Orange County NC Website
Browse       Search
Orange County DAA PN: R00592-226N <br />C&D Landfill Phase 2 Construction April 2021 <br /> Release of Liens - 1/1 <br /> CONTRACTOR'S AFFIDAVIT OF RELEASE OF LIENS <br /> <br /> <br />TO: (OWNER) <br /> <br />________________________________ <br />PROJECT INFORMATION <br />(Name & Location) <br /> <br />________________________________ <br />CONTRACT DATE <br /> <br />The undersigned hereby certifies that to the best of the undersigned's knowledge, information and belief, <br />except as listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all <br />Subcontractors, all suppliers of materials and equipment, and all performers of Work, labor or services <br />who have or may have liens or encumbrances or the right to assert liens or encumbrances against any <br />property of the Owner arising in any manner out of the performance of the Contract referenced above. <br /> <br />EXCEPTIONS: <br />_____________________________________________________________________________________ <br />_______________________________________________________ <br />______________________________________________________________________ <br /> <br /> <br /> <br />SUPPORTING DOCUMENTS ATTACHED <br />HERETO: <br /> <br />1. Contractor's Release or Waiver of Liens, <br />conditional upon receipt of final payment. <br /> <br />2. Separate Releases or Waivers of Liens <br />from Subcontractors and material and <br />equipment suppliers, to the extent <br />required by the Owner, accompanied by a <br />list thereof. <br /> <br />CONTRACTOR: _________________________ <br /> <br />Address: _______________________________ <br /> <br /> _______________________________ <br /> <br />By: _______________________________ <br /> <br />Notary: <br /> <br />Subscribed and sworn to before me this date: <br /> ______________ <br /> <br />Signature Notary Public :___________________ <br /> <br />Printed Name: ___________________________ <br /> <br />My Commission Expires: ___________________ <br /> <br />DocuSign Envelope ID: 0844D1D6-E311-4FC5-8B5B-BB1E27A908ED