Laserfiche WebLink
<br />STATE OF <br /> <br />) <br /> <br />SS AFFIDAVIT AND WAIVER OF LIEN <br />SUBCONTRACTOR <br />OWNER'S PROJECT NO. <br /> <br />COUNTY OF <br /> <br />) <br /> <br />of <br />being first duly sworn, states as follows: <br /> <br />1) I am the (title and/or position) of <br />(hereinafter referred to as <br />("COMPANY") and am familiar with the facts herein stated. <br /> <br />2) COMPANY has performed for <br />(hereinafter referred to as "ENGINEER"), certain labor, and/or furnished <br />certain supplies, materials, equipment and/or other facilities for use in the <br />construction of certain buildings and improvements on certain land owned by <br />(hereinafter referred to as <br /> <br />"OWNER"), at <br /> <br />3) COMPANY has paid in full for all such labor, supplies, materials, <br />equi pment and other facil iti es furni shed by it, or by others for it, in <br />connection with the Project, arid full payment has been made by all such <br />others for all 1 abor, supp 1 i es, materi a 1 s, equi pment and other fad 1 i ti es <br />furnished by them. <br /> <br />4) COMPANY has no lien or claim rights on account of any labor, <br />supplies, materials, equipment or other facilities furnished by it, or by <br />others for it, in connection with the Project. <br /> <br />5) COMPANY hereby waives all liens and claims against OWNER, its <br />premises, assets and property, and all claims against ENGINEER. <br /> <br />6) COMPANY will hold OWNER and ENGINEER harmless against any and all <br />liens, and claims and suits on liens, including all expenses, costs and <br />attorney fees associ ated therewith, arising out of any labor, suppl ies, <br />materi a 1 s, equi pment or other facil i ti es furni shed by it, or by others for <br />it, in connection with the Project. <br /> <br />Further affiant saith not. <br /> <br />Subcontractor <br /> <br />Attest: <br /> <br />Secretary <br /> <br />By <br /> <br />- 11 - <br />