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n~ »n reCw-w~ts• RAMCO fORM /20~,
uEN ~ww. ~s ~ua~ ~~~~ ~~ ~~~~
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~ of Indian River j
8ato~e me. th~ unda~signsd autho~iq. Mrsonally sppsarsd ....... ...................................... .... ...... ......................
who. being duly swo~n, says that he is ths lienor hsrein or the ags~t of the lieno~ hersin.......---•....•--.-•.-.•-----•••• ---~--
Pan American Aluminum Corporation
...........................................................~-~ ----.... ---- .............................................
(Lienw's Nams)
whose add~ess is....~'..~r.~.~r....N . U. S. 1, Vero Besch , FL 32960
............................................................ . .................... ... ............... ,
(lie~ot's Address)
................................ . . ........................................................ .
and that in pursua~ce oi a cont~sct with... CUStOnI }~OUSlt1g $~/St6IpS
.. ................3306.Enter~rise..Road. ..Ft.....~-ierce,...FL....3345~.-~-~- -.......................... ......
lienor furnished {abor, services or mat~riats consisting of: (Osscribe specially fsbricated materiais saparatel~)
Single Hung Windows, Glass Sliding Door Units &
Mull ~ Bar
Saint LLiCie ...Coun Florida:
on tfie tollowing described real property in ................................. ....................................... ...... ty.
(Desc~ibe real property suHiciently for identification, including street and number, if knownl
Lot l0, Block 15, Section 29 ~ S.C-.
Nlark Reinsberg ' ,. .
ownedby .............. ........................................ ........................... .~ --................. ...............................
Eight Hundred Seventy one and 43¢ 871.43
of a total value of ............................................•-----........................ --............do{lars (S ...............---•......._...........)
ofwhichthereremainsunpaidS.-.--•--.-$?1.'.~3~-~--- ~~~~ --~•~~~-----.forwhichamountheclaimselie~ontheabova
described real property.
_ . .......- -~ - ..........- ~
He further says that lienor furnished the first of said labo~, Se~~~ces o~ mate~~ais on ... December
~ 6 .............. , 19... $~., and the last of the seme on. DeC@I11b6Y' 1 E) , ~g 81, and (if the lien
is claimed by one not in privity with the owner) that the lienor served his notice to owner on ... January..-.... -. _.
.......... ................. ... ..................
. ~ - .......... 6 ..................., ~9..81-~• br--.. ....Cert.ified...Mai.l................
tMethod oi Service)
and, (if the lie~ is claimed by one not in p~ivity with the co~t~actorl that the lisnor served a copy oi his notice to
ow~e~ o~ .... Custom...Housing-- Systems ... .......................................... ... .......... .................................
(Cont~actor)
on ...... ....................... .................................... . , 19.........., by---........................ ..................--~-• -~ - --................ ,
(Method of Service)
and addit+onally, (it the lien is clai~ned by one not in privity with tha subcontractor) that the lienor served a copy
of his notice to owner on ..........................~ -.............................--- ---- -................... ...........................................
(Subcont~actor)
5~0989
on .................................... ........................... ....... . 19.........., by......................_..........._............................ . .. .......
~f `~v ~~ ~~ f 9 ~ `• 07 (Method oi Service)
• ~~,~ii~it:tf.~#~ ~
;~~ ~ -~ , ...Pan. A,me~i.c.a??,..;A~.um~num.. G.ax~poxat.i.on
; ~ fJ~rp ~NC ~~CG~![i( : Lis ot
::;-.:, . , -
'~ '~,~~l~ S! LUClE CL~~N1 Y.f; A.
s~i •: - 'r~ 'y . RQGER PCITRl;S
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~~~/'~' :• - ~IE~cK CIRCUli f;]IiR~
:~ ,,~ , _ kfr.r.;~n ~~ f:~=;: ~ c~Q ~Y ~-.--.... ........... . . ... - ...._...
`.~ ~~ Agent
• ~~ ~ ,. .:~ '?n • .
. , . ~~
.. .
~, f~6m to srtd ~bsc-ibed before me this._._ ............._l. ..th.............dey of .....M~TCh.... ...................... .......... ..19...... .~.
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. ,. . .. .~. ~~ . .~i~~/.L0.~1.!.....l.!/l. .. ... .. ..........
Notary Public
7his /nslrum~~nl pr~•par~~lAdW~MCRICAH ALUMINUM CORP!~~-a~uc~r~hoF~to~-~Tt~
~1 ddrres 4575 N. U. S. t MV COMMISSIQN EXPIl1ES AU6. 2.1963
~j `-e-o Beach, Florida 32960 ~ ~ ~~~ ~NS. UNDERWRITERS
~n!~X3~ PACE ~/ ~ ' -~' ~'p 1305) 461-8581
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