00 65 19.16 - Affidavit of Release of Liens.pdf
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- Lancaster County, Pennsylvania
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This is a Contractor's Affidavit of Release of Liens submitted by Herbert, Rowland & Grubic, Inc. to the Elizabethtown Area Water Authority for the Water Main Replacement Project Phase 4 (Contract No. WR-4). The affidavit certifies that all labor, materials, equipment, and outstanding claims arising from the contractor's performance have been paid and satisfied in full, with no remaining obligations or claims for which the owner might be liable. The document is executed under oath by an authorized representative of the contractor with personal knowledge of the facts stated and requires notarization.
This affidavit serves as a lien release document required as part of the project completion and payment process. It provides legal assurance to the Elizabethtown Area Water Authority that the contractor has resolved all financial obligations related to the project and that no mechanic's liens or other claims will be filed against the project. The affidavit references the Water Main Replacement Project Phase 4, which involves relocation of approximately 13,860 feet of DIP water main, replacement of fifteen fire hydrants, and transfer of approximately 180 existing water services to new 12-inch DIP water main infrastructure.
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Text version
Herbert, Rowland & Grubic, Inc. 00 65 19.16 - 1 009280.0426
CONTRACTOR’S AFFIDAVIT OF RELEASE OF LIENS
To Owner: Elizabethtown Area Water Authority Owner's Contract No.: WR-4 From Contractor: Contract Name:
Project: Water Main Replacement Project Phase 4 Contract Date:
Commonwealth of:
County of:
The undersigned, being duly sworn according to law, deposes and certifies that the cost of all labor, material, and equipment and outstanding claims and indebtedness of whatever nature arising out of the performance in
County, have been paid and satisfied in full as of (County) (State) (Date) and that there are no outstanding obligations or claims of any kind for the payment of which the Owner on the above named project might be liable, or subject to, in any lawful proceeding or in equity.
The undersigned is authorized by Contractor to execute this document on Contractor’s behalf and has personal knowledge of the facts state herein.
This day of , 20
Contractor:
By:
(Authorized signature)
(printed name)
Title:
Subscribed and sworn to me this date:
Notary Public:
(signature)
(printed name)
Commission Expires:
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