General Subcontractor Affidavit Form

General Subcontractor Affidavit Form

This General Subcontractor Affidavit ("Affidavit") is executed as of Effective Date: by and between Subcontractor Name: whose principal place of business is at and General Contractor Name: whose principal place of business is at .

RECITALS

WHEREAS, Owner Name: contracted with General Contractor to perform work on the project known as Project Name: located at Project Location: .

WHEREAS, Subcontractor entered into a subcontract dated Subcontract Date: to furnish labor, materials, and services described as Scope of Work: for a subcontract sum of $ .

WHEREAS, General Contractor requires, prior to payment or final closeout, that Subcontractor execute this Affidavit certifying certain facts concerning payments, liens, claims, and compliance with the subcontract and applicable law.

NOW, THEREFORE, in consideration of the mutual covenants herein contained and other good and valuable consideration, the parties agree as follows:

1. Definitions

For purposes of this Affidavit, the term "Work" means all labor, materials, equipment and services furnished by Subcontractor pursuant to the subcontract described above. "Payments" means all sums paid or payable to Subcontractor under the subcontract.

2. Affiant's Certification of Payment

Subcontractor certifies under penalty of perjury that, to the best of its knowledge and belief, the following statements are true and correct for the period commencing on Period Start: and ending on Period End: :

3. Lien Waiver and Release

Subcontractor acknowledges that, upon receipt of payment described above, Subcontractor shall execute a waiver and release of lien or claim to the extent of such payment. Subcontractor further certifies that, except as expressly set forth in this Affidavit, Subcontractor has no lien, stop notice, claim, or demand against the project, the Owner, or the General Contractor arising out of the Work performed under the subcontract.

Check applicable statement(s): Unconditional waiver and release upon final payment for amounts previously billed and received. Conditional waiver and release upon receipt of specified payment.

4. Claims, Liens and Encumbrances

Subcontractor affirms that there are no outstanding claims by Subcontractor's laborers, material suppliers, subcontractors, or others for unpaid labor or materials for the Work except as listed below. Subcontractor agrees to promptly release and discharge any lien, claim of lien, or stop notice that may be filed or recorded by Subcontractor or on Subcontractor's behalf upon receipt of payment.

5. Compliance with Laws; Taxes and Payroll

Subcontractor represents and warrants that it has complied with all applicable federal, state and local laws, ordinances, codes and regulations in the performance of the Work, including without limitation payroll, withholding, workers' compensation, unemployment insurance, and tax obligations. Subcontractor agrees to provide upon request payroll records, certified payrolls, lien releases from suppliers and subcontractors, and tax documentation necessary to substantiate such compliance.

6. Indemnity

Subcontractor shall indemnify, defend and hold harmless General Contractor and Owner from and against any loss, liability, claim, damage, cost or expense (including reasonable attorneys' fees) arising out of or relating to claims for payment by Subcontractor's subcontractors, suppliers, laborers or employees for Work performed under the subcontract, except to the extent such claims arise from the negligence or willful misconduct of General Contractor or Owner.

7. Remedies; Withholding

If any statement in this Affidavit is untrue, General Contractor may withhold payment or recover payment made and pursue any remedies available at law or in equity. The remedies provided herein are cumulative and in addition to any other rights or remedies available to General Contractor or Owner.

8. Attachments

Subcontractor attaches and incorporates the following documents as part of this Affidavit: invoices, lien waivers from lower-tier subcontractors, certified payroll records (if applicable), and any change order documentation that supports the amounts claimed below.

9. Notices

All notices required or permitted under this Affidavit shall be in writing and delivered to the addresses listed below by hand delivery, certified mail, or recognized courier service.

10. Governing Law; Entire Agreement; Severability

This Affidavit shall be governed by and construed in accordance with the laws of the state in which the Project is located, without regard to conflict of law principles. This Affidavit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior understandings. If any provision of this Affidavit is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.

11. Amendments; Waiver; Counterparts

No amendment, waiver or modification of this Affidavit shall be valid unless in writing and signed by both parties. A waiver of any breach shall not constitute a waiver of any subsequent breach. This Affidavit may be executed in counterparts and by electronic or facsimile signature, each of which shall be deemed an original and all of which together shall constitute one instrument.

12. Certification

Subcontractor certifies, under penalty of perjury under the laws of the state in which the Project is located, that the statements made in this Affidavit are true and correct to the best of Subcontractor's knowledge and belief.

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