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4 7 7 9~ RAMCO FORM 120K
itA 1177 MECW1NIq'
ItEN IAYr. fi 717.0E , .
_ _ .
1~ V~iV~
8sfors me. tM undersigned authority. personally appeared R01181d• • A. BOChen ek
who, being duly sworn. says that he is tM lienw herein or the agent of the lienor herein.
Bochenek Ceramic Tile
• (lienor's Name!
whose addressis...607--5-.•-•Market Agenue=••.Fort Pierce, Florida 33452
_ (Uenor's Address)
and that in pursuance of a contract with...Cata..-C0118t1'1,iCti On Corporation; Louis Cata
....-------and...xo~i.~..~?oa............: . .
lienor furnished labor, services or materials consisting of: (Describe specially fabricated materials separately!
Tile and Labor in Tub Room and Shower Room
on the following described real property in..........s-~.~..-IuC~ e
...........................................•-••----Counq. Florida:
(Describe real property wfficiently for identiFication, including street and number, if known)
Lot 22, Rloc'd 26? Sectio:: 24. A11?o known as 853 S.E. O'Donell Zane;
Port St. Zucie, Florida 33452
Cate Construction Corporation; Zouis Cata and Louis Noa
owned by
of atotal value of Seven--Hundred $i~hty Five and 85~10~llars (t --•••'T85-'-85.•--•-•----•--•--1
of which there remains unpaid S..-....78~ ~ 8~ for which amount he claims a lien on the above
described real property.
- Janua
He further says that lienor furnished the first of said labor, services or materials on
2 80 - Janua 16 . ~ 9 80 ,and (ii the lien
........................................19.........., and the last of the same on.....--...-..
-
is claimed by one not in privity with the owner! that the lienor served his notice to owner on ..F et?-~'~.a-?'.~• - • • • - • • - • • -
.................................~9..80..by.......Certified ?yiail...............------......._...............-..-....----......-....,
(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........Cata Construction-Corporation-•••---••••:••••••-••_•
(Contractor)
on... FPbruar~.....1.~ 19.80.... by.-...-..~ertifi ed.. M~~7............................----
- - (Method of Service)
and additionally, (if the lien is claimed by one not in privity with the subcontractor) that the lienor served a copy
of his notice to owner on
~ ~ (Subcontractor!
_ .................19...........by._.........-......................................---.......................
on - - -N
'i (Method of Service)
F,~tr, n1c Bochenek Ceramic Tile
57. WCtF CvU; Y.i; n. Lienor _
CL£R~ C fiCL~IT C; U3 f I
qt,
Sworn tb and subscribed before me this-........._.......~ _.__..-_..-_day f - " - . • • - • • • • • • • -
K a
`4 ...~t........
7ltis Inslru?ni•nf prr~porrd b~•: •~'.~3 i'' `
;ldihi~ss Notary Public. St~l~ ' '
Commission ~ • .
anor ~]GU P~tiE1~~ y .