Fill and Sign the Affidavit of Labor or Materials Furnsihed Form

Affidavit of Labor or Materials Furnished Page 1 of 2 AFFIDAVIT OF LABOR OR MATERIALS FURNSIHED (Colorado Revises Statute §38-22-130(1)) Comes now, ___________________________________, whose address is _______________________________________________________________________, and after being duly sworn hereby states as follows:1. Beginning on or about the _____ of _______________, 20_____, the undersigned Affiant furnished labor or materials in the improvement of the real property located at ___________________________________________________________.2.The Affiant undertook to furnish labor and materials for said improvements based upon agreements between the Affiant and principal contractor, __________________________________, in the value of $_____________.3. Further, the principal contract and his surety ________________________________, have executed a bond for these improvements subsequent to C.R.S. §38-22-129. 4. The Affiant has not yet been paid the value of the labor or materials provided.5. Pursuant to C.R.S. §38-22-130 if this affidavit remains uncontroverted by the principal contractor forty-five (45) days after date of service, the surety shall pay to the Affiant the full amount of his claim. This the _____ day of _______________ , 20_____. _______________________________________Signature of Affiant_________________________________________Print Name of Affiant Affidavit of Labor or Materials Furnished Page 2 of 2STATE OF COLORADOCOUNTY OF _____________________ The foregoing instrument was acknowledged before me this _____________________ (date) by _________________________________________ (name of person acknowledged.) ______________________________Notary Public Printed Name: _________________ My Commission Expires: _____________________ Certificate of Delivery I, _____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to ___________________________________ by: ( )Personal Service ( )Mailing a true and correct copy of same by registered or certified U.S. mail, postage prepaid, return receipt requested to ___________________________, ( ) Leaving a true and correct copy of same at the recipient’s residence or place of business at ____________________________________________________ with some person in charge.So certified this the ______ day of ___________________, 20____. ________________________Signature