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M H» yttwuwCS RAMCO FORM 120+4
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saf«e nor. the undKSi~ned autfiorigr. p«sw~ally appeared i.l l . ~roim
who. being duly sworn. says that 11e is the lierlor herein a the agent d the lierwr herein, .
_~icr ~e-r..`. 1.e~ :rical .~Qr tra.ctar. Irc
.
ltierlor's Namel
whose address is ~f~~ ~Pr~"~ A`/e. - 't....Pi£rce. 3345n ~
ILierlor's Address)
and that in purswna d a ooMract with 3r o~~ C n s t riu t o"'+. a t 2 0. n ~ j
lieoor fwnished labor. services or materids consistirq oi: (Describe saecially fabricated materials separately) ,
?.a';or and ;^a ~erials tc irsyall t:ti'o volt a^^p cycle r~eter:~
o^ er.Tire ~-enerator °or radio Gtatior.. ar_d retirire as der
~~.,n_cr` red*as:~t•~
:,a~or aid ^^ater~als to replace ~0-?0-4 r2r:~e a:r.~ reterG
1 LTt 7-gin rar.Fe .
on the following described reN property in - =~t-• '.t1C 1e County. Florida:
(Describe real property suffftiently for identificstion, including street and number. if known)
. °roadcast Automation rssoc.. Inc.
( 1~-o Yro:,^~~ ~:s - ~-99 radio)
ewnedby 7 ~.r ~Z.: Ar,r ?^d -~n~^ .~G~er~'-
ofatotslvalwd ~i ~ ~^_'.L':L'_C~ ~'~ft;J ?::u t ~~~O-------dolbrslf' F~~ 1:' 1
d which there remains unpaid f - ~ • ~ o ,for which amount hs claims a lien on the above
described real property.
He further says that lierar fianishad the fast d said bbor, services or materals on
"ay 29th - _ ,19_- ~-~-and tM last d the same on . = L:;;;'.;+,;' t ~ _ : • 19... QC, and (if the lien
is claimed b1? one not in pmrity with the owner) that the lienor served his notice to owner on . ~I3~p
- - .19._
(Method of Service)
and, (if the lien is claimed by one not in privity with the oontractorl that the lierwr served a copy of his notice to
owner on
(Contractor)
on - ~ - ..19 ,by. ,
(Method of Service)
and additionNly (if the Herr is chimed by one not in privity with the wbconvsctor) that the lienor served a coPY
of his notice to owner ore-_------------------_ _ i
. (Suboontracto.l
on - - - ....19 ,by
-5 ~ ~ 45 (Method of Service)
'
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F1LEC t - L~-G-4:r-tc ~G Cl%~L'`.'~.
ST.LUCIECCL~t ~:t'(~ VenOr
ROGER PalTr;~s
CLEPK CtP.G3tT C. { ~~i ~nJ
' YLi~~., ~"crlr'c' . J ~ ~ BY 'J' (1J "7-~%~/l/` ~.~"~~.ka.,.'..
? e
Agent - e;
to ands
~ Sworn ubscribed before ms this . ~
~ _ . day of ~ti- ~ ~~s 2!, ~ = 1 • J-
rl? G~1tt11>ibld~if as ~~Y~~~-~ c
~~Lf ~'J~T'~ .
tl~~ MY wfll~ IMi f: .l~., .
o~ trs
r~IM/i Notary Public
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