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HomeMy WebLinkAbout2818 y- 1 R~ ts~r MEtw-M~Cf RAMCO FORM 120~a - uEN i~w. ~s »aa ~l~ttlli ~~ ~t~Yt ~ ~ ~,~ 5140Q5 ~ °~ ~ Befo~e me, the undersigned authority, personally appearsd .~Old.. ~75~ .~. . I.1.~'ht.ina ..:;.er.t.er ~ Ine . who, being duty swor~, says that ha is tha lienor herei~ w tha agent of the lianor herein, . ... ...... ....... ..... ~~ld_ :'oast...Li~h.ti_ra .:er~er.~.._Inc.,.__ _ .......... . .. . (Lienor's Name) whoseaddressis. 10.04 $out.h._.4th._Strzet.,_. .. Fort ..F.i.erce, Florid~ ~~450 . . .. ..... . . (lie~o~'s Address) • and that in pursuance ot a contract with.. `%U St0?R 3ous ir? .. Svs t.em_s ~ Inc . ..... .. . . ..... . .. . . . . - .. 33.4.6...w~.*-..~?cpr~s~....;.ci...., ..Fort...~lerce. ~-..Flor.id~ .. .. .. , lienor turnished labor, sen-ices or materials consisting of: (Describe specially iabricated materials separately) Ligntin~ Fixtures and Supplies : on the following described real p~operty in ....SC . LU C 1 e ~ .... .... County, Florida: . .................. ........................ ... .... (Describe real property sufficiently for identitication, including street and number, if known) 2401 S.::. ~test"~:orelar:d port St. T,ucie~ :'i.orida 3?u52 Lot ?7~ ~l~c'r 5?, Sect2on 5 ownedby.... I':r.._~- Yr.s•...~n..r:_...~oopEr.... . _. ..... _.... ............ ....... . __ ... . ....... _.. . of a cotei va~ue ot ... F if t.ee:^ ~~d 07.I1.~~ _. douars IS ---1 K. Q? . ...) of which there remains unpaid 5......~..~.. ~7 .......... ... .... .. ... ., for which amount he claims a lien o~ the above described real property_ ' . _...... ._ . . He turther says that lienor turnished the firat of said labor, services or mate~~ais on .. ?ec P~r! be r . _ .1_ ~th.~ ...... . ..... . . , 19. :~~.., and the lest of the sams on~!eC.°L .~~r = ~~?'1..... ,19..A~.., and (it the lien is ciaimed b~ one not in privity with the owner) that the lie~or served his notice to owner on .... ... ... . J~tn~l3r:y...~t'~.... ...... ..19~-~-...by .. - =:~1Z . ............................................. .............. .......... .. ......... .... , (Method oi Service) and, (if the lien is clsimed by o~e not in privity with the contractorl that the lieno~ served a copy oi his notice to owne~on .':u~t:~!C.. s~:~.ci.=.?~...~~ S~.P'"~.,....Inc.. ........................... ......... .. .... .... .... ....... ... . (Contractor) .. .............. ......... ............. . , o~.J~r.u~r~...9t.'=.....:.~ .................................... t9 ~.2..., by...4:~i1...... ........ ` ' (Method of Service) and additionally, (if the lien is claimed by one not in priviq with the subcontractor) that the lienor served a copy ot his notice to owner on . . . . ... . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . _ . . . . .. . . . . . . . . - . . . . . . . . .. _ . . . . . . . . . . . . . . . . . . . . . . . ~ ~ 5i4U05 (Subcontractor) on ... ..... .. ............. ...... --.........- .......79...........bY......... ._..-- ... .. .... ..................... '.. ... ........ .. .. Iga' J~;i: 16 j+'. ys: " (Method of Servicel . :;ol~? 'oa~s.t...~..~-z~tt.in?..'e..r:t.er,...Z''!~.: 11,E: tr.C c: i~.~.:r.~ ... ... .... .. . . SL t L'C~t LLUV i f. i ~:.. Lie o RCGER 1'GITFtAS C' Efi~S C:3C:1:? C~ L'~~ ~ C ~ ~ , ~ . , - ; c~- BY ........: .... .- . Agent........ ....;;: ..~;_~i;: ....... Jo r ~. ~~ ettler ': ice ~~~,~~~1"~J I . lt~ ~ ~ ~. Sworn to and subscribed betore me this . ... .... ....L . .... ....... ... ..... .day of ......... . .. Rs~.~l.el-~cy..... .. • '~~ y.~. /..~ 9. g- • . . .. ~_. ~..` ` ~~ ~~ ; „ ~ ~ . . • . .. .. ... y1 .. .... -J,...:-~-;~ Notary Publ = a ~' 9 ~ ,~ . :,r 1oW ~- . 7'/tis Inslrum~v~l pn•pnr~~d h~•: I> ~~/~f~fltcli '~0'3 P;~-1;C. $~~I!' ,", 4: '~i// ~~`•*'• ~ ~ •'Y . ot Florlda~~j~r ~ ~ ~~~~ ~a~ My ~~.7ni~:~~or~ ~xr~res -~iay 3t, ~ ~ $~R!( •