project <br />through the date hereof. <br />In consideration of this payment, the undersigned waives and forever releases <br />(1) any mechanics' or other lien claims it has or may have against Northwest Asphalt, Inc., the <br />Project owner or the property upon which the Project is located, and <br />(2) any claim it has or may have against Northwest Asphalt, Inc. and Northwest Asphalt, inc.'s <br />sureb.1 under the labor and material payment bond, if any, provided by Northwest Asphalt, Inc. <br />for the Project If this is a partial payment only, this waiver release is effective only to the extent <br />of the payment received. <br />DATED: <br />BY: <br />ITS: <br />Failure to return this lien waiver may delay future payments. <br />Page 76 of 201 <br />