PROJECT 0000
00672/1
SECTION 00672 - CONTRACTOR'S AFFIDAVIT OF PAYMENT OF
DEBTS AND CLAIMS AND RELEASE OF LIENS
Project No.
Contract No.
Name of Project
Owner
Contractor
State of
City or County of __________________
The undersigned, pursuant to Article 14 of the General Conditions, hereby certifies:
A.
That, except as listed below, he has paid in full or has otherwise satisfied all
obligations for all materials and equipment furnished, for all Work, labor and
services performed, and for all known indebtedness and claims against the
Contractor for damages arising in any manner in connection with the performance
of the Contract referenced above for which the Owner or his property might in
any way be held responsible.
EXCEPTIONS: (If none, write "None". If required by the Owner, the Contractor
shall furnish bond satisfactory to the Owner for each exception.)
PROJECT 0000
00672/2
B.
That to the best of his knowledge, information and belief, except as listed below,
the Releases or Waivers of Lien attached hereto include the Contractor, all
Subcontractors, all suppliers of materials and equipment, and all performers of
Work, labor or services who have or may have liens against any property of the
Owner arising in any manner out of the performance of the Contract referenced
above.
EXCEPTIONS: (If none, write "None". If required by the Owner, the Contractor
shall furnish bond satisfactory to the Owner for each exception.)
SU