VA Interim Affidavit and Agreement 1 1995
STATE OF _____________________
_____________ OF _______________
On this _____ day of ____________, 20_____, before me personally appeared _____________________________________ President of _______________________, Owner of Property and General Contractor, to me personally known, who, being duly sworn on his oath, did say that all of the persons, firms and corporations, including the general contractor and all subcontractors who have furnished services, labor or materials according to plans and specifications, or extra items, used in the construction or repair of buildings and improvements on the real estate hereinafter described, have been paid in full and that such work has been performed to satisfaction and accepted by owner as of date herein.
Affiant further says that no claims have been made to affiant by, nor is any suit pending against affiant by any contractor, subcontractor, laborer or materialman, and further that no chattel mortgages, conditional bills of sale, retention of title agreements, security agreements, financing statements, or personal property leases have been given or are outstanding as to any fixtures, appliances, or equipment which are now installed in or upon said real property, or in the improvements thereon.
Affiant on behalf of said Owner of Property and General Contractor does for a valuable consideration hereby agree and guarantee to hold Stewart Title Guaranty Company (by reason of the fact that it has issued its title insurance policies), harmless against any lien, claim or suit of or by any general contractor, subcontractor, mechanic or materialman, and against chattel mortgages, conditional bills of sale, retention of title agreements, security agreements, financing statements, or personal property leases in connection with the construction or repair of such building or improvements on said real estate.
The real estate and improvements referred to herein are situated in the _______________
of __________________________ State of ______________________, and are described as follows; to-wit:
__________________________________ Owner of Property __________________________________ Owner of Property __________________________________ General Contractor
Executed, subscribed and sworn to before me the day and year above written. __________________________________ Notary Public
NOTE: FOR USE WHEN OWNER AND GENERAL CONTRACTOR ARE THE SAME.
No guidelines are available for this form at this time.