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HiQRTHWESTJ <br />NORTHWEST ASPHALT, INC <br />1451 Stagecoach Road * Shakopee, MN 55379 <br />Phone 952-445-1003 * Fax 952-445-1056 <br />Receir:)l a-n-td laiver of Lien and,Bond Claim Ric;hts <br />The undersigned, Sir Lines -A -Lot acknowledges receipt of payment <br />from Northwest Asphalt, Inc. or its s1kontraCtOT (if applicable) in the amount of <br />IT o pt+51 <br />$ i ? 335 .75 as PA L .,FINAL 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 Canter 3rd Addition <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 />surety under the labor and material payment bond, if any, provided by Northwest Asphalt, Inc. <br />for the Project ff this is a partial payment only, this waiver release is effective only to the extent <br />of the .payment received. <br />DATED: August 15, 2023 <br />BY.- <br />WRIT. -,I• •-.- •-s <br />Failure to return this lien waiver may delay future payments. <br />Page 80 of 201 <br />