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,
(Individual, Pariner or duty authorized representative of corporate contractor)
who being duly sworn according to law 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
City of Nashua, New Hampshire of 229 Main Street, Nashua. NH 03060
(Owner) (Address)
and
of
(Contractor) (Address)
Dated for the construction of the
and necessary appurtenant installations have been paid in full.
(Individual, Partner or duly authorized representative of corporate contractor)
{Title)
(individual, Partner, or duly authorized representative of corporate contractor)
Sworm to and subscribed before me this day of , 2020
(Notary Public)
