Contractor'S Affidavit And Waiver Of Lien Form printable pdf download

CONTRACTOR’S AFFIDAVIT AND WAIVER OF LIEN

STATE OF____________________

COUNTY OF__________________

I, _____________________________ of _____________________________________________, being sworn, says he is the

____________________of ____________________________________________ (hereinafter referred to as the “Contractor”

has finished all materials, labor, tools, equipment, construction facilities and everything of every sort and has performed all

work required by the contract entered into with Public Storage, 701 Western Avenue, Glendale, CA 91201 (hereinafter

referred to as “PS”) dated the _____day of ______________, 20___ pertaining to:

Property Address work performed at:________________________________________________________________________

Description of Work:

______________________________________________________________________________________________________

The contractor has fully paid for all said materials, labor, tools, equipment, construction facilities and everything of every sort

furnished by it, or by its subcontractors or material men, upon said premises and furnished therefore for said work.

The current amount due from PS, and unpaid to Contractor, is the sum of $______________, and upon payment to the

Contractor of said sum, Contractor hereby waives all liens and claims against PS, its premises and property for said sum, and

further, Contractor represents that no other person or party has right to a lien on account of any work performed for, or material

furnished to Contractor for said work.

By: ___________________________________________________________

Contractors Federal Tax ID # ________________________________

Sole Proprietor Social Security # _____________________________

BEFORE ME, the undersigned authority, on this day personally appeared ____________________ known to me to be

the person whose name is subscribed to the foregoing instrument and acknowledged to me that he executed the same

for purposes and consideration therein expressed, GIVEN under my hand and seal of office, this _____ of

______________, 20___.

My commission expires ____________

NOTARY PUBLIC: ____________________

Contractor'S Affidavit And Waiver Of Lien Form