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IN TH$ CIIiw,UIT ~[Arl' OF THE JWICIAI, CII~[JIT OF FIURIQA IN A8D '
FOR ST. I~IE QOL~Ti'Y. CIVIL ACTION.
CASE NO.: 80-58 CA
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B T. BUITAE'i17~
Plaintiff,
vs.
FIARIDA POf~t & LIGHT ~~ANY ~
Defendants. t
NO?PICE OF LIIIJ FOR
OOMQII~SAPIQ~1 Aid? MEDICAL
ffi~:EITS OF' THB ~ AOCIDF~
AND Il~IDII~TIITY OOMPANY
4
S
The ~ AOCIDENT AND INDE~TIi'l'Y ~~ANY, aS the Worlallen' s
Compensation Carrier, of Huston's Office Supply, by and through its iuider-
signed attorneys, and pursuant too Florida Statute 440.39, hereby gives t
i
Notice, that BF.Eif1AIiD T. BUtTAFtXXJO, was in the course and scope of his
employment when he was injured in an accident and stly resulted in
his injury at the time and place alleged in the Plaintiff's Canplaint here-
tofore filed in this cause. The Hartford Accident and lndeimity Company
has paid various to or oci behalf of the Claimant, BEE~TAIiD T. BUITAFZAOD,
i for-canpensation in medical benefits and further gives notice that they have ~
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i continued to make such payments of com~sation and medical benefits and
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will expect to make further payments in accordance with the Florida Worker's
Ca~satian Act, Chapter 440 of the Florida Statutes.
t
Wf~ORE, the HARTFORD AOCIDflJP & Il~Ei~T1ITY OOMPANY, prays that ;
this Notice be recorded and that the same constitute a lien upon any recovery
by the Plaintiff for the full aim~ait of the benefits which have been paid
in the past and for the full amauit of the bermsfits, which may be paid in
the future, pursuant to the Florida Worker's CcYt~ensation Act.
I I~32EBY C~IFY that a copy of the foregoing was sent by Certified
Mail, to MIC~~iE[, P. I~IIAK, ESQ. , P.O. Drawer 3351, 211 S. and Street, Fort
Pierce FL 33450; (~JOIi~ H. MDSS, ESQ. , P.O. Boa 3406, Vexo Beach, FL 32960
this ~ day of June, 1980.
LAW OFFICE NK G. CIBUTA
~ 4~396~1. 1651 Fo P
~ ~ ~ ~ Plaza 1 1 - 'te 200-D
P FL 33401
~ ~ ~~~a~'``, 30 /68 -3360
fir.
Rtcoas vES~~n__ -
E~ BY
L,?wOcfrcE.c~ ~~c~3 PaGE (.rlJt/ ERAr1K c. cIBLiIA, JR.
FRANK G. CIBULA, TR., PLAZA 1551,SUITE 200-D, 1551 FORUM PLACE, WEST PALM BEACH, FLORIDA 33401, PNONE X305! 6R4-33b0