RUS Form 231, Certificate of Contractor

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U.S. Department of Agriculture
Rural Utilities Service

CERTIFICATE OF CONTRACTOR
____________________________________________________________________ certifies that he or she is the
____________________________________________ of ____________________________________________ ,
TITLE

NAME OF CONTRACTOR

the Contractor, in a Construction Contract No. _____________________________________________________ ,
dated ___________________________________________ , 20______ , entered into between the Contractor and
___________________________________________________________ , RUS designation ________________ ,
NAME OF RUS BORROWER

the Owner, and that he or she is authorized to and does make this certification on behalf of said Contractor in order
to induce the Owner to make payment to the Contractor, in accordance with the provisions of said Construction
Contract.
Undersigned further says that all persons who have furnished labor in connection with said construction have been
paid in full, that the names of manufacturers, material suppliers, and subcontractors that furnished material or
services or both in connection with such construction and the kind or kinds of material or services or both so
furnished are:
NAME

KIND OF MATERIAL OR SERVICES

___________________________________________

____________________________________________

___________________________________________

____________________________________________

___________________________________________

____________________________________________

___________________________________________

____________________________________________

___________________________________________

____________________________________________

___________________________________________

____________________________________________

___________________________________________

____________________________________________

and that the releases of liens executed by all such manufacturers, material suppliers, and subcontractors have been
furnished the Owner.

________________________________
Date

By___________________________________________________
President

This Certificate must be signed with the full name of the Contractor. If the Contractor is a partnership, this Certificate must be
signed in the partnership name by a partner. If the Contractor is a corporation, this Certificate must be signed in the corporate
name by a duly authorized officer.

RUS FORM 231 (Rev. 2-04)