Release of Lien Form Subcontractor Florida

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Release of Lien Form Subcontractor Florida Powered By Docstoc
					                              AFFADAVIT AND FINAL LIEN RELEASE
                                                                EXHIBIT D

                            AFFIDAVIT AND FINAL RELEASE OF LIEN (Subcontractor)

                                                          THE STATE OF

                                                          COUNTY OF

BEFORE ME, the undersigned authority, on this day personally appeared ______________________________________known to me
to be a credible person and officer of  (hereunder called “Subcontractor”), and who, being duly sworn, upon his oath declares and
acknowledges as follows:

1.      I am the duly authorized agent for Subcontractor which has authorized me to make this affidavit, to enter into the agreements
        and to grant the lien waivers herein set forth, on its behalf, and all of the facts and recitations herein are true and correct.

2.      Pursuant to an agreement             between Subcontractor, and Onicx, LLC a Florida Limited Liability Company (the
        “Contractor”), Subcontractor has supplied materials and performed labor in connection with the construction of improvements
        upon certain real property at      . Said improvements are more particularly described as       .

3.      Subcontractor has fully performed all Subcontractor’s work and has requested payment in the amount of $____________
        which Subcontractor represents is the full balance due and owing to Subcontractor for all materials supplied and work and
        labor performed by Subcontractor in connection with construction of said improvements.

4.      In consideration of and conditioned upon the payment by Contractor of said sum, Subcontractor waives and releases any and
        all liens, rights to liens, and interests, whether choate or inchoate and including, without limitation, all mechanic’s and
        materialman’s liens and other liens and claims now, or which in the future may be owed, claimed or asserted by Subcontractor
        against the aforesaid land, improvements (including personal property related thereto) OWNER and Onicx,LLC for all work
        done and materials and services furnished by Subcontractor.

5.      Subcontractor warrants, represents, and certifies that it has paid all laborers, subcontractors, materialmen, and all other
        persons or parties who have provided labor or materials through, for, or on behalf of Subcontractor to the above noted
        construction of improvements, and Subcontractor is not aware of any claim for payment or lien by such person or party who
        has furnished work on the construction of improvements through and under Subcontractor except as follows:

TELEPHONE NUMBER OF PARTIES NOT PAID                                                                                      AMOUNT OWED

6.      Subcontractor agrees to indemnify and hold Contractor and OWNER harmless against any and all loss, costs, damage and
        expense of whatever kind of character which Contractor or OWNER may suffer or incur by reason of the inaccuracy of any of
        the statements contained herein or by reason of the filing or assertion of any lien or claim arising out of Subcontractor’s work.

        EXECUTED this ______ day of ____________, 20__.


         SUBSCRIBED AND SWORN TO before me by the said _____________________________this ______ day of ___________,
20__, to certify which witness my hand and seal of office.

                                                                                                              Notary Public

                                                                                             Notary Public in and for ___________County

                                                                                             My commission expires: ________________

                                                                    D-1                                                 Onicx __________

                      3922 Premier North Drive ▪ Tampa, Florida 33618 ▪ 813.964.0967 ▪ Fax 813.964.0666 ▪ CGC 1512319

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Description: Release of Lien Form Subcontractor Florida document sample