Document Date
Meeting Description
Document Type
Meeting Date
Page Number
202
B-9.1
CONTRACTOR'S AFFIDAVIT
STATE OF:
COUNTY OF:
Before me, the undersigned, a
(Notary Public, Justice of Peace, Alderman)
in and for said County and State personally appeared,
Cndividual, Partner or duly
who being duly sworn according to law
authorized representative of corporate contractor)
deposes and says that the cost of all the Work, and outstanding claims and indebtedness of
whatever
nature arising out of the performance of the contract
between
(Owner)
and of
(Contractor) (Address)
dated for the construction of the
(Project Name)
and necessary appurtenant installations have been paid in full.
(Individual, Partner, or duly authorized representative of corporate contractor)
(Title)
Sworn to and subscribed before me
this day of 20
(Notary Public)
Page Image
