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Home My WebLink About10-7287MECHANIC'S LIEN CLAIM BY GENERAL CONTRACTOR IN THE COURT OF COMMON PLEAS OF !yi v1 COUNTY V. h~~ J ~r ~L~/~i ( me and Addre$ O~irrer) .~ c .~;w~: _'"3 ., ~: ~: - ~ . ~_ No. I b ., YIr1 L I~ The undersigned files a Mechanic's Lien as folbws: Owner /Reputed Owner with Addrless: S Property Su~~ S Lien: Lien Claimant and Address: ~~ ;~:, ~7 l.(~ c.,.~ ~~ _~ __~ ~; J ~.^~ r~ ~..~ ~tis ~i .. ° r~ i~T] ;. ,a~ ~i7c Phone: Name of Project: Legal Description attached. 1. Description of labor and materials with pricing (check one): A lump su a ed sum contract was entered into with the above Owner on the following date.~~~ , a true and accurate copy of which is attached. The contract with the Owner is not for a lump sum/agreed sum and unpaid invoices are attached, describing in detail the labor and materials. The contract with the Owner is not for a lump sum/agreed sum and below is a detailed description of labor and materials furnished, with the prices for each item: 1 of 3 ~~ All rights reserved. (925) 899-8449. Email-info~NationalLienLaw.oom. Revised 12105 ~~ 4~ ,~~a`~ ~ ~,~'~ V V LaboNMaterials Description ,~fac~,e~ Price ~ ZSo3.S"/ 3. The principal amount due through a"due date") is $ - 03, ,plus interest, after deducting just credits and offsets, and inclu ing change orders. The total price of the work performed was ~.fa3.57; less payments of $ Q 4. The date of completion of the work for which this claim is made: 1~3 /6 5. The name and address of the person or company subcontractor has a contract or order with is: Dated• / ~~ Name & Title: ~(,d/~~~/~~ (ame o aims . Fumis ing Labor ~~ f ~~ (Signature) 2of3 ~~ _~ Ali rights reserved. (925) Sgg-849. Email-info~NationalLienLaw.com. Revised 12~D5 AFFIDAVIT OF SERVICE OF NOTICE (MECHANIC'S LIEN CLAIM BY GENERAL CONTRACTOR) IN THE COURT OF COMMON PLEAS OF C~~t ~1~~~ COUNTY ~s~e~s ~f1~2[6~~/-~ .~HC . l2ler oft. GSh~~~G i7of S~ (Name and Address of I) V. ~l'IGlor 22/ S. ~iLdQ/ - ~ ~ - (Name and Add of Owner) NO. AFFIDAVIT OF SERVICE O NOTICE COMMONWEALTH OF PENNSYLVANIA / SS COUNTY OF ~,G(litr !1 ~i~~.Ct7~ ~~~~~T ~s~-~- ,being duly sworn according to a law, deposes and says as follows: 1. I am an adult and am (title) ~l~S^jQ~~H ~ of Lien Claimant in the above-captioned proceedings, and submit this Affidavit pursuant to 49 P.S. §1502(a){2). 2. Attached hereto is a Proof of Service indicating service was made by certified mail as to a notice of the filing of the Mechanic's Lien CI ' 'n, bearing the court term and number and date of fiNng of the said claim. (s~~~) J~ly~~! T -~Sf~r (Printed Name) 3of3 ~~ ~~ Ail rights n,served. (925) 899-8449. Emaihinfo~NationaiLienLaw.com. Revised 12!05 s •- ~ ~ Foster's Automotive Inc. Repair Order #0046386 117 E. Strawberry Ave. Date Printed :11/19/10 Mechanicsbur's~, PA 17055 page ; 1 717 766-7175 Center HAVE YOUR BATTERY AND ANTIFREEZE CHECKED TODAYIII! Customer : GELSDORF MALLORY, SEAN DANA Vehicle :1999 VOLV S70 Address : 221 S MARKET ST Cleanse : ETV5192 Insp City : MECHANICSBURG, PA 17055- VIN : YV1 