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Click ‘Get Form’ to open it in the editor.
Begin by entering the county, district, or municipality where the premises are located in the designated field.
Fill in the street address and city of the premises. If there is no street address, provide a clear description of the location.
In the section for improvements, succinctly describe the work that has been completed under this contract.
Indicate the date when substantial performance was achieved by filling in the appropriate date field.
If applicable, have the payment certifier sign and date the certificate. If there is no payment certifier, ensure both owner and contractor signatures are included.
Complete the fields for names and addresses of both owner and contractor as well as any payment certifier if relevant.
Choose between option A or B regarding lien preservation and fill in accordingly with legal descriptions or addresses as required.

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