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Fezvut Number. Tax Folio Number: <br /> .€r opq'address; <br /> U <br /> STATE OF IRLGRMA <br /> C. <br /> Before rye: the umersig ed authority: dul-y authorized to U&e ae�z�o�7,�ledameiits.and administer <br /> oati personally appeared 02creinafrer.giant). <br /> -9,71ho after being,dull?-sworn,deposes and says: <br /> 1. Alhant_is the(clie&one).- �&7ner of the abo-ve described prop��a - <br /> e Owner's Authorized.Agent <br /> 2. A Notice of Commencement, as.required pursuant to Section 71 3.13"of the <br /> P49da Statiates,has been filed fox_recordingm the off.cial public records.of <br /> County, Florida, as it relates to improvements to be made to <br /> that.certain real property described herein. <br /> 3. "A copy of said recorded Notice of Cornmezoementis at=hed hereto. <br /> Afant Signature. - <br /> Shmn ffe�.tri. ez <br /> Print hlasnc: , <br /> e <br /> S«rom to.and subscribed before me on this ?X— . day of�w—I �20.1 <br /> S <br /> Y 1 kL�' rr is ersonall r im-ol to me or has.produD. <br /> . ' , vtha _p c <br /> as idantiLEcaticrL. <br /> Notary Public Signature: <br /> � C,�REN PUTYRSK77 <br /> t'yyPrat��4� state of Fic ide-Notary Pu 77 <br /> blic <br /> Print.Name` : — ° �� CommissionrG0 -14-2 <br /> o� " Ny.Comm.Expires 07-14-2020 <br /> y oF` sondedThiough <br /> west rn Surety Company <br /> Ny Comnssion Expires: <br />