LS55A9X2605584 CELi_ : (717) 497-6859 Ext : SEAN Engine : 2320/DOHC Trans :STD WORK : (717)385-9024 Ext : DANA Mileage :237394 Parts labor Gwn Put Number Description Price Op Tech pp~pSpn ~~ Charpe 1.00 SUBLET ECti,THROTTI,S,RELOA 776.93 DIAO 2 EVAL RUNS POOR, BCIS HAD, 2 INJECTOR 0.00 1.00 Pl4g1 PR06itAK NI6T FES 2.40 DRIVERS BAD, SUREST TO DEALER FOR ECbt 1.00 ST1L1 STATE INSP STICICSR 2.00 RSPLAC~1'P AND FLASHING. DEALER 4.00 19145559 HANIGOOIC 394.00 DETSRNINID THROTTLE BODY BAD ALSO AND 4.00 TIRE TAR 4.00 REPLACED. DIAfAiO8TIC8 NO CAHRGE/COURTESY 1.00 SUREST PROf;atADt 150.00 DLit TO RECENT SNGIIQ REPLACEMENT 1.00 GASOLIIiE 15.01 CSTO 2 EVAL SUSP~SION FEELS LOOSE, TIGHTai 35.12 1.00 ECM 906.00 LOOSE STRLiT RETATIIiiR BOLT, ROa1D TEST, 1.00 944428229 BATTERY 16f0UlTP 8.02 GOOD 1.00 HG 0.00 SEI005 STATE EMISSION INSPiCTIOlT 42.55 STIC1®'1L~ STICI~R PENDIlfG DELIVERY OF VALID REGISTRATION CARD SIN016 PA STATE INBPECTI011 26.00 3TICICSR # 9TICICER PENDING VALID REGISTRATION AND INS CARDS HRAICEB LF RF LR RR 108 lOB SH 5B 1 TIRES LF RF LR RR ur a.w ~, g~ L7K Bed Recm nmendstlon OK Bad Re / R011D TEST OR / FLUIDS OK / t CE OK / BATTERY 6 TERI[OK / NOlgyg OK / Leg OK '~ ALTERN7-TO~t OK / TIR33 OK / A7Q3S/CV OK / BELTS OK / STEER/SUSP OK / y~pyRg OK / HOSES OR / ExHAUST OK / I,IGBTING OK / ANTIFREEZE OR / gg~g OK / OTHER OK I haroby authorias repair and diagnostic work to be done along with necessary parts and satsrials and great yon and your agents peraission to operate the vehicle herein described on streets, highways or elsewhere at their discretion for the purpoN of testing and or inspeetioa. An espress aeohanic. lien is hereby acknowledged on the above vehicle to secure the asount o! repairs thereto. PARTS AND LABOR SUBJECT TO NARRANTy OF 24 MONTHS OR 24,000 MILES fiHICHEVSR OCCURS FIRST unless otherwise stated. i..eioor : Parts Sublet Other Fees . Supply Charg Subtotal Sales Tax $2,254.36 $0.00 $4.00 x $2,362.03 $141.48 Paid ey Total: $2,503.51 Pay Ref : Paid : $0.00 ~Ue : $2, 503.51 Foster's Automotive Inc . Repair order X0046386 117 E. Strawberry Ave. Date Printed :11/19110 Mechanicsburst. PA 17055 page : 2 717 766-7175 Center HAVE YOUR BATTERY AND ANTIFREEZE CHECKED TODAY!!!! Customer : GELSDORF MALLORY, SEAN DANA Vehicle :1999 VOLV S70 Address : 221 S MARKET ST License : ETV5192 Insa City : MECHANICSBURG, PA 17055- VIN : YV1 LS55A9X2605584 CELL : (717) 497-6859 Ext : SEAN Engine :2320/DOHC Trans :STD WORK : (717) 385-9024 Ext : DANA Mileage :237394 Parts Labor Quan PaR Number Description Price Oa Tech p~cdpg~ ~~ Charpe 10 10 10 10 OLD MILEAGE 224129 OLD STICfOCR: AI9-4372374 NE][T INSP DIJE TIR020 MDOl1T i H71I.ANCE B'OUR TIRES 0.00 1010 H7-TTERY HaLDanr MISSING, REPLAas 0.00 OK Bad Reeomnwndagon OK Bad Recomnsendatlors OK Bad Recomrnendetlon / RQi1D TEST OK / FLIIIDS OK / OR '~ BATTERY 6 TERM OK / NOI8E3 OK / L~xs OR / ALTERN7-TOR OR / TIRE3 OK / ~Q,Eg~~ OK / BELTS OK / gTEER~SpSP OK / gRpygg OK / HOSES OK / E70li-UST OK / LIGHTING OK / ANTIFREESE OK / BRAxEB OK / OTHER OK I hereby authorise repair and diagnostic Mork to be doss. along Mich sseapsary r; 