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Contractor's Interim Payment Affidavit

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CONTRACTOR'S INTERIM PAYMENT AFFIDAVIT – CORPORATION

After Recording Return to:

--------Above This Line Reserved For Official Use Only--------

STATE OF FLORIDA

COUNTY OF

BEFORE ME, the undersigned authority, personally appeared

who, after being first duly sworn, deposes and says of the affiant's personal knowledge the following:

1. The affiant is the of

hereinafter referred to as the "Contractor."

2. Contractor, pursuant to a contract with , hereinafter referred to as the "Owner," has furnished or caused to be furnished labor, materials, and services for the construction of certain improvements to real property as more particularly set forth in said contract.

3. This Affidavit is executed by the Contractor in accordance with Section 713.06 of the Florida Statutes for the purposes of obtaining payment from the Owner in the amount of

$

4. All of the work to be performed under the contract has been fully completed, and all lienors under the direct contract have been paid in full, except the following described work and listed lienors:

Work still to be performed under contract:

Name/Address of Lienor

Amount Due

Name/Address of Lienor

Amount Due

Contractor's Interim Payment Affidavit

Page 1 of 2

Signed, sealed and delivered this day of ,

By:

Name of Affiant

Title of Affiant

Type or Print Name

Name of Corporation

Attest:

Secretary

STATE OF

COUNTY OF

Sworn to (or affirmed) and subscribed before me this day of

by who is

personally known to me or produced as identification, and who did take an oath.

NOTARY PUBLIC

Printed Name of Notary

Commission Expires

Certificate of Service

I, hereby certify that I have delivered this

day a true and attested copy of the foregoing to by:

Actual Delivery to the person to be served.

Mailing a true and correct copy of same by registered or certified U.S. mail, with postage prepaid, or by overnight or second-day delivery with evidence of delivery.

If service cannot be made by the above methods, by posting on the premises.

Signature

Contractor's Interim Payment Affidavit

Page 2 of 2

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What the Contractor's Interim Payment Affidavit Is

A Contractor's Interim Payment Affidavit is a sworn declaration, supplied by a contractor or subcontractor, that summarizes work performed, materials supplied, and amounts due during a defined billing period. It typically accompanies a progress payment request and may certify that subcontractors and suppliers have been paid to date or that liens will be waived upon payment. The affidavit documents payment history, retention amounts, percentage complete, and any change orders, creating a record used by owners, lenders, and construction managers to verify pay applications.

Why this affidavit matters for payments and risk control

The affidavit clarifies earned amounts, confirms compliance with contract terms, and reduces owner and lender risk by documenting subcontractor payment status and lien waiver intent. It supports timely payments and helps resolve disputes over scope, quantities, or change orders.

Why this affidavit matters for payments and risk control

Who prepares and relies on the Interim Payment Affidavit

The form is used by contracting parties and project stakeholders to support progress billing and trust in disbursements.

  • Prime contractors preparing monthly or milestone pay applications and certifying downstream payments and lien waivers.
  • Subcontractors submitting pay requests to primes while certifying labor and materials performed during the interim period.
  • Owners, lenders, and construction managers reviewing documented work, retainage, and subcontractor payment attestations before authorizing release of funds.

Accurate completion preserves payment flow and reduces the likelihood of withheld funds or downstream lien claims.

Step-by-step: completing an interim payment affidavit

Follow these steps to prepare a compliant affidavit that supports a pay application and mitigates lien risk.

  • 01
    Gather records: Collect invoices, lien waivers, and payroll records supporting billed work.
  • 02
    Fill required fields: Enter contractor, project, period, and dollar amounts precisely.
  • 03
    Attach support: Include supplier invoices, subcontractor waivers, and change order documents.
  • 04
    Sign and notarize: Have the authorized representative sign and obtain notary or witness if contract requires.

Core sections to include in a professional interim payment affidavit

A complete affidavit has standardized sections that make verification straightforward for owners, lenders, and third-party reviewers.

Header

Project and contract identifiers plus contractor contact details so reviewers can confirm the affidavit applies to the correct job and contract.

Scope summary

Concise description of work performed during the billing period, including percent complete, milestones achieved, and references to change orders when applicable.

