NOTE: Require the general contractor to sign this form upon completion of the job as a pre-condition to making the final disbursement. Final Affidavit and Release of Lien State of Florida County of Miami-Dade BEFORE ME, the undersigned authority, personally appeared <**name of contractor president**>, who, after being by me first duly sworn, deposes and says of his personal knowledge that: 1. He is President of <**name of contractor**>, a Florida Corporation (hereinafter call the "Contractor"). 2. Contractor, pursuant to the Contract dated _____________ (hereinafter referred to as the "Contract") with <**name of owner**> (hereinafter referred to as the "Owner"), has heretofore furnished or caused to be furnished labor, materials and services for the construction of certain improvements as more particularly set forth in the Contract. 3. Contractor represents that all work to be performed under the aforesaid Contract has been fully completed and that all lienors under the direct contract have been paid in full, except the following:
4. In consideration of final payment to the Contractor in the amount of $_________ and all other previous payments paid by the Owner to the Contractor, the undersigned hereby for and in behalf of the Contractor, waives and releases its lien and right to claim a lien for labor, services, or materials furnished to the Owner. 5. The Affiant represents that he has authority to execute a full and final release of lien for and on behalf of the Contractor. 6. The Affiant makes this Affidavit and Release of Lien pursuant to Chapter 713, Florida Statutes, for the express purpose of inducing the Owner to make final disbursement and payment to the Contractor in the amount of $_____________. Signed, sealed and delivered this ____ day of ______, 20___ ________________________________ <**name of contractor's president**> Sworn to (or affirmed) and subscribed before me this ____ day of _____, 2001 by <**name of contractor's president**> who is personally known to me or who produced a valid Florida drivers license as identification ___________________________ Notary Public My Commission Expires: ________________ |