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<br />QR BK3786 <br />2 of 3 <br /> <br />PG 63~ <br /> <br />CONTRACTOR'S AFFIDAVIT <br /> <br />State of Florida <br />County of Polk <br /> <br />BEFORE ME, the undersigned authority, personally appeared WILLIAM <br />MICHAEL MOORE who, after being by me first duly sworn, deposes and says of his <br />personal knowledge as follows; <br /> <br />1. He is the vice-president of B&M Construction Co. Inc" which does business in the <br />State of Florida, hereinafter called the "Contractor". <br /> <br />2. Contractor, has not furnished or caused to be furnished, any labor, materials or <br />services for the construction of any improvements on certain real property located at <br />Section 34, Township 25 S, Range 21 E, US Hwy. 301 in Zephyrhills, Florida. <br /> <br />Dated this 5th day of August, 1997. <br /> <br />BY:~~~ <br />William Michael Moore <br />VP-B&M Construction Co. Inc. <br /> <br />Sworn to and subscribed by me this 5th day of August, 1997, by William Michael Moore, <br />who is personally known to me. <br /> <br /> <br />My Commission Expires: <br /> <br />OFFIOAL NaI'ARY SEAL <br />JOANN LANIER <br />NaI' ARY PUBUC sr ATE OF FLORIDA <br />COMMISSION NO, CCSS0569 <br />MY COMMISSION EXP. MAY <br />