FINAL CONTRACTOR'S AFFIDAVIT
Before me, the undersigned authority, personally appeared
, who, after being duly sworn, deposes and says that:
1. Affiant is the of hereinafter
called "Contractor" and as such makes this affidavit upon personal knowledge.
2. This affidavit is made pursuant to Section 713.06(3)(d)(1) Florida Statutes for the
purpose of inducing final payment from to Contractor for work done at (legal
pursuant to the contract or invoice dated
3. All laborers, materialmen and subcontractors who worked for Contractor under
said contract have been paid in full, except for those listed below:
SWORN TO and subscribed before me this day of ,
by (name), as
(name of corporation), a (State) corporation, on behalf of the corporation.
He/She [please check as applicable] /______/ is personally known to me, or has produced /
his/her (state) driver's license, or / / his/her
(type of identification) as identification.
NOTARY PUBLIC, STATE OF
(Commission Expiration Date)