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4 ' '13 ~
ru? »n MEC~u?w~cs• RAMCO FORM 120yi
uEw ~Aw. rs naa
t~i~tim ~t~~
of Broward
Before me, the undersigned authority, personally appeared .....HOWard $Ct1nlCC~er
who. being duly sworn, says that he is the lienor herein or the agent of the lienor herein, .
..................-Symons..Corp.................................................................
(lisnor's Neme)
whose address is .........................150_ Brya n - Roadr. • •Dania,-,.Fla.....33004....................
(Lisnor's Address) • ~
1
Marbilt Inc.
and that in pursuance of a contract with , .
lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately)
t
Symons Steel Ply Formilming systems, etc.
St. Lucie
on the following described real property in ....................................................................................County, Florida: #
(Describe real property sufficiently for identification, including street and number, if known)
Seascape Condominium, 2400 S. Ocean Drive, Hutchinson Island, Fla.
-
Hutchinson Island.Limited••Partner$hip-
ownedby - - ,
of a total value of ...SeVenly.t'•.lg'l, )t..CI),QI1SaJ1(~..~?~US dollars IS -ZB.-~.-QO---.----....---)
' 58,16L,68= as of 9/30 0o
of which there remains unpaid 5 .................,~~rfwhich amount he claims a lien on the above
I -
described real property.
~ He further says that lienor furnished the first of said labor, services or materials on .............January............. ~
22 79 continuing
79.........., and the last of the same on...............................-........ 19.......:... and (if the lien
anuar i
is claimed by one not in privity with the owner) that the lienor served his notice to owner on J............y ~
`r s
-........24 ~9.~.9...,by---.certified.....mail.....................................--------•- 1
(Method of Service)
and, (if the lien is claimed by one not in privity with the contractor) that the lienor served a copy of his notice to
owner on _ i
l ~
~ (Contractor) '
( (Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy I
1 •
of his notice to owner on
(Subcontractor)
fllEO At+_~
.:,r.JED -
on ........._ST. WCIe..~.:.:.ti..;.FLA: -.................19........... by.
(Method of Service)
RECC'. - _ .
OEC Il 10 35 A1M'"I9 r agent
~ S .mons Cor ~ '
~.....y .p................. r.,~.., .
' L~If3nd
4b~9b13 - -
.s:~F~., .
Sworn to and subscribed before me this ...............4.... _......._.......day C 1'Yl}Jer_ ' • - ...:::.;.%..r:..,...18....
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