The Michigan Sworn Statement form is a crucial document used by contractors, subcontractors, and suppliers involved in public work projects within Michigan. It serves to declare the payment status of subcontractors, suppliers, and laborers, ensuring transparency and accountability in the payment process for work performed on public projects. For those looking to navigate the complexities of project finances and legal accountability, understanding how to accurately complete and submit this form is essential.
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In the realm of construction and public works in Michigan, the Michigan Sworn Statement form plays a crucial role in ensuring transparency and financial accountability. This legal document, required from contractors, subcontractors, and suppliers, provides a detailed report of the labor and materials supplied to a specific project, along with the status of payments to all parties involved. The form lists each subcontractor, supplier, and laborer, specifying the type of improvement furnished, the total amount of the contract, what has already been paid, what is currently owing, and details regarding fringe benefits and withholdings that are due but unpaid. By requiring this sworn statement, Michigan law aims to protect all parties within the construction supply chain, ensuring that workers and suppliers are paid for their contributions. The document serves not only as a financial reckoning but also as a declaration that no undisclosed liabilities, such as bond liens, exist beyond those stated within. Highlighted by a warning against fraudulent claims, this form underscores the seriousness with which Michigan treats the integrity of financial transactions in public works projects. The form culminates with a notarization, affirming the veracity of the information provided, thus serving as a critical instrument for financial and legal transparency in construction projects across the state.
SWORN STATEMENT
STATE OF MICHIGAN
)
) ss.
COUNTY OF
<<<name of person signing sworn statement>>>, being duly sworn, deposes and says: That <<<name of company>>> is a/the <<<select one>>>(contractor)(subcontractor)(supplier) for an improvement to the following described public works situated in __________ County, Michigan, described as follows:
Contract No. <<<MDOT Contract ID Number>>> Project Name: <<<eg. I-96 from U.S 23 to Kent Road>>>
That the following is a statement of each subcontractor and supplier and laborer, for which laborer the payment of wages or fringe benefits and withholdings is due but unpaid, with whom the <<<same selection as above>>>(contractor)(subcontractor)(supplier) has <<<select one>>>(contracted)(subcontracted)(supplied material)(supplied labor) for performance under the contract with the owner, lessee, or general contractor thereof, and that the amounts due to the persons as of the date hereof are correctly and fully set forth opposite their names, as follows:
Name of Subcontractor,
Type of
Total
Amount
Balance
Amount of
Amount of Laborer
Supplier, or Laborer
Improvement Furnished
Contract
Already
Currently
to
Laborer
Retention
Fringe Benefits
Price
Paid
Owing
Complete
Wages Due
and Withholdings
But Unpaid
Due But Unpaid
SUB TOTALS
TOTALS
That the (contractor) (subcontractor) has not procured material from, or subcontracted with, any person other than those set forth on the reverse side and owes no money for the improvement other than the sums set forth on the reverse side.
Deponent further says that he or she makes the foregoing statement as the (contractor)(subcontractor)(supplier) or as <<<authorized agent if signator is not officer or employee of company>>> of the (contractor)(subcontractor)(supplier) for the purposes of representing to the owner, lessee, or general contractor of the public works described on the reverse side and his or her agents that the public works described on the reverse side is free from claims of construction or bond liens, or the possibility of construction or bond liens, except as specially set forth on the reverse side hereof..
WARNING TO DEPONENT: A PERSON, WHO WITH INTENT TO DEFRAUD, GIVES A FALSE SWORN STATEMENT FOR THE PURPOSE OF OBTAINING PAYMENT IS SUBJECT TO CRIMINAL and CIIVIL PENALTIES AS PROVIDED BY LAW.
(Deponent)
Subscribed and sworn to before me this
day of
, 20___.
, Notary Public
County, Michigan
My commission expires:
Acting in _______________ County
91742v2
__________________
, being duly sworn, deposes and says: That ______________________
is a/the (contractor)(subcontractor)(supplier) for an improvement to
the following described public works situated in _______ County, Michigan, described as follows:
Contract No.
