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?17 ?3? 0442 P.11/ll
Contractor's Affidavit of
Release of Liens
AIA Document GT06A ·
Electronic Format
OWNER [ ]
CONTRACTOR Ix]
SURETY [ ]
OTI~R [ ]
THIS DOCUMENT 14.45 IMPORTANT I~OAL CONSE(~CES: CONSULTATION WTI'H AN ATTOKNEY IS b'NCOURAG~D WITH I~F.~PECT TO ITS
COMPLETION OR MODIFICATION. AUTHENTICATION OF TI.liS ELECTRONICALLY DRAFrED AIA DOCUMI[~rT MAY BE MADE BY USING
DOCUMENT D401.
TO OWST~gc Trinity U. M. Church
(N~.,ad~a,,s) 421 Bridge Street
New Cumberland, PA 17070
PRO/~CT: Trinity U. M. Church
~,e~.~a~-~; 405 Bridge Street
· New Cumberland, PA 17070
ARC~T~CT$ PRO,CT NO.: 01021
CONTRACT FOPc Renovations to 405 Bridge Street
New Cumberland, PA 17070
COb?TRACT DATED: October9,2001
STATE OF: PA
COUNTY OF: New Cumberland
The uadersil~ed hereby ectlifies that to the bes~ of the and=~d's knowle~e, information and belief, ~xcept as lis~ed below, the
Relc~es of Waivers of Lien at~ched hereto include the C ontmctof, all Subcomracmm, all suppliers of matedah and equipment, and
all performers of Woit/, labor or service~ who have or may trove lieas or eacamb~mces o~ ~he ri/hr w asse~ liem or ~cumbrances
a~ust a~y p,~perty of the Owner a.dsmg lu any manner out of thc performance of the Contract ref~c~ced above:
EXCEPTIONS:
SUPPORTING DOCUMENTS ATTACHED HERETO:
Contractor's Rclcasc or Waiver of Liens, conditional
upon receipt of fit~l p~yraent
Sepmmtc Rel~ses or Waivers of Liens f~om
Subcontractors and .mtedsl ~3d equipment mpplier~, to
the ~'~'nt required by thc Owac% accompanied by a list
thereof.
P-u:~lie K. Baldwin. No~ PuNic
City of Hanisbur~, DsaI~a Couaty
CONTRACTOR:' F. P. Verbos, Inc.
(Nm~,~md=~,-~.=,; P.O. BOX 4126A
Harrisburg, PA 17111-0129
($1K,~tU~ of a*aho~iz~d ~pr~z. tati~)
Sub~bed ~d sworn t~ore me on ~ ~t*;/~/~/~/~
My Co~,~ ~kes: / t - ~
AIA DOCUM~qT G?06A - CONTRACTOR'S AFl,DAVIT OF pm e~..~ OF LI~NS - 1994 EDITION - AIA - COPYRIGHT 19~;4 -
INSTITUTE OF AP. CHITECT~, 173~ NEW ¥O~J~. AVENU~ N.W., WASHINOTON D.C 20006~52~2. W~N~G; U~lic~d phomco~yi~ viol~es U.S,
cx~yn~hi laws sad is subjeci to le~d l~eCOfiO~. This dc~mem w~ elec'=o~icllly produced with pemds~ion of th~ AIA and ~'~ b~ r~l.~rod~ed wi~om wiola~ion
vatil lhe da~e of e~girali(m ~ ~o~xl below.
Elec~'onic Formal G706A - 1994
User Document G?06A. CON- 10/5]200J. AIA License N-mbe~ ~004~6, which expires on ~2/7;200~ - Page