3. parts and aaterials and grant you and your agents peraission to operate the Parts: $2,254.36 vehicle herein described oss streets. highMays or elseMhere at their discretioa SUWet: $0.00 Eor the purpose of testing and or inspection, len aspress seahanias lien is Other Fees : $4.00 hereby ackaoMledged an the above vehicle to secure the asiourst of repairs Supply Charg $~,~Q thereto. P]1RTS l-ND LABOR svBaECT TO ~a-RRANTY of 2a rsoNTHS are 2a,ooo MASS Subtotal : $2,362.03 itHICHEVER OCCURB FIRST unless otherMise stated. Sales Tax : $141.48 Paid By Total: $2,503.51 Pay Ref : Paid : $Q,QQ Due : $2,503.51 PROOF O/F SER/V~ICE/O''F /~ ~~~ ~ Di'- ~ ~e~r/7on /y r7 ~~ q lu 4/S~.l i (Name of Document) 1 declare that: J>!t/ ~~ ~ ~S~o~ I am over tl,~e age of 18 years, and my business address is: On the date set forth below, I served the above-described document as follows: CERTIFIED MAIL WITH CERTIFICATE OF MAILING Print. Form Placing true and correct copies enclosed in a sealed envelope(s), first class, certified, return receipt requested, postage fully prepaid, for collection and mailing addressed as set forth below, I am readily familiar with the business practice for collection and processing of cornespondence for mailing with the United States Postal Service. This document was served on the following persons/erttities: Name of PerscnlvCcmpany Served: Address: 7aa~e !ai i/~., ,~ 2~ s ~a~~..~ s~ 6~H 'cs u ~..~ `~ -~ , ~?.~~ ~' ,~~- f ,~: _ ~,y~ ~~;, _ ~, w, ,~ . ~~ I declare and state under oath, as well as under penally of perjury, that the foregoing is true and conBCt to the best of my knowledge and belief. Executed on // ////!B (date), at /'QSiC~~i (Job Title) (Signature of Pe o ing N ice) Copyright 2006 NaRionalLienLaw.com, LLC. All rights r~esenred. (925) 899-849. E-~A- info~NationalLienLaw.onm. ~~o ^~a~? ~~p -, ~~~ -.; NOTICE OF INTENTION TO FILE A LAWSUIT ~~ ~~ '=~ . ~~ i -.p.,,T3 1.I i r.._ TO ENFORCE MECHANIC'S L/EN (General) ~ ~ Vim. ;~ .._ ,~,„_ ~:. , . s'~; Via Certified Mail ~ _ _ TO OWNER: FROM GENERAL C C _ ~ • --~~ ~' (addr+ess-no. and street) (address-moo. and sheet) ~ H GS~Gr~ ~ /70.~ cedd~ess-~,,, , Z~~ caddy--~, arm, Z~p> 71776~6~ -306 7~ ~-~6~-~/7S~ Please take notice that the undersigned lien claimant intends to bring a lawsuit ("Petition for 1=.x Parte Attachment to Secure Mechanic's Lien") for the purpose of filing a Mechanic's Lien if payment is not made for moneys owed as follows: PROJECT NAME: (1) General services furnished by Lien Claimant: (2) Amount due: Through ~ (date) is $ ~~ ~ . ~~ after just credits (total performed, with extras of $ n ,less payments of $ _ ). Unpaid invoice(s) attached. Attorney's fees and court costs will also be requested. If payment is not made within ten days (10) of mailing of this demand, Claimant intends to bring such a lawsuit, without further notice. If you have any questions or wish to make payment arrangements, please call immediately to di uss. Dated: la z7 ~f~ (Sign tune and Title) ~w~~ ~ ~s,~~` fires, ¢~ ~- PROPERTYDESCRfPT/ON(common street address or other description): s D ~/ -~ Yt~i~sss,~~X~o sS"~~1