HomeMy WebLinkAbout1213 IN THE CIRCUIT COURT OF THE NINETFENTH JUDICIAL CIRCUIT OF FLORIDA ,
IV AND FOR ST. LUCIE COUNTY ~ CIVIL ACTION
CASE N0. 73 - 24 CA
WILLIE ROSS and ROSA LEE ) 30~~•
RoSS, his wife, ~ 3o3G38
)
Plaintiffs, )
)
vs. ' )
)
RINKER MATERIALS CORPORATION, )
and A F~ B CRANE SERVICE, ) ~
)
Defendants. )
)
SATISFACTION OF WORKMEN'S COMPENSATION LIEN
K.'VOja ALL MEN BY THESE PRESF.NTS, that Reliance
Insurance Companies, hereby acknowledges the payment of
Five Hundred ($500.000) Dollars, as full and complete
settlement of the Notice of Lien for Payment of Compensation
and `~iedical Benefits of the Reliance Insurance Companies,
filed in the above-styled case on or about January 19, 1973.
IN LJITNESS ~~EiEREOF, I have hereunto set my hand and
seal this day of ~~1~~ , 1975.
- ~ RELIANCE INSURANCE CO?~IPA.~VY
. _ '
; . . ~
' '
i _ ~ , ~ ~ . ~ i- ~ . .
~
! " ~ ` ° ~ ~ - BY- ~~/.,Gri~? u~Z'CUt ~ _
' - • - ~ ~ ~ = Vern Barc ay
% 'J ~-''C. .
. . - -
F =~TA~E•`~F` FLORIDA )
~ ~ ~ ~ - ) SS .
§ Cb~JNTY OF PAL.M BEACH)
: ~
~ PFRSO'_~IALLY APPEARED before me, an officer duly authorized
k to take acknowledgments and administer oaths, VERN BARCLAY,
~
~ an authorized representative of Reliance Insurance Company, to
~ me well known to be the person described herein, and who
~ executed the above and foregoing Satisfaction of Worlanen's
~ Compensation Lien, and he acknowledged to me that he has read the
~ same, knows the contents thereof, and that he executed the
~ same in the capacity and for the uses and purposes therein
~ expressed.
,
OTA Y P LI tate o F ori a
- at Large
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