HomeMy WebLinkAboutCONTRACTORS FINAL AFFIDAVIT - RELEASE OF LIENCONTRACTOR'S FINAL AFFIDAVIT AND RELEASE OF LIEN
ATE OF Florida SGANNEE)
)UNTY OF Saint Lucie BY
I� / i'gty
BEFORE ME, the undersigned authority, personally Appeared �
_ jci �/1u�0 ,who after being -by
me first duly sworn, deposes and says of his personal knowledge that:
He is (AGENT or OWNER) of (COMPANY or PROPERTY) which (does business or is located) in the State of
Florida (hereinafter called the "Contractor").
Contractor, pursuant to the Contract dated l� %� ( hereinafter referred to as the "Contract")
with_ii 4W4t 0 (herein er ferred to as the "Owner"), has heretofore furnished or caused to
be furnished labor, materials and services. for the construction of certain improvements as more particularly set
forth in the Contract. .
3 Contractor represents that all work to be performed under the aforesaid Contract has been fully completed and
that all lienors under the direct contract have been paid in full except the following:
Name of Lienor: Amount Due: $0.00
4- In consideration of final payment of the Contractor in the amount of $ 0'690 . and all other previous
payments paid by the Owner to the Contractor, the undersigned does hereby for and in behalf of the Contractor,
waive, release and relinquish the Contractor's.right to any claim or demand or right to impose a lien or liens for
work done or materials or services furnished or any other class of lien whatsoever, on any of the property owned
by Owner on which improvements have been completed in connection with the aforementioned Contract.
5- The affiant represents that he has authority to execute a full and final release of lien for and in behalf of the
Contractor.
i
6- The affiant makes this Affidavit and Release of.lien, pursuant to Chapter 713, F.S., for the express purpose of
'inducing the Owner to make final disbursement and payment to the Con or in the ount of $0.00�
tractor S'gnature (Agent
nc�a rn ,1r0
j Printed Name (Title)
State o i fVw%? Iell,
Company Name
Count3 of C
I HE �Y CERTIFY that on this day, before me, an Officer duly autho i d in the State aforesaid and the County
aforesa d to take acknowledgments, personally appeared �l'3 Yl lit �%i K
to me k lown to be the person(s) described in or who has/have produced —T7 as identification and who
execute d the foregoing instrument and he/she/they acknowledged before me that he/rshg/they, executed the same.
of
(Seal)
my hanand official seal in unty and State last aforesaid this
),V V/ , 20
®p3niis.; CHERYL FREEMAN
r° • Notary Public - State of Florida
_;Pa= Commission A GG 196530
``�oFrti° My Comm. Expires Jul 1Z.Z02Z
Bonded through National Notary Assn.
day
Notary Printed Name
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