CONTRACTOR'S FINAL PAYMENT AFFIDAVIT STATE OF FLORIDA, COUNTY OF____________________. BEFORE ME, the undersigned authority, personally appeared _________________________ (name of affiant), who, after being duly sworn, deposes and says of his or her personal knowledge the following: 1. He or she is the _________________________(title of affiant), of _________________________(name of contractor's business), which does business in the State of Florida, hereinafter referred to as the "Contractor". 2. Contractor, pursuant to a contract with _________________________ (name of owner), hereinafter referred to as the "Owner", has furnished or caused to be furnished labor, materials, and services for the construction of certain improvements to real property as more particularly set forth in said contract. 3. This Affidavit is executed by the Contractor in accordance with Section 713.06 of the Florida Statutes for the purpose of obtaining final payment from the Owner in the amount of $__________________. 4. All work to be performed under the contract has been fully completed, and all lienors under the direct contract have been paid in full, except the following listed lienors: NAME OF LIENOR AMOUNT DUE
Signed, sealed, and delivered this __________ day of
____________________, ______ By___________________________ ___________________________ ___________________________ Sworn to and subscribed before me this __________ day of
____________________, ______
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