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. _ . ~ . : . - S'i'ATE Oi~ FLO~tIDA 1~ ~ FOC FORM UC 18 i)H pAHTMk;iVT OF' f.ONc~fN ttCE fREV. 7/73) _ ~ UIVISION flF EMFI.OYl1F:~'I' SE CC,~R!'['Y _ ~ TALLA~~ASSEE 32304 ~ - vQ. 2ns9>> - = . ~~~~_~i2+ - : IVOTICE OF TAX LIF.Ia ~ t.ien \'o. 5-~7 33 - ~ Pursuant to the provisions of Section li~fi.15 (1), Floricla Statuteti,.knon•n .is che Florida Un- - _ en~plo~~ment C~jmpc=i~sacion !.l~~~, noticc is herehy gi.~cn that chere ha~~~ bc~c~n asscssc•.1, pursuanc to the - pro~~isions of~sai~1 la~~•, a~.iinst A-1 Roof Caating,~ Inc. (A Florida Corporation) _ ~ 80Q Cory Campb~ll Road - I'~rt Fierce, Flori3a 33450 an "cmplo~•cr" liabic ~cir thc pa~~mci~t of rontrib:itions t~~ thr L'nc•mj~1_o}'r.ic•nt Compcnsation E=und of f~loriJa, F~ursuant tu thc pro~•isi.>ns i~f sai~l lai~•, thc sum of S 45. 10 corcrinK thr follot~•ir,y, contribctiu:~s, incerrst an~9 ~enalties, ~~•hich .a(ccr ~Ieman~! fur F~a~•mcnt thcrruf rrm:iin unE~~zid, amf tha: b~• virtuc• of tnr abo~•r mcntion~d la~~• the amount o( saici concributions ~rire~), ~oRrchcr n•ith penalties,,intcrc•st, an~l c~~sts that rna~' circrue in a~ditioir thcreto, ~onstitut~- .i licn in fa~•ur oi State uf ~ ~ Florida I)eparimeni oi t:omi~~erc~u~c~n _thr titlr tu an~l inccrrsc, ~+hcther lc~,al ~~r c•yuitablc, in .3n~• rc•.il . pro~crt~~, chattcls rcal. ur pc~rsona; property~ of said emp~a;~er. _ Pc~::,~s for n•6ich contributions, ir.terest, an~l penalt~~s hace bcen assrtitic~f, an~1 thc- amount~_ thercot. arc as follot~s: - ' INT~RESTTHROLGH , PERIOD CONT~IBUTIONS PE NA LT IES ~ 3rd Quarter 1974 4I33 25 00 - 4th Quarter ~.y 74 5 I 7? ~ ~ 10 00 " I , _ - - `~i•` •'t " -':RU 0 . I _ • ST r F;=_ ~ .1 F A. _ . I . - vV1.i J ' - HECORC YERIF~fD - ~ ~ _ - - ~~r Z . IG G4 ~ ~r5 - - - ~ I. ~ I . - ( ~ - ~ ~ ~t3'.7~_$~ ~ " ~ - - _ - . _ , - - _ _ ror~~ ~ 10 ,~LO 35 00 WIT~V~SS THE OFFICIAL SF.AL OF Tl1F. STf1T~ OF FLORiD~ t)LPART1fE~T OF COi1~iF,RCE ~ ~ - a~~! ihe hand of thc L'irector oi the Ui~~ision of Employ~mer.t. Security~ thereof, at Ta~laha~sec~, F lorida, ~ _ ihis.~:~.~:_da)- of_ AprZi 75 . - . _.A.ll.19 ~ , ~ _ ~ - - : . r ~ ~ . . _ ~ ~ . ~ ;'°`*`ti`••",j ST:1TF ()E FLOt~II):~ ~ : , - ~EP:~HT1fF,1T ~t' CUOl1tEHCE - : r~~; ~ - - ' . S-=t• ` 'r- ' - - ~ . _ ~f . _ • ~ ~~~St _ . . . ~ _ ~ . . • ~ -.2 - ' • _ Y~hig ~i~l~rtr}e~,# ~eparec~ b} . _ -:~r~ ~ •~e~, n t= ~ } ~ ~ i~ ~ - _ ' S~.y.3;~~';tlT-...Inqr~m _ _ _ Ueparimenl.of ~:omm~rcc~ ~(j l~t3¦~ ~~~ecTO~, o~v~s~o~: oF CaldM~ell Bld~.. Tsllahe~.~~~~. 1'la. . B~;OX~~t7~~ PAGf ~~IJ E.Y..+LOVME'!T j~GURITY - _ i i f