Final Payment Affidavit

Contractors Final Payment Affidavit

State of Florida, County of ______________, Florida Statutes 713.06

PRIME CONTRACTOR

 

 

 

 

Name of Person Making this Affidavit“AFFIANT”):

 

His/HerTITLE:

 

PROPERTY OWNER

 

 

 

 

AMOUNT currently due the PRIME CONTRACTOR:

$

LIST OF ALL LIENORS UNDER DIRECT CONTRACT WITH THE PRIME CONTRACTOR AND AMOUNT DUE:

Name:

Amount Due: $

Name:

Amount Due: $

Name:

Amount Due: $

Name:

Amount Due: $

BEFORE ME, the undersigned authority, personally appeared the AFFIANT, who after being duly sworn, did depose and say of his or her own personal knowledge th e following:

  1. He or She is the TITLE of the above - identified PRIME CONTRACTOR, which does business in the state of Florida.
  2. PRIME CONTRACTOR, pursuant to a contract with the PROPERTY OWNER, has furnished or caused to be furnished labor, materials and serv ices for the construction of certain improvements to the real property as more particularly set forth in said contract.
  3. This affidavit is executed by the PRIME CONTRACTOR in accordance with section 713.06 of the Florida Statutes for the purposes of obtaini ng final payment form the PROPERTY OWNER in the above - identified AMOUNT.
  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 for the above - listed LIENORS.

Sworn to and subscribed before me, on this date provided by AFFIANT, who is personally known or proved to me, who did swear and state that the above - instrument was signed by him or her.

Notary Public

Signed, sealed and delivered

this____ day of ____________, 20____.

PRIME CONTRACTOR by the AFFIANT

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