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AIA Document G706' - 1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: CONTRACT FOR: TO OWNER: (Name and address) CONTRACT DATED: STATE OF: COUNTY OF: OWNER: ❑ ARCHITECT: 0 CONTRACTOR: 0 --SURETY:-❑ .O_THER:-p.,, The undersigned hereby certifies that, except as listed below, payment has been made in full andlall obligations have otherwise been satisfied for all materials and equipment furnished, for all work, labor, and services performed,9and for all known indebtedness and claims against the Contractor for damages arising in any manner ;in connecioniwith the performance of the Contract referenced above for which the Owner or Owner's property right in any way be held responsible or encumbered. EXCEPTIONS: SUPPORTING DOCUMENTS ATTACHED HERETO: 1. Consent of Surety to Final Payment. Whenever Surety is involved, Consent of Surety is required. AIA Document G707, Consent of Surety, may be used for this purpose Indicate Attachment 0 Yes ® No The following supporting documents should be attached hereto if required by the Owner: CONTRACTOR: (Name and :address) BY: (Signature of authorized epresetitative),. 1. Contractor's Release or Waiver of Liens, (Printed name and title) Subscribed and sworn to before me on this date: conditional upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subcontractors and material and equipment suppliers, to the extent required by the Owner, accompanied by a list thereof. 3. Contractor's Affidavit of Release of Liens (AIA Document G706A). Notary Public: My Commission Expires: AIA Document G706m — 1994. Copyright ® 1982 and 1994 by The American Institute of Architects. A11 rights reserved. WARNING: This AIA' Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA" Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This draft was produced by AIA software at 10:58:19 on 03/02/2005 under Order No.1000142432_1 which expires on 10/20/2005, and is not for resale. User Notes: (2220934989)