00 65 19.16 - Affidavit of Release of Liens.pdf
PDF 231 KB Posted
- Attached to
- WCTA Meter Replacement Project
- Solicitation number
- US.257570
- Issued by
- Lancaster County, Pennsylvania
About this file
This file is a Contractor's Affidavit of Release of Liens form, a standard legal document used in Pennsylvania construction contracts, specifically for the WCTA Meter Replacement Project administered by West Cocalico Township Authority. The affidavit serves as a certification that the contractor has paid all labor, material, equipment costs, and outstanding claims related to project performance in the designated county. The document requires the authorized contractor representative to swear under oath that no outstanding obligations or claims exist for which the owner might be liable, thereby protecting the owner from potential liens or legal proceedings arising from the contractor's work. This affidavit is typically executed upon project completion or at final payment stages.
The form is a standard contractual requirement with no specific pricing information, set-asides, or funding details included within the document itself. It functions as a compliance and verification instrument rather than a financial or procurement document, requiring notarization and the contractor's authorized signature to validate the certification. The affidavit's execution date and specific project details would be completed at the time of submission, ensuring documentation that all financial obligations related to construction work on the meter replacement project have been settled in full.
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Text version
Herbert, Rowland & Grubic, Inc. 00 65 19.16 - 1 011364.0448
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 .