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ATA ® <br /> =1 111 Document G706A: - 1994 <br /> Contractor's Affidavit of Release of Liens <br /> PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: E <br /> IRC Fire Station #6 ARCHITECT: E <br /> 101 S. Highway A 1 A CONTRACT FOR: General <br /> Vero Beach, FL 32963 Construction CONTRACTOR: E <br /> TO OWNER: (Name and address) CONTRACT DATED: 7/ 19/05 SURETY: ❑ <br /> Indian River County <br /> 1840 25th Street OTHER: ❑ <br /> Vero Beach, FL 32960 <br /> STATE OF: Florida <br /> COUNTY OF: Indian River <br /> The undersigned hereby certifies that to the best of the undersigned' s knowledge, information and belief, except as <br /> listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers <br /> of materials and equipment, and all performers of Work, labor or services who have or may have liens or <br /> encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner <br /> out of the performance of the Contract referenced above. <br /> EXCEPTIONS: <br /> SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) <br /> 1 . Contractor' s Release or Waiver of Liens, Barth Construction, Inc. <br /> conditional upon receipt of final payment. 1717 Indian River Blvd., Suite 202A <br /> Vero Beach, FL 9:9 <br /> 2. Separate Releases or Waivers of Liens from BY: <br /> Subcontractors and material and equipment (Signattori of authorized <br /> suppliers, to the extent required by the Owner, representative) <br /> accompanied by a list thereof. Phil Barth <br /> (Printed name and title) <br /> Subs ribed and sworn to before me on this date: ;��/2�dly <br /> Notary Public: Marion Tupek <br /> My Commission Expires: July 21 , 2008 <br /> -pin % Marion H Tupek <br /> .d' W Commission DD339878 <br /> or rvo" Expires July 21 , 2008 <br /> AIA Document G70i — 1994. Copyright © 1982 and 1994 by The American Institute of Architects. All rights reserved. WARNING; This AiAi° <br /> Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AfAr' Document, or any 1 <br /> portion of it, may rester 7n severe civil and condnal penalties, and will be prosecuted to the maximum extent possible under the law. This document <br /> was produced by All software at 15:01 :23 on 05/12/2006 under Order No. 1000206383_1 which expires on 11/9/2006, and is not for resale. <br /> User Notes: (3932131218) <br />