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rlw 1!)7 MfCNAN~Cf RAMCO FORM 1Z0'~a
UIN lAW ft 713W
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~owdq of B re v a rd
Before me. the undersigned authority, personally appeared ..... George Bobinko Manage r
who. being duly sworn, says that he is the lienor herein or the agent of the lienor herein.. ......... . .
Climatrol_Sales_Lnc
(lienor's Name)
whose address is 5~4 .S_ Industry._Roa_d_ Cocoa, FL 32922
ILienor's Address)
and that in pursuance of a contract with R o b t? r, t_ ~ 0 h n S o n
..5.702. Seminole. _Ro.ad .. _ . Ft.. Pi.erce,. FL_ __
_ _ _ _ ,
lienor furnished labor, services or materials consisting oi: (Describe specially fabricated materials separately)
Fabrication and installaiton of screen pool enclosure
on the following described real property in $ t. _ L_U C i e C 0 U n ty ......County, Florida:
(Describe real property sufficiently for identification, including street and number, if known)
Lot 11 Block 32 Unit 4 N~-11-34-39 Lakewood Park
also konwn as 5702 Seminole Road Ft. Piecce, FL
owned by _ __ Robert.,, E._ Johnson
ofatotalvalueof Twenty-five hundred ninety-five 2595.00
.._..... _ _ . dollarslS ..... __ . _ _.
of which there remains unpaid S .. _ 12 9 5 . OO ,for which amount he claims a lien on the above
described real property"
He further says that lienor furnished the first of said labor, services or materials on
-September 12~s .8C ,and the last of the same on _ __ 9-12-80. 19 _ ,andlifthelien
is claimed by one not in privity with the ownerl that the lienor served his notice to owner on
, 19 , by _. _ _. _. _ _ ,
(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
_ _ _ _ _
(Contractor)
on ,19. _, by.... .- - _ __ _ _,
(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)
_ , by. _
on ~~
SU.7,~9~ (Method of Service)
~~_4 ~~~ _4 ~ ~~ Q!~ . _ Gl i.matrol_ Sal e.s _f nc . _
'~ ::% ' ~ S' UCIF ~POITRA~A~ BY ~~ ~~J~ /c~~/".~7L~o~
~iOGER Pt~i f _ _ _
- ~ ," ~:*: v_ '.'~ c CLERK CIRCUIT COURT //
' ~, . .. _ ~ ~ Agent
".. ..
.- ..._ -
Sworh t~~ad~abritf~d before me this 14 .. .... da of . ember _ _ _ _ 19. $ O .
~' ~ - Notar Public
fl-i.ln.~rrrrn~~H1~~11r~~p,rrv,l h,": Geor a Bobinko
9 r:orarY Ft'?UC S?A?E Cf flC-i-~A Af ("AtKC;g
Idrl-~. 529 S Industry ROad ,;, `~,:;..,,,;~., ~,;,.. ,
Bn~ICc)`t4 P~GE ~ Cocoa FL EL•.:::o jnx~ :.~,,::~ ~ . _ .
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