; Project Name:
That the following is a statement of each subcontractor and supplier and laborer, for which laborer the payment of wages or fringe benefits and withholdings is due but unpaid, with whom the (contractor)(subcontractor)(supplier) has (contracted)(subcontracted)(supplied material)(supplied labor) for the improvement on the above referenced public works project and that the amounts due to the persons as of the date hereof are correctly and fully set forth opposite their names, as follows:
Deponent further says that he or she makes the foregoing statement as the (contractor)(subcontractor)(supplier) or as _____ ____ of the (contractor)(subcontractor)(supplier) for
the purposes of representing to the party from whom payment is requested and to the prime contractor who has furnished a payment bond covering the public works project described on the reverse side and his or her agents that the public works described on the reverse side is free from claims of payment bond liens, or the possibility of payment bond liens, except as specially set forth on the reverse side hereof.
91742
FULL CONDITIONAL WAIVER
Our contract with <<<name of company>>> to furnish<<<general description of
work/material furnished. Eg. Concrete work and related items. Eg. Aggregate
materials>>> materials to <<<MDOT>>> Project No. <<<MDOT Contract ID
Number>>> has been fully paid and satisfied with respect to our rights under the Payment / Lien Bond covering said Project and all of our rights to pursue payment under the Payment/Lien Bond No. _____________ issued by <<<name of prime
contractor>>> as principal and <<<name of payment bond surety>>> as surety,
together with any rights, demands, or causes of action we may have against _<<<name
of prime contractor>>> or <<<name of payment bond surety>>>, are hereby fully waived and released and the “Notice of Lien Claim” (if any) dated ,<<<insert “N/A” if none. Insert date of Notice of Lien Claim if one has been filed>>> and any amendment(s) thereto, is hereby rescinded.
This waiver is
conditioned upon our receipt of payment in the amount of
$<<<amount of payment for which waiver is being given>>>
<TYPE OR PRINT COMPANY NAME>
__________________________
by:
<<type or print name>>
its:
<<type or print title>>
) SS
The signator is known to me and acknowledged the foregoing instrument this
___ day of ________, 20___.
________________________________
____________________, Notary Public
_____________County, Michigan
My commission expires: ___________
Acting In _____________ County
91748v2
Our contract with _________________ to furnish ______________________
materials to _______ Project No. _____________ has been fully paid and satisfied with
respect to our rights under the Payment / Lien Bond covering said Project and all of our rights to pursue payment under the Payment/Lien Bond No. _____________ issued by
_______________________ as principal and ____________________ as surety,
together with any rights, demands, or causes of action we may have against
_____________________ or __________________ , are hereby fully waived and
released and the “Notice of Lien Claim” (if any) dated _______________, and any
amendment(s) thereto, is hereby rescinded.
This waiver
is
$
.
___________________________
_____________________
91748
FULL UNCONDITIONAL WAIVER
Our contract with <<<name of company>>> to furnish general description of work/material furnished. Eg. Concrete work and related items. Eg. Aggregate
materials>>>
materials to <<<MDOT>>> Project No. <<<MDOT Contract ID
Number>>>
has been fully paid and satisfied with respect to our rights under the
Payment / Lien Bond covering said Project and all of our rights to pursue payment under the Payment/Lien Bond No. _____________ issued by <<<name of prime
contractor>>> as principal and <<<name of payment bond surety>>> as surety, together with any rights, demands, or causes of action we may have against <<<name
of prime contractor>>> or <<<name of payment bond surety>>> , are hereby fully waived and released and the “Notice of Lien Claim” (if any) dated ,<<<insert “N/A” if none. Insert date of Notice of Lien Claim if one has been filed>>>, and any amendment(s) thereto, is hereby rescinded.
