Claim by Wulfekuhle Injection and PlumbingCLAIM FOR PAYMENT FOR MATE ; ALS AN ilt LA Ir 4R
I, the undersigned affiant, President of the Claimant, being duly sworn, depose and say that the
following statement is true to the best of my knowledge and belief, and is made of my personal knowledge:
On the dates set forth in the Statement of Account attached as Exhibit "A ", Wulfekuhle Injection &
Pumping Inc. , (the "Claimant ") furnished material or labor for, or performed labor upon, the building or land
for improvement, alteration, or repair thereof, situated upon, or being identical with the following legally
described real estate in Dubuque County, Iowa (the "Real Estate "):
Lots 378, 379, 381, 381, 382, 413, 414, 415, 416, & 417 East Dubuque Addition, part of the Lower Bee
Branch Creek Restoration Project
The items in Exhibit "A" were furnished pursuant to a contract made by the then owner of the Real
Estate contractor, or subcontractor and were furnished by Claimant who is a subcontractor thereunder. These
items were furnished beginning the 4th day of October, 2010, and ending on the 5th day of October, 2010, at the
respective dates, amounts and prices stated in Exhibit "A ", which is a true and just statement of account after
allowing all credits.
The owner of the Real Estate was then City of Dubuque, Iowa, whose last known mailing address is 50
W. 13th Street, Dubuque, Iowa 52001, and City of Dubuque, Iowa whose last known mailing address is 50 W.
13th Street, Dubuque, Iowa 52001, is now the owner of the Real Estate.
There is now due and owing to Claimant the principal sum of $ 7,643.52 with interest thereon at 18%
per annum from the 15th day of December, 2011, for which sum and interest, together with costs and attorney
fees as provided by law, Claimant asserts a claim pursuant to Iowa Code Section 573.7.
I certify under penalty of perjury and pursuant to the laws of the State of Iowa that the preceding is true
and correct.
Dated
STATE OF IOWA
DUBUQUE COUNTY
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Lee Ar Wulfekuhle, President
Wulfekuhle Injection &
Pumping Inc., Claimant
27657 Highway 52 North
New Vienna, Iowa 52065
On this day of , 2011, before me, the undersigned, a Notary Public
in and for the said State, personally appeared Lee A. Wulfekuhle, to me personally known, who being by me duly
sworn, did say that he is the President of the corporation executing the within and foregoing instrument, that the
corporation has no seal; that the instrument was signed and sealed on behalf of the corporation by authority of its
Board of Directors; and that Lee A. Wulfekuhle as President acknowledged the execution of the foregoing instru-
ment to be the voluntary act and deed of the corporation, by it and by him voluntarily executed.
JGL;_Hi ,, ,, J;u,_:k C r
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■EtnnUroi 75 8',15
My Goinin,
Notary Public for the State of Iowa
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