Fill and Sign the Tennessee Paid Form

CONTRACTOR'S NOTICE TO OWNER THAT ALL LIENS HAVE BEEN PAID - GUARANTEE – FORM - INDIVIDUAL State of Tennessee County of _________________ On this ______ day of _______________ , 20 _______ , before me personally appeared ____________________________ , contractor, to me personally known, who being duly sworn by oath, did say that all of the persons, firms and corporations, including general contractors and all subcontractors, who have furnished services, labor or materials according to the plans or specifications, or extra items used in the construction or repair of buildings and improvements on the real estate hereinafter described, have been paid in full or will be paid in full no later than ten (10) days from the date a bill is rendered for such services, labor or materials and that such work has been fully completed and accepted by the owner, and further that such owner has paid the contract price in full, the receipt of which is hereby acknowledged. Affiant further says that no claims have been made to affiant by, nor is any suit pending on behalf of any contractors, subcontractors, laborers or materialmen, and further that no chattel mortgages or conditional bills of sale have been given or are now outstanding as to any materials, appliances, fixtures or furnishings placed upon or installed in the aforementioned premises. Affiant as a party does for a valuable consideration hereby agree and guarantee to hold the owner of the real estate, the owner's successors, heirs and assigns, harmless against any lien, claim or suit by any general contractor, subcontractor, mechanic or materialman and against chattel mortgages or conditional bills of sale in conjunction with the construction of such buildings or improvements on such real estate. The real estate and improvements referred to herein are situated in the County of _____________________ , State of Tennessee, and are described as follows: (give street address) _____________________________________________________________________________ . ____________________________________ Contractor ______ ______________________________ Type or Print Name Sworn to and subscribed before me on the date above first written. ____________________________________ Notary Public My Commission Expires: _________________ TN-02336-66-11-205 Contractor’s Notice to Owner That All Liens Have Been Paid Page 1 of 1