by: <<type or print name>>
its: <<type or print title>>
___ day of ___________, 20___.
Notary Public
91747v2
materials to ______ Project No._________________ has been fully paid and satisfied
with respect to our rights under the Payment / Lien Bond covering said Project and all of our rights to pursue payment under the Payment/Lien Bond No. _____________ issued
by _______________________ as principal and ____________________ as surety,
91747
PARTIAL CONDITIONAL WAIVER OF LIEN
Our contract with <<<name of company>>> to furnish <<<general description of work/material furnished. Eg. Concrete work and related items. Eg. Aggregate
materials>>>to <<<MDOT>>> Project No. <<<MDOT Contract ID Number>>> has
been partially paid and satisfied in the amount of $<<<amount of payment for which waiver is being given>>>with respect to our rights under the Payment / Lien Bond covering said Project and our rights to pursue payment under the Payment/Lien Bond
No.issued by <<<name of prime contractor>>> as principal and
<<<name of payment bond surety>>> as surety, together with any rights, demands, or causes of action we may have against <<<name of prime contractor>>> or <<<name
of payment bond surety>>> are hereby waived and released to the extent of said partial payment of $ <<<amount of payment for which waver is being given>>> and the “Notice of Lien Claim” (if any) dated ,<<<insert “N/A” if none. Insert date of Notice of Lien Claim if one has been filed>>> and any subsequent amendment(s) thereto, are hereby rescinded, waived and released for the amount of $ <<<amount of payment for which waiver is being given>>> and are hereby amended to reflect only the remaining balance claimed to be due under our contract in the amount of $<<<remaining balance after deduction of all partial payments to date>>>.
This waiver is conditioned upon our receipt of payment in the amount of
$<<<amount of payment for which waver is being given>>>
______________________________
91744v2
Our contract with ___________________________ to furnish _____________,
__________________________________ to _________________________ Project
No. _________________________________ has been partially paid and satisfied in
the amount of $___________with respect to our rights under the Payment / Lien Bond
covering said Project and our rights to pursue payment under the Payment/Lien Bond No. _____________ issued by ____________________________ as principal and
____________________________ as surety, together with any rights, demands, or
causes of action we may have against __________________________ or
_______________________________________ are hereby waived and released to the
extent of said partial payment of $_________ and the “Notice of Lien Claim” (if any)
dated _________________________, and any subsequent amendment(s) thereto, are
hereby rescinded, waived and released for the amount of $____________ and are
hereby amended to reflect only the remaining balance claimed to be due under our
contract in the amount of $___________.
91744
Completing the Michigan Sworn Statement form is essential for any contractor, subcontractor, or supplier involved in public works improvements within Michigan. This document plays a crucial role in ensuring transparency and honesty in financial dealings related to construction projects. It is used to declare that all subcontractors and suppliers have been paid or to outline amounts still owed. The process of filling out this form accurately requires attention to detail and an understanding of the project's financial aspects.
Once completed, this form serves as an official declaration of financial transparency concerning the public works project. It assures all parties, including the state, that payments to involved subcontractors, suppliers, and laborers have been handled or disclosed honestly. Additionally, completing this form accurately helps protect against potential legal disputes or claims related to payment issues.
What is a Michigan Sworn Statement form?
A Michigan Sworn Statement form is a legally binding document used in construction projects. It is a declaration by a contractor, subcontractor, or supplier about the payment status of laborers, subcontractors, and suppliers. This document outlines the work or materials provided, the contract amount, amounts already paid, and the balance owing, ensuring transparency and accuracy in financial dealings on public works projects in Michigan.
Who needs to fill out a Michigan Sworn Statement form?
Contractors, subcontractors, and suppliers involved in improvement projects on public works in Michigan must fill out this form. It's specifically designed for those who have financial obligations like unpaid wages, fringe benefits, and withholdings to laborers or amounts owed to subcontractors and suppliers.
How does the Michigan Sworn Statement form protect against fraud?
This document includes a stern warning about the legal consequences of providing false information. The false sworn statement with the intent to defraud, aimed at obtaining payment that is not rightfully due, exposes the individual to criminal and civil penalties under law. This provision is a deterrent against dishonesty and ensures integrity in financial disclosures.
What information is required on the Michigan Sworn Statement form?
The form requires comprehensive details including the name of the person signing, the name of the company, their role (contractor, subcontractor, supplier), the county where the project is located, details of the public works project (contract number, project name), and a detailed account of all parties (laborers, subcontractors, suppliers) owed money, the amount of labor or materials furnished, contract price, amount paid, and balance due.
Is the Michigan Sworn Statement form a public record?
Since it is connected to public works projects, the sworn statement may become part of the public record, depending on the governmental body's regulations and the project's scope. This accessibility ensures transparency and allows for the monitoring of financial responsibilities towards laborers and suppliers.
How often should the Michigan Sworn Statement form be updated?
