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. 4'~'~'2~1 - ~ / ru? un Maw?w~' RAMCO FORM 1205'e urr u?w. rs naa ~l~tm ~t~en of ST. LUCIE } Before me. the undeni ned authority, personal) a MICHELLE PETERSEN g Y ppeared who, being duly sworn, says that he is tM lienor. herein o? the agent of the lienor herein, CURTIS ELECTRIC CORPORATION lLisnor's Name) 641A Tangelo Terrace, Fort Pierce, Fla. 33450 (Usnor's Address) RAYMOND ZABAWA and ELDRED G. MILLER, and that in pursuance of a contract with , individually, and as officers and owners of R.Z.A.M., INC. lienor furnished Tabor, services or materials consisting of: (Describe specially fabricated materials separately). labor and materials Lucie on the following described real property in .............J. t.~...-......................................................-......County. Florida: (Describe real property sufficier>tly for identification, including serest and number, if known) 3200 North U,S. 1 Fort Pierce, FloridA 33450 • and more fully described on attached Exhibit "A" R.Z.A.M., INC. owned by Eighteen Thousand Three Hundred Eighty- ofatotalvalueofFiVe and 23/100 - 18 385.23 ........-............8e'tfars ls of which there remains.,~~paid s.1? '.700' ,for which amount he claims a lien on the above described real property. i He further says that lienor furnished the fiat of said labor, services or materials on - October 12 79 December 31 79 79........... and the last of the same on.....-.......-......-...--............. ,19....•-.---• and (if the lien is claimed by one not in privity with the owASri that the iisnor served his notice to owner on lienor in privity with owner . ~9....-•----• br-------..................-----.......-------.........-.......-............................-...................- , (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 ......................N~A--..............................................-.......-.......................---...-.............----•- ~ icontractor) on.......-•--------.-----•- ---.....--•---------------•--................19.-........,by.........----...............-•--•---•-------..........-...................., (Method of Service) and additionally, (if the lien is claimed by one not in privity with the wbcontractor) that the lienor served a copy of his notice to owner on N/A (Subcontractor) l ~ (Method of Service) - CURTIS ELECTRi CORPORATION ~ ~iYr ~ ~j . e ~ 8~1~' iy1L` M.~• ~ 7 .ly.... ..l tip, Secretary-Treas rer Sworn to and subscribed before mitl~ts.- 26th .___..--~+Y o~.,~ .Y.- FR~?!$rY.e..... ................19- 80... . 3z~ ~ ' ~ ~ ~ .~~Y Public € Add pss`rr~~~~ St'~1ra,~'o- ,'~I?`~©rida °at Large Suite 208. Citizens Federal Bldg. ' • My co~sion expires : J1Ir?e 5, 1981 8410 S. Federal Hvw.