Form 106 "Contractor's Affidavit of Completion, Payment of Debts and Claims, and Release of Liens" - Montana

What Is Form 106?

This is a legal form that was released by the Montana Department of Administration - a government authority operating within Montana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2019;
  • The latest edition provided by the Montana Department of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 106 by clicking the link below or browse more documents and templates provided by the Montana Department of Administration.

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Download Form 106 "Contractor's Affidavit of Completion, Payment of Debts and Claims, and Release of Liens" - Montana

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STATE OF MONTANA
DEPARTMENT OF AD MI NISTRAT ION
ARCHITECTURE AND ENGINEERING DIVISION
1520 East Sixth Avenue • P.O. Box 200103 • Helena MT
59620-0103 Phone: 406 444-3104 • Fax: 406 444-3399
CONTRACTOR’S AFFIDAVIT OF COMPLETION,
PAYMENT OF DEBTS AND CLAIMS, AND RELEASE OF LIENS
Project Name:
Location:
A/E #:
I CERTIFY to the best of my knowledge and belief that all work has been performed and materials supplied in strict
accordance with the terms and conditions of the corresponding contract documents between the STATE OF MONTANA,
acting by and through its DIRECTOR, DEPARTMENT OF ADMINISTRATION, hereinafter called the Owner, and
, hereinafter called the CONTRACTOR, for the above referenced project.
I further certify and declare that all bills for materials, supplies, utilities and for all other things furnished or caused to be
furnished by the CONTRACTOR and used in the execution of the contract will be fully paid upon receipt of Final Payment
and that there are no unpaid obligations, liens, claims, security interests, encumbrances, liabilities and/or demands of State
Agencies, subcontractors, materialmen, mechanics, laborers or any others resulting from or arising out of any work done,
caused to be done or ordered to be done by the CONTRACTOR under the contract.
In consideration of the prior and final payments made and all payments made for authorized changes, the CONTRACTOR
releases and forever discharges the OWNER from any and all obligations, liens, claims, security interests, encumbrances
and/or liabilities arising by virtue of the contract and authorized changes between the parties, either verbal or in writing, and
any and all claims and demands of every kind and character whatsoever against the OWNER, arising out of or in any way
relating to the contract and authorized changes.
I further certify and agree that the warranty period is defined as commencing with Substantial Completion (or with each
Substantial Completion if there is more than one) of the Project, or any portion thereof, and continuing for one (1) calendar
year from the date of Final Acceptance of the entire project unless otherwise modified in writing as part of the Substantial
Completion or Final Acceptance.
This statement is made for the purpose of inducing the OWNER to make FINAL PAYMENT under the terms of the contract,
relying on the truth and statements contained herein.
(Seal)
CONTRACTOR
(Signature)
(Title)
Subscribed and sworn to me this
Day of
,
(Seal)
NOTARY
Notary Public for the State of Montana
My Commission Expires:
Contractor's Affidavit of Completion, Payment of Debts and Claims, and Release of Liens (Rev 3/19)
Form 106
1 of 1
Clear Form
STATE OF MONTANA
DEPARTMENT OF AD MI NISTRAT ION
ARCHITECTURE AND ENGINEERING DIVISION
1520 East Sixth Avenue • P.O. Box 200103 • Helena MT
59620-0103 Phone: 406 444-3104 • Fax: 406 444-3399
CONTRACTOR’S AFFIDAVIT OF COMPLETION,
PAYMENT OF DEBTS AND CLAIMS, AND RELEASE OF LIENS
Project Name:
Location:
A/E #:
I CERTIFY to the best of my knowledge and belief that all work has been performed and materials supplied in strict
accordance with the terms and conditions of the corresponding contract documents between the STATE OF MONTANA,
acting by and through its DIRECTOR, DEPARTMENT OF ADMINISTRATION, hereinafter called the Owner, and
, hereinafter called the CONTRACTOR, for the above referenced project.
I further certify and declare that all bills for materials, supplies, utilities and for all other things furnished or caused to be
furnished by the CONTRACTOR and used in the execution of the contract will be fully paid upon receipt of Final Payment
and that there are no unpaid obligations, liens, claims, security interests, encumbrances, liabilities and/or demands of State
Agencies, subcontractors, materialmen, mechanics, laborers or any others resulting from or arising out of any work done,
caused to be done or ordered to be done by the CONTRACTOR under the contract.
In consideration of the prior and final payments made and all payments made for authorized changes, the CONTRACTOR
releases and forever discharges the OWNER from any and all obligations, liens, claims, security interests, encumbrances
and/or liabilities arising by virtue of the contract and authorized changes between the parties, either verbal or in writing, and
any and all claims and demands of every kind and character whatsoever against the OWNER, arising out of or in any way
relating to the contract and authorized changes.
I further certify and agree that the warranty period is defined as commencing with Substantial Completion (or with each
Substantial Completion if there is more than one) of the Project, or any portion thereof, and continuing for one (1) calendar
year from the date of Final Acceptance of the entire project unless otherwise modified in writing as part of the Substantial
Completion or Final Acceptance.
This statement is made for the purpose of inducing the OWNER to make FINAL PAYMENT under the terms of the contract,
relying on the truth and statements contained herein.
(Seal)
CONTRACTOR
(Signature)
(Title)
Subscribed and sworn to me this
Day of
,
(Seal)
NOTARY
Notary Public for the State of Montana
My Commission Expires:
Contractor's Affidavit of Completion, Payment of Debts and Claims, and Release of Liens (Rev 3/19)
Form 106
1 of 1