HomeMy WebLinkAbout0533 FLA. 1Y67 LAWS IIAMCO fORM 120•
ss ~~s.oe
'Yit ~f 't~ert
~ C~l~i ~
~txte of ~losi~x ~ .
~outtl~ of Paln Beach County D b? Outpatient Facilities
8~ior~ nN, th~ ur~rsiQMd auflwrily, personally appearsd. -.J,am~s R. vernex.
the ayenl
who, b~in~ duly sworn, sayi thal 1» is 1hs lienor herein or ~ ~ of ~he lienor he~ein,
Acousti Bngineering Company of Florida
. .
(Lienor s Name) .
• 501 Ardmore Road,~West Palm Beach,~Florida 33d02
whose addreu ~s _ _ _ ,
(lienor s Address)
and Ihat in pursuance of a contracf with C. A. Gardner b Company
P. O, Box_15591, Nashville, Tennessee 37215 ,
lienor (umished labor, services or materials co~sis~ing of: (Describe specially Fabrica~ed materials separately)
Resilient Floorino materials and installation.
,
of a total value of Twelve Thousand Twenty Three and 00/l~lan (s 12,023.00 ~
of which ihere remains unpaid S 722 ~ ~S ,(or which amount he daims a lien on !he fdlowing _
described real property in St. Lucie County County, Florida:
(Desaibe reaf prope~ly suHiciently for identi(ication, induding slreet and number iE known)
See attached legal description.
Commonly known as D~ T Outpatient Facility
Fort Pierce, Florida
i
i
~
! '
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~ Owned 6y Lawnwood Medical Center, Inc. an affiliate of Hospital
_ . _ .
Corporation ~of ~Aimerica
~ Hs (urther says that lienor furnished the first of said labor, services or materials on Apr i 1 5,
~ 78 ' Ju l. Z~• 78
19... and the last oF the same on Y t , i9 , and (if the lien
€ ril 24
is daimed by one not +n privity with the owner) that ~he iienor served hrs notice to owner on AP ~
1978.., by _ Certified Mai 1- Return Receipt ;
~Melhod of Service)
S
ACOUSTI ENGINEERING OOMPANY OF FIARIDA -
y ~ or
` ~ .
; ;
~ _ . .prne `
~ Agent or Attomey i
~
~ Swan ?o and subscribed bsfore me this.........20th..._ _.....~y of September 19 78 . ~
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~ . ~ l~~Ot10A IIT I11~
~ . V : ; ~ M ~v r~ !N~ _
~ %%rn I!/t1/lIl!!~7// ~~r~~~~~rrJ /~y: Betty ,~ane Ba~tle~' ~-'~~~r~~~ ;
; P . O. Box 2025 • ~i : ~ ~ ~ Q~
? _ West Palm Beach, ,'t~tor~.da 33402 _
~ ~ r 296 ' ,1` : 5~3~ z
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may, I S ~~~,..-+el..~aTM""
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