Notice Of Commencement Form - State Of Florida, County Of Collier
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1Permit No. _______________Tax Folio No. _______________________
NOTICE OF COMMENCEMENT
State of FLORIDA
County of COLLIER
The undersigned hereby gives notice that improvement will be made to
certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement.
(legal description of the property, and street address if available)
Description of Property
1.
:
____________________________________________________________________________________________________.
General description of improvement
2.
: ______________________________________________________________.
Owner Information
3.
:
a. Name and address: _______________________________________________________________________________.
b. Interest in property: _______________________________________________________________________________.
(if different from Owner listed above)
c. Name and address of fee simple titleholder
:
____________________________________________________________________________________________________.
(name and address)
Contractor
4.a.
:
___________________________________________________________________________________________________.
b. Contractor’s phone number: ______________________________.
(if applicable, a copy of the payment bond is attached):
Surety
5.
___________________________________________________________.
a. Name and Address:
b. Phone number: ________________________________. c. Amount of bond: _______________________________.
(name and address)
Lender
6a.
:
__________________________________________________________________________.
b. Lender’s phone number: _________________________________.
7. Persons within the State of Florida Designated by Owner upon whom notices or other documents may be served
as provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address: ________________________________________________________________________________
____________________________________________________________________________________________________.
b. Phone numbers of designated persons: ______________________________________________________________.
8a. In addition to himself or herself, Owner designates ___________________________ of _______________________
to receive a copy of Lienor’s Notice as provided in Section 713.13 (1)(b) Florida Statutes.
b. Phone number of person or entity designated by owner: __________________________________.
(the expiration date may not be before the completion of construction and final
Expiration date
9.
of notice of commencement
payment to the contractor, but will be 1 year from the date of recording unless a different date is specified)
__________________________________.
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true
to the best of my knowledge and belief.
__________________________________________
_____________________________________
(Signature of Owner or Lessee, or Owner’s or Lessee’s Authorized Officer/Director/Partner/Manager)
(Signatory’s Title/Office)
The foregoing instrument was acknowledged before me this ______ day of ______________________________,
(year
(name of person
(type of authority,...e.g.
_______
), by _______________________________
) as _______________________
officer, trustee, attorney in fact)
(name of party on behalf of whom instrument was executed)
for _______________________________
.
DWIGHT E BROCK, CLERK OF CIRCUIT COURT
___________________________________
______________________________________
(Signature of Deputy Clerk)
(Signature of Notary Public – State of Florida)
___________________________________
______________________________________
(Printed name of Deputy Clerk)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known ________ OR Produced Identification _______
Type of Identification Produced ____________________________
Rev. 11/2011
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