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<br />
<br />Fv? customer nampd on the reverse sick v. :' yOLl tn pre. NFl t '1,,:~ti\\;ation ::f the specified addi'ess, of matwt'1I~'
<br />specll:ed on the reverse side and/or ell >,(:'-18d 3ketch Of sr,ecltCJt'cT sneet. By tne acceptance at this crde:/OLi
<br />agree to protect and Indemnify said cListonr:~r :llld Sears. Hoerluck ,':1l1d Co.. from all claims or demands on accow't ot
<br />IrlJury to persons or property oCCUrring dUring or as a resuit of said Installation You are responsibie for payment oj all
<br />contributions and taxes due under and for all requirements of Federal and State Social Security and Income Tax 1:1WS
<br />with respect to any payrolls incurred in performance of the work herein specified. These provisions do not in any way
<br />amend or modify any other agreement that you may have with Sears, Roebuck and Co. On completion of the job, you
<br />agree to obtain the customer's signature on the Letter of Satisfaction below, and execute the Waiver of Lien, submitting
<br />both to Sears, Roebuck and Co" along with your invoice.
<br />
<br />WAIVER OF LIEN
<br />(TO BE SIGNED BY CONTRACTOR)
<br />
<br />To Whom It May Concern:
<br />
<br />I, the undersigned Contractor, having been employed by the customer whose name appears on- the
<br />reverse side, do hereby certify that the work referr~d to on the re,!~rse side has been completed to
<br />the custoiD.fi~~.9_tj~i?c:;!ioQ I hereby acknowledge receipt ot PAYMENT IN FULL, and hereby waive and
<br />reililqulsh ail liens and ;-:11 rights and claims of liens which L the Lindersigned, now have or rnay hereafter
<br />have for labor 01 mate!:?' icirnlslircC I the underslqllecl certify that all the \fork. ('ud matenais
<br />
<br />iurnlshed, if any IJV arl'! mh"I' O:lI't" " C,' tie' lID'):: the clrder c.! tne
<br />
<br />h~~c
<br />
<br />~u nv
<br />
<br />or rnaterial suppl\c( c~airY':lnCi Ih2. ~';qnt. tC) tllc JU.2,!1 a lien
<br />
<br />
<br />:i,':] which may
<br />. mechanic
<br />
<br />lor Furthci, i the' ,t<1(Jr-:rr...1i!F<1 ::";rf:F Ir, C~i: !:'P the 0:''''1'\1 ,d(iiiSe ,v
<br />
<br />he tiled 3CF\lnst tnt? on:lr1:c"8t, 1":+'11': Ce'18,:3F' ,)\, a::\
<br />
<br />1\/url~
<br />
<br />IilS
<br />
<br />'1 t. i i urthcr
<br />
<br />agree lo pay anv and all ooS1S, exoellses anO ;jttOri 1tlV '(-,CS incurred OJ tile custO:!I(~i Ii" nOSE ,;eJY"
<br />appears on the reverse Side and/or Sears, KoebucK 31leJ Co, tram and against .allcosts and expenses
<br />arising from or by reason at such lien or the release or dlsc.liarge at such liens.
<br />
<br />Signed and delivered this
<br />,.,....
<br />
<br />day of
<br />
<br />19
<br />
<br />Signature of Contractor
<br />
<br />CERTIFICATION OF COMPLETION
<br />(TO BE SIGNED BY CUSTOMER)
<br />
<br />TO: SEARS, ROEBUCK AND CO.
<br />
<br />The installation of
<br />ordered by me has been completed satisfactorily
<br />
<br />NOTICE TO CUSTOMER: DO NOT SIGN THIS STATEMENT UNTIL THE INSTALLATION IS SATISFACTORILY COMPLETED.
<br />
<br />Customer's Signature
<br />
<br />Date
<br />
<br />.
<br />~'."
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