Fill and Sign the Contractor Affidavit 497331495 Form

Contractor’s Affidavit to Induce Lender to Release Funds STATE OF ____________________ COUNTY OF _______________________ PERSONALLY appeared before me, the undersigned authority in and for said county and state, _______________________ (Name of Affiant) , who, having been being first duty sworn by the undersigned Notary Public, deposes and says: 1. Affiant is executing and submitting this Contractor’s Affidavit personally and as _________________________ (Name of Office) of ____________________________ (Name of Corporate Contractor) , a corporation organized and existing under the laws of the state of ____________________, with its principal office located at ___________ _________________________________________________________ (street address, city, state, zip code) , a General Contractor operating in ________________ (Name) County. Affiant is executing this Contractor’s Affidavit in order to induce _________________________ (Name of Lender) , hereinafter called the Lender , to release funds pursuant to a Request for Draw submitted by the General Contractor in the amount of $_______________, under a Construction Contract, hereinafter called the Construction Contract between _____________________ (Name of Owner) , a corporation organized and existing under the laws of the state of _________________, with its principal office located at ___________________________________________ ___________________________ (street address, city, state, zip code) , hereinafter called the Owner , and General Contractor. 2. I hereby certify and warrant to Lender that: A. I am fully authorized to execute and deliver this Affidavit on behalf of the General Contractor, which has contracted with Owner to act as the General Contractor for the construction of improvements and/or repairs to a project located upon property at ____________________________________________ ____________________________________ (address of property) , hereinafter called the Project . B. General Contractor has been paid in full for all amounts owing to it for work performed and materials supplied on the Project under the Construction Contract through __________________ (date) , and all of General Contractor’s sub-contractors, suppliers and laborers who have performed work and/or furnished supplies or labor for the Project through that date have been paid in full. C. All invoices, bills and other amounts incurred in construction and/or repair with respect to the Project through the date inserted in Subparagraph B above have been paid in full and there are no construction liens or other similar liens against the Project and no claims for labor, services, or materials currently remain unpaid. D. General Contractor hereby waives and releases and forever quit claims to the Owner, all of its rights to claim a construction lien or any other lien or encumbrance for materials furnished and work or labor performed on the Project up to and including the date inserted in Subparagraph B above. E. If a construction lien or other lien is filled against the Project for any labor, services, materials, supplies or equipment furnished or alleged to have been furnished to or at the request of the General Contractor, the General Contractor agrees immediately to bond over or otherwise cause all such liens to be released in accordance with the law of the state in which the Project is located. F. If any other demand is made or litigation commenced against Lender or Owner that relates in any way to the matters set forth in this Affidavit, the General Contractor hereby covenants to bear sole responsibility for all costs and expenses incurred by the Lender and/or the Owner in relating to such demand or in such litigation. Such cost and expenses specifically include, but are not limited to, all costs and expenses of legal counsel retained by Lender and/or Owner. ____________________________ Name of General Contractor By:_____________________________ (Printed Name of Affiant) _____________________________ (Signature of Affiant) SWORN to and subscribed before me, this the _____ day of _______________, 20_____. _____________________________ NOTARY PUBLIC My Commission Expires: ___________________ The undersigned General Contractor does hereby authorize the release of $_____________ from the proceeds of the Mortgage Loan and to disburse same to _________________________________. To the best of our knowledge the above disbursement is in full satisfaction of all outstanding claims for labor and material furnished to date in connection with the improvements to the above Project. ______________________________ (Name of Contractor) By:____________________________ ____________________________ (P rinted name & Office in Corporation ____________________________ (Signature of Officer)