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RAh1C0 fORM 12045
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Betore me, ths u~dsrsigned Notary Publlo, psrsonelly appeersd James C, Daven.port
who wes duly aworn end says thst he Is (Nl~jltnnrh~ (the egent of iha lienor he?e1n~
(DELETE ONE)
Sun Insulation Inc
~
(Lienor's Name)
P. O, Box 6339 Vero Beach ..Florida,...32~61_-63~9
whose address is ~........................i
(Lienor's Address) "
and that in eccordan~e wlth a cont~ect with Ju~l an Dey~elo~ment. .
P. 0. Box 477, Palm Ba~, Florida_. 3290~0477----.....~ - .
. . . .
lieno~ furnished labor, services or materials .consisting oi: (Desc~ibe specially tabricated mate~ials separately)
Insulation Labor and Materials
~ St. Lucie . Count Florida: ;
on the foliowing desc~ibed real property in . y.
(Describe real prope?ty suiticiently for identification, including st~eet and numbe~, it knownl
Indian River Estates SuLdivision, Unit 4, Block 33, Tract C
930, 932,.934, 936 East Midwa~ Road
Ft, Pierce; Florida
owned b Preferred Associa.tes ._Inc s'
y . . . . . : .
no/100 1 890 00 '
of a total value of .,_~ne Thousand Eight Nttndred. Ni.nety, dollars (S .._.!.......r......
ot which there romains unpaid S..,.1 , 890 .00 and tumished the tirst of the items on '
December 8 ~ ~ g. 87 and the last of the items o~ ....DeG~~l1b.~~..~.,...I.9~7 . end (if the lien 3
. ....t..... ~
is claimed by one not in privity with the owner} that the tienor served his notice to owner on n!~~1,1~.d
' Januar 21 SS Certified Mai_Z Li......'.. `
y....._. 19.........:. by....._.... . .nc,i~~~?led......................
(Method of Service)
and, (it r y u~l d) ~h~a~~the {ienor served copies of the notice on the contractor on mailed on
Januar
; .
;
by Certi fi ed Mai 1/Unclaimed and on the subcontractor . ~ ~
E ~ (Method oi Service) ,
~ on y......................
19....'....., b
I
( 1Method of Service)
~ ' ~ Sun..InsuZation....I~c.............
i,
f . . . . .
~ n Lienor
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E, . eY..
James C. Davenpoz'~ent
~ ~ 22nd .
Sworn to and subscnbed before me this da of ~ebruary_..,........ ~g.,8.$_,,.
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1'Iris l~tslriun~?t~ pr~rpnrrd b>•: . .'o~ ' f, .
' Ad~lrc•ss : My Commission ~?Xp~'~ ti.~~1~~~''1988• ,
" s .i ; . _
' Svn Insulation, Inc. ~ ' ~ •
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+ P. O. Box 6339 - - ~ ~ ~ .
' ~ Vero Beach, FL 32961-6339 ~,v%j~'~•.....•~~3~~~a~~ .
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