Financial schedule

Line-by-line accounting of contract value, previous payments, current request, retainage, credits, and net amount due for the period.

Subcontractor status

List of impacted subcontractors and suppliers with payment status and any outstanding claims or disputed items.

Supporting attachments

Attached invoices, lien waivers, certified payrolls, and approved change orders that substantiate amounts claimed in the affidavit.

Certification block

Signed statement by an authorized officer attesting to truthfulness, plus notarization or witness language if contract or state law requires.

Required data elements at a glance

Contractor ID: Legal name
Project Info: Project name
Period End: MM/DD/YYYY
Amounts: Currency values
Signatory: Name and title
Authentication: Notary or witness

Configuring an online affidavit workflow

Design a digital workflow to collect, verify, and archive affidavits alongside supporting documents.

Field Configuration
Signer order Sequence signers (contractor, prime, owner) to enforce approvals
Required attachments Make invoices and lien waivers mandatory uploads before signature
Authentication Enable email OTP or stronger signer verification per contract needs
Retention rule Auto-archive signed affidavit to project folder with audit trail

Digital signing considerations and platform features

Choose a signing platform that supports required authentication, notarization workflows, and secure storage for construction records.

  • Authentication options: Email OTP, SMS, or KBA
  • Notarization support: Remote Online Notary capable
  • File formats: PDF, DOCX supported

Ensure the platform captures a verifiable audit trail, stores attachments securely, and integrates with project systems used by owners or lenders.

Typical routing and submission flow

A consistent submission process reduces review time and prevents payment delays.

  • Prepare document: Contractor completes affidavit and attaches supporting records
  • Sign and verify: Authorized representative signs; platform records authentication
  • Submit with pay app: Affidavit and attachments accompany the pay application
  • Owner review: Owner or lender verifies documents and releases funds if compliant

Typical timing and deadlines to track

Track both internal payment cycles and statutory deadlines that affect lien rights and final payment.

Affidavit submission:

Submit it with each periodic pay application per contract schedule

Owner review window:

Owner often has 7–30 days to review pay applications

Retainage release:

Final retainage release tied to final affidavit and closeout requirements

Lien preservation:

Statutory notice and filing periods vary by state; check local statute

Document retention:

Keep supporting records according to retention rules listed below

Key milestones in the pay application lifecycle

A clear milestone sequence helps coordinate payment requests, review, and final closeout.

01

Prepare affidavit

Compile work logs, invoices, and lien waivers for the billing period

02

Notarize and sign

Execute affidavit and secure notarization or required witnesses

03

Submit pay application

Attach affidavit and supporting documents to the payment request

04

Owner approval

Owner or lender reviews and authorizes partial or full payment

Common mistakes that delay payments

  • Incomplete supporting attachments lead owners to withhold payment pending clarification or audit.
  • Mismatched contractor or payee names between contract, W-9, and affidavit can trigger backup withholding or payment holds.
  • Unsigned or improperly notarized affidavits are often returned unreadable and delay processing by weeks.
  • Failure to list subcontractor payments or outstanding claims can expose the contractor to lien filings or disputed retainage.

Consequences of inaccurate or missing affidavits

Payment delay: Funds withheld pending verification
Lien exposure: Subcontractors may file lien claims
Contract breach: Noncompliance can breach payment terms
Tax issues: Incorrect payee data risks backup withholding
Contractor liability: False statements can create indemnity obligations
Legal costs: Disputes increase litigation expense

Who can sign and certify the affidavit

Authorized Contractor Representative

An officer or managerial employee with authority to bind the contractor should sign. The signer must be able to attest to financial and payroll records and to authorize release of lien waivers.

Subcontractor Project Manager

Subcontractor signers typically are project managers or company officers who can verify labor, materials, and subcontractor payment status appearing on the affidavit.

eSignature vendor pricing comparison for affidavit workflows

Common vendor pricing and feature availability for managing affidavits and supporting documentation. signNow appears first in the vendor column.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial Yes, 7-day free trial No No Yes, limited Yes, limited
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently asked questions about Interim Payment Affidavits

Answers to common questions about completion, authentication, and submission of Contractor's Interim Payment Affidavits.


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