It should be updated whenever there is a significant change in the project's financial situation, such as after making payments to subcontractors, suppliers, or laborers. Regular updates ensure the document accurately reflects the current financial status of the project, helping to avoid disputes and misunderstandings.
What happens if discrepancies are found in the Michigan Sworn Statement form?
If discrepancies or inaccuracies are discovered, it may lead to investigations and could delay payments until issues are resolved. Discrepancies also risk breach of contract allegations and might expose the declarant to the mentioned legal penalties if found to have provided false information intentionally.
Can the Michigan Sworn Statement form be submitted electronically?
The specific requirements for submission can vary by county and project. While electronic submissions are increasingly common for legal documents, it's important to verify with the relevant county's regulations or the project's administrative office whether they accept electronic submissions of the Michigan Sworn Statement form.
What are the notarization requirements for the Michigan Sworn Statement form?
The form must be notarized to verify the identity of the signatory and validate the statement. The notarization section requires the notary public's signature, the date of notarization, and details of the notary's commission. Proper notarization is crucial for the document's legal standing.
Where can I find a template for the Michigan Sworn Statement form?
Templates for the Michigan Sworn Statement form can typically be found through legal resources, construction industry organizations, or specific county government websites in Michigan. Ensuring you have the latest version of the form is important for compliance with current laws and regulations.
Filling out legal documents, such as the Michigan Sworn Statement form, requires a high level of attention to detail. However, people often make mistakes, some of which are common and can lead to legal complications or delays. One frequent error is incorrectly identifying the role of the entity filling out the form (i.e., contractor, subcontractor, supplier). Ensuring the correct designation is crucial for the legal validity of the statement.
Another mistake is filling in the wrong project name or contract number. This might seem minor, but it can lead to confusion and potentially question the statement's accuracy. It's essential to double-check these details against the project records.
When listing subcontractors, suppliers, and laborers, a common oversight is omitting some of the names or not accurately specifying the type of improvement furnished. Every entity that contributed to the project should be listed to ensure the statement fully represents the project’s financial aspects.
Errors in the calculation of balances currently owed are also commonplace. These mistakes may occur due to simple math errors or not updating the form with the most recent payment information. This can signal financial mismanagement or, worse, intentional deceit, neither of which is desirable in a legal document.
Forgetting to specify the amount of retention, fringe benefits, wages due, and withholdings can lead to inaccuracies regarding financial obligations. Detailed and accurate representation of these amounts is necessary for transparency and for avoiding disputes over payments.
Ignoring the inclusion of a comprehensive list of all materials supplied or labor provided is another pitfall. It is not enough to just list the subcontractors and suppliers; what they provided needs clear articulation to support claims of payment or to establish the basis for any future lien claims.
A significant mistake is not having the sworn statement notarized. The oversight of this step can question the document's validity. The notarization provides a level of legal formalization and authentication that is often required for these documents to be recognized.
Incorrectly filling in the signature fields, such as the print name or title of the signatory, can also be problematic. This may appear to be a minor error, but it's essential for establishing the authority of the individual who is verifying the statement's accuracy.
Failing to provide a clear statement of no outstanding payments beyond those listed, or incorrectly indicating the absence of potential construction or bond liens, can have serious legal implications. It's crucial to accurately reflect the financial and legal situation regarding the project’s payments and liens.
Lastly, overlooking the "WARNING TO DEPONENT" section and not understanding the legal implications of submitting a false statement may lead some to provide inaccurate information. This not only poses a risk of criminal and civil penalties but can significantly undermine the integrity of the project and its legal and financial foundations.
For those working within the construction industry in Michigan, especially those handling contracts and legal documents, the Michigan Sworn Statement form is just one of many documents needed to manage a project efficiently and legally. This form is crucial for contractors, subcontractors, and suppliers, serving as a declaration of the payments due for labor and materials, and helping to avoid legal disputes. Alongside this form, there are several other documents often required for a comprehensive approach to project management and legal compliance.
Together, these documents form a framework that supports clear communication, legal compliance, and financial transparency on construction projects. For contractors, subcontractors, and suppliers, understanding and properly using these forms are vital steps in protecting their interests and ensuring the smooth completion of construction projects in Michigan.
