HomeMy WebLinkAbout0114 - This instrument prepared by:
' DONALD B. MEDALIE
Attorney at Law
nw~o~ surms 201 S. E. Second Street
Fort Lauderdale, Florida 33301
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~Il~~m vE ~~en
~tdtt QE FLORIDA
~ouncp ot----------------axo~Bn............__..............
Before me, the undersigned authority, personally appeared: I
DONALD B. MEDALIE,Attorney for ALL STATES STEEL,Division of UNIVERSAL STEEL ~
,
_.and..G+ONSTRUC'CIODI..bSATERIALS,ZNG_.....----• ~
(Name ot Lienor, Agent or Attorney)
200 N.E. ?th Street Hall nda e Florida '
.
(Residence os Business Address of Lienos) ~
bcing duly sworn says that in pu~suance oJ a contract with .___V~~~.--Eot~f---~'e~ge~so~•:a}td--~~oft ~
(Name of Lienor's Em ploye~ or person with whom he cont~acted )
pcr
f
ormed labor and
hc ~'u~nished } the f ollowing se~vices and (He~e c~escribe the labo~ Q~ sesuices performed os
materials
~
materials ~usnished. Describe specially fab~icated materialssepa~ately)
&~rttctura~--~teel:
G
FtlFO aN. EcaRDEO ?r'
- 'S~=L~UCi~tOtfftTY.EIA._----
ROCEF P~~~TRAS
CLERK Cf,iCUlT COURt -
-RE~t1REY~lEF#sE6 `
~
:
S~-~6-----1~-~.-At+l-'.T3...__..
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rpe~7CQ 264486
to the value ol..."'-.._Y~{_RT_(.w7~7'G~"""""""-""""""""""-'•-"""-"""'-"""""'«"...'•""'-""""'
(State cont~act price) -
;
ort the following desc~ibed ~eal property. (Describe real propesty sufJiciently /o~ identification, giv-
ing sheet and number if known) :...~t__.38-j---6eetior3-•-~4-~ ~'ot~s~ip---34-; itange---39-• E-°--
- St...~,uc~~_.~unty,.Elorida----------------•--
- ~
~
ou~ned b Vann Cott,~FerqesQ~__~~d..~xo.~~
. l'-•--------•-----
(Name of owne~ against whose inte~est lien is claimed )
o whose inte~est in such ~eal so e~t u._._ ~
a.., ~ p Y ~ee--s}~ng~~
(State owne~'s inte~est, as f
ee rim ple, lif
e estate, leare-hold, i/ known )
a
~ labo~
He fu~the~ says that the last item of se~vices was{ pe~formed l on the.....29th..__,.. ;
a materials f usnuhed J
daY of------•--------_._.August--------------------, 19..73-, and the fir~t item was aupplied on '
the _21st dey M~e_h ,19y3,and, of the contract price stated, the~e is unpaid
the amount of------------------~1,_85.8.~6-.__..._...-•----...----•--......_.....__~.~-- :
(Stute amount unpaid)
for ,r~hich amount he claims a lien on the real psop ~ty hesein d . ~
~?~r~,,~ .
, ~ ? " . ~
~ ~~a- , o a 'd"$~ e 'i-----._...--`-'=~
•
. e(Signatu~e o/ Lieno~)
?t • . ~ Attorney for ienor
. ~ .
o-a5'Hbtc?~~ed and sworn to be/ose rrie thu..__.24th._._._._._.da~~ of.......Sep~~ 19....~3
.~y . - .
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' •.ClQYARY PUalIC STATF OF iIARIDA AT URaF ' 1~{t";
ti• ,
. Mr tOMMiSS10N EX~IRES M~R. 21, 1977 ~ Public
' j ~IOED?HRU GENERAL INStJRAN[~ UNDElWRI~tK
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My Cortmission expi~es (CountY) (State)
~ 8001(~~9 PACf 1~4
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