00 65 19.16 - Affidavit of Release of Liens.pdf

PDF 228 KB Posted

Attached to
Alterations for Penn Township Municipal Building - Shop
Solicitation number
Not on record
Issued by
Lancaster County, Pennsylvania

About this file

This is a Contractor's Affidavit of Release of Liens document related to the Alterations for Penn Township Municipal Building project in Pennsylvania. The affidavit serves as a sworn certification that the contractor has paid all labor, material, equipment costs, and outstanding claims arising from the project performance in the specified county. The document is executed by an authorized representative of the contractor and notarized, confirming that no outstanding obligations or claims exist for which the owner might be liable. The affidavit must be completed and submitted as part of the contract documentation, with the contractor certifying under oath that all project-related financial obligations have been satisfied in full as of the specified date.

This affidavit is a standard contractual requirement typically submitted upon project completion or at final payment. It protects the owner from potential mechanic's liens or claims by contractors, subcontractors, or material suppliers. The document requires specific project information including the owner's contract number, contract name, project location, contract date, and the Commonwealth and County where work was performed. The affidavit must be signed by an authorized contractor representative with personal knowledge of the facts stated and notarized before a qualified notary public, with the notary's commission expiration date documented on the form.

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Text version

Herbert, Rowland & Grubic, Inc. 00 65 19.16 - 1 006566.0459

CONTRACTOR’S AFFIDAVIT OF RELEASE OF LIENS

To Owner: Owner's Contract No.:

From Contractor: Contract Name:

Project: 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:

File details come from the government source that posted it. Updated .