The Affidavit form, similar to the Michigan Sworn Statement, is a written declaration made under oath before a notary public or other authorized officer. Both documents necessitate the signer to truthfully declare their statements, support claims, or present information, with legal consequences for any false statements, denoting their comparable importance in ensuring accountability and integrity in various legal and official matters.
A Mechanic's Lien, similarly, requires accurate representation of unpaid labor, services, or materials provided, mimicking the Sworn Statement's purpose to declare unpaid wages, benefits, and withholdings. Both documents serve to protect the financial interests of those who contribute labor or materials to a project, enabling them to claim payment through legal or contractual mechanisms when necessary.
The Payment Bond Claim forms closely resemble the Sworn Statement in that both are utilized within the construction industry to ensure that subcontractors and suppliers are duly compensated. The Sworn Statement catalogues the financial dealings and unpaid balances on a specific project, parallelly, a Payment Bond Claim is submitted to realize payment from a bond issued if those financial obligations are unmet.
Notice to Owner (NTO) forms, which subcontractors and suppliers use to inform property owners of their involvement in a project and right to file a lien if unpaid, align with the Sworn Statement’s motive. Though the Sworn Statement outlines specific unpaid balances, both documents ultimately aim to safeguard the right to payment for services rendered or materials provided on construction projects.
Conditional Waiver and Release Upon Final Payment documents share a common ground with the Sworn Statement through their association with the construction payment process. While the Sworn Statement details unpaid work, a Conditional Waiver acts conversely, providing proof of settlement and relinquishing the right to future claims or liens once a final payment is received, complementarily securing transactional fidelity in construction economics.
Unconditional Waiver and Release Upon Progress Payment forms, like the Sworn Statement, play a critical role in the progression of construction projects. They certify that payments have been received up to a certain point without contest, just as the Michigan Sworn Statement verifies outstanding amounts. Both forms are pivotal in clarifying the financial status and progression towards the resolution of debts within construction ventures.
The Proof of Claim form, used in bankruptcy proceedings, parallels the Michigan Sworn Statement's function in declaring amounts owed. Creditors furnish Proof of Claim to outline the debt owed by the bankruptcy estate, similar to how a contractor, subcontractor, or supplier uses the Sworn Statement to report unpaid labor costs and material expenses, exemplifying their shared objective of securing owed payments.
A Release of Lien document contrasts yet complements the Michigan Sworn Statement's intent by signifying that previously claimed debts have been settled. The Sworn Statement can initiate a claim process by acknowledging outstanding debts. In contrast, a Release of Lien concludes this process, verifying that payment has been made and obviating the described liabilities, hence closing the loop on financial disputes in property improvements.
The Construction Contract itself, while not a sworn document, sets the groundwork that necessitates the use of a Michigan Sworn Statement by defining the project's scope, terms, and the financial responsibilities of each party involved. The Sworn Statement comes into play when discrepancies or delinquencies in financial duties arise, serving as a tool to reaffirm the obligations initially stipulated in the contract.
Lastly, the Schedule of Values, often used in the construction industry to breakdown the project costs, shares similarities with the Sworn Statement by detailing financial aspects of a construction project. However, while the Schedule of Values provides a comprehensive forecast or record of costs, the Sworn Statement specifically addresses the actual payments due to subcontractors, suppliers, and laborers, illustrating a focused snapshot of financial accountability.
When filling out the Michigan Sworn Statement form, it is crucial to follow a set of guidelines to ensure the document's accuracy and legality. Here are tasks to embrace and avoid during this process:
When it comes to legal documentation, misunderstandings can lead to significant consequences, especially with something as pivotal as the Michigan Sworn Statement form. Below, we’ll dispel seven common misconceptions about this form to ensure clarity and compliance.
Clearing up these misconceptions about the Michigan Sworn Statement form is vital for anyone involved in construction projects within the state. Understanding its significance, requirements, and the need for accuracy ensures that all parties are protected and legal obligations are met.
When preparing and submitting a Michigan Sworn Statement form, it is crucial to understand its purpose and the detailed requirements needed to complete it accurately. Below are key takeaways to guide individuals and businesses through the process:
This sworn statement is a critical document intended to ensure transparency and accountability in public works projects in Michigan, serving to protect all parties involved—from the state and prime contractors to the subcontractors, suppliers, and laborers—by affirming the status of payments and potential liens.
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