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t~l~t~t ~r~ ~t~ert
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RAMCO FORM 120'.
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1
~ ~txte of ~loriaa
~ou~ of Brevard
Before me. the undersigned authority. personally appeared Cdl"~ JOI1nS Manaqer
who. being duly swo~n, says that he is the lienor he~ein or the agent ot the lienor herein.
Ciimatrol Sales inc
(Lieno~'s Name)
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~ whoseaddress~s 529 S Industry Road Cocoa, Florida 32922
(Lienor's Address)
~ and that in pursuance of a contract with Robert A Ol i ver
I 1565 S, E. Cambridge Drive Pt ST Lucie, FL ~
i lienor furnished labor, services or materials consisting o(: (Describe specially labricated materials separately) '
I
; Fabrication and installation of screen pool enclosure
' on the iollowing described real property in $t ~UCIe ~OU11tJ/ County. Florida:
, (Describe real property sufticiently for identification, including street and number, if known)
1565 S, E, Cambridge Drive Pt St Lucie, FL
also known as lot 24 block 71 Unit 5
owned by Robert A Ol i ver ~
T~irt six hundred n#net one 3691.00 ~
of a total value of y y dollars (S ) !
of which there remains unpaid S 2~~~ •~~ , for which amount he claims a lien on the above ~
described real property.
i
{ He further says that lienor furnished the first oi said labor, services or materials on
j December ~ 2 . 19 $~. and the last of the same on December ~ Z . 19 HO . and (if the lien i
I !
I is claimed by one not in privity with the owner) that the lienor served his notice to ow~er on :
.19 .by . '
I (Method of Service)
;
and, (if the lien is claimed by one not in privity with the contracto-) thet the lienor served a copy of his notice to t
~
owner on ~
lConttactor)
on ~ , 19 . by , •
(Msihod of Service) ~
~ a~d additionally. (if the lien is claimed by one not in privity with the subcontractor) that the lie~or served a copy ;
i
ot his notice to owner on ~
:
~~y~ - -. n „ , ,• ~ (Subcontractorl ~
~ ..
• ~'
,
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on ~~; ,.;~ ~,;,..~ r~ , 19 .by i
:.'- i : " : r' '• ~ = (Method ~t Service) •
; It.• :. '- ` - ~ .
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~ ' Climatrol Sales Inc ~ 1
Si`7'711 ~ ~ ~ Lienor •
~
~ B . ~~-'~ ' ~
, •,; Y ~ -~~
- ~ =~ ~ Agent
lj ~ ... `' _ I \~l , `i-
.t ,.,. ::,, ._ A~,_
~-~7 ~ . ~ 18th Februar 81
Sworn tO,p,fd ~t~cribed'~(bA fpe this da oI 19 ~
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~ _ :~~-~- ~ ~ 1 .- ~ <<K349 a ~ .
; ~~ ~ Y. ~ ~ ~ ~~" 8~(?l( p ''~I "'`~ '~. ~ '
,s ';~' ~; :;4. ~ ~~ Notary Publ ~
.
: fl~i• I ~T"s~-i~~~j~~l-r~s,~~l f.ti : Carl JOhns ` • ~
~,~,~,,,~~';~~~ J:~ ~,- .`~~.;,~~ 529 S, Industry Road ~
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`'~. Cocoa , F1 ori da 32922
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