PROC0013 (06/06)
www.stonybrook.edu/procurement
Lien Release, Certification of Payment and Subcontractor
Whereas, the undersigned _______________________________ (Contractor) having its place of
business at __________________________________________ (Address) has furnished or
caused to be furnished certain materials, equipment, services and / or labor in connection with
Contract number ____________ and Project Title _________________ which is being provided
for Stony Brook University (Owner), pursuant to Owner’s agreement with Contractor.
Contractor does hereby:
Certify that all laborers, workers, and mechanics employed on said project were paid the wages
and supplements recorded as earned on the attached payroll records. No deductions have been
made either directly or indirectly from the wages and supplements other than deductions shown
on the payroll records. The payroll records submitted for the above period and attached hereto
are correct and complete. The number of hours shown for each employee reflects the actual
hours worked by that employee. The classification shown for each employee is accurate and
conforms to the work he or she performed.
Certify that there are no known mechanics’ or materialmen’s liens outstanding at the date of this
invoice, that all due and payable bills with respect to the work have been paid to date or are
included in the amount requested in the current invoice, and that, except for such bills not paid
but so included, there is no known basis for the filing of any mechanics’ or materialmen’s liens
on the services/material, and that waivers from all subcontractors and materialmen have been
obtained in such forms as to constitute a waiver of lien under the laws of the State of New York
for all preceding payments.
Waive and release any and all liens or claims of liens it has upon the foregoing described Project
through the date of the invoice.
Contractor hereby certifies that no subcontractors were utilized in the project billed on th