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IN THE CIRCOIT COURT OF THE NINETEENTH
JUDICIAL CIRCUIT OF FLORIDA, IN AND
FOR SAINT LUCIE COUNTY.
CASE NO. 74-814 - CA
JOHN ROUSER, et al, )
Plaintiffs, )
vs. )
-
PRE-STRESSED SYSTEMS, INC., )
Defendant/Third Party )
Plaintiff,
)
vs.
- )
P.C.J. CORPORATION, INC.,
-
Third Party Defendant.
SATISFACTION OF WORKMEN'S COMPENSATION. LIEN
t
This will acknowledge the receipt of the sum of $476.00
in full and complete settlement of the workmen's compensation lien
for benefits paid to or on behalf of the plaintiff, JOHN ROUSER,
in the above captioned matter.
- - AUTO-OWNERS INSURANCE COMPANY
_ - ,!I
,
! By : ~j
Sworn to and subscribed _ -
before me on this ~5 ~ day
of November, 1978 ~;t_i~~ j•tIF} 'st~CGnDE~
_-,U.,-v FL,..
- - ,
. _ ~ ~f
N.- 7~,~PU L~ i STATE OF FLORIDA ' 1 ~ ~C~ ZQ 1~ • y8
_
.M~i- ~'o~ission'• expir~~~ Pe:t~c•~;4:.. ~ ~ ~
-A X00 E;:_:~ -396
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