Common use of CONTRACTOR'S AFFIDAVIT Clause in Contracts

CONTRACTOR'S AFFIDAVIT. COMMONWEALTH OF MASSACHUSETTS ) ) SS COUNTY OF ) TO WHOM IT MAY CONCERN: THE UNDERSIGNED, (NAME) BEING DULY SWORN, DEPOSES AND SAYS THAT HE OR SHE IS (POSITION) OF (COMPANY NAME) WHO IS THE CONTRACTOR FURNISHING WORK ON THE BUILDING LOCATED AT OWNED BY . That the total amount of the contract including extras* is $ which he or she has received payment of $ prior to this payment. That all waivers are true, correct and genuine and delivered unconditionally and that there is no claim either legal or equitable to defect the validity of said waivers. That the following are the names and addresses of all parties who have furnished material or labor, or both, for said work and all parties having contracts or sub contracts for specific portions of said work or for material entering into the construction thereof and the amount due or to become due to each, and that the items mentioned include all labor and material required to complete said work according to plans and specifications: NAMES AND ADDRESSES WHAT FOR CONTRACT PRICE INCLDG EXTRAS* AMOUNT PAID THIS PAYMENT BALANCE DUE $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ That there are no other contracts for said work outstanding, and that there is nothing due or to become due to any person for material, labor or other work of any kind done or to be done upon or in connection with said work other than above stated. DATE SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF , 20 . NOTARY PUBLIC * EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT. Exhibit D

CONTRACTOR'S AFFIDAVIT. COMMONWEALTH OF MASSACHUSETTS ) ) SS COUNTY OF ) TO WHOM IT MAY CONCERN: THE UNDERSIGNED, (NAME) BEING DULY SWORN, DEPOSES AND SAYS THAT HE OR SHE IS (POSITION) OF (COMPANY NAME) WHO IS THE CONTRACTOR FURNISHING WORK ON THE BUILDING LOCATED AT OWNED BY . That the total amount of the contract including extras* is $ which he or she has received payment of $ prior to this payment. That all waivers are true, correct and genuine and delivered unconditionally and that there is no claim either legal or equitable to defect the validity of said waivers. That the following are the names and addresses of all parties who have furnished material or labor, or both, for said work and all parties having contracts or sub contracts for specific portions of said work or for material entering into the construction thereof and the amount due or to become due to each, and that the items mentioned include all labor and material required to complete said work according to plans and specifications: NAMES AND ADDRESSES WHAT FOR CONTRACT PRICE INCLDG EXTRAS* AMOUNT PAID THIS PAYMENT BALANCE DUE $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ That there are no other contracts for said work outstanding, and that there is nothing due or to become due to any person for material, labor or other work of any kind done or to be done upon or in connection with said work other than above stated. DATE SIGNATURE SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF , 20 . NOTARY PUBLIC * EXTRAS INCLUDE BUT ARE NOT LIMITED TO CHANGE ORDERS, BOTH ORAL AND WRITTEN, TO THE CONTRACT. Exhibit D.