$.... No. ....
(name of local governmental unit)
CONTRACTOR'S CERTIFICATE
FOR CONSTRUCTION OF ....
(name of local governmental unit)
ISSUED PURSUANT TO
SECTION 66.0713 (2), WIS. STATS.
We, the undersigned officers of the (name of local governmental unit), certify that (name and address of contractor) has performed the work of constructing .... in .... benefiting the following premises: (insert legal description) in the (name of local governmental unit) .... County, Wisconsin, pursuant to a contract entered into by (name of local governmental unit) with .... (name of contractor), dated ...., and that .... entitled to the sum of .... dollars, the unpaid balance due for the work chargeable to the property described above.
If the unpaid balance due is not paid to the treasurer of (name of local governmental unit) before the first day of the following December, that amount shall be extended upon the tax roll of the (name of local governmental unit) against the property above described as listed in the tax roll, and collected as provided by law.
This certificate is transferable by endorsement but an assignment or transfer by endorsement is invalid unless recorded in the office of the clerk of the (name of local governmental unit) and the fact of the recording is endorsed on this certificate. THE HOLDER OF THIS CERTIFICATE HAS NO CLAIM UPON THE (Name of local governmental unit), EXCEPT FROM THE PROCEEDS OF THE SPECIAL ASSESSMENTS LEVIED FOR THE WORK AGAINST THE ABOVE DESCRIBED LAND.
This certificate shall bear interest from its date to the following January 1.
Given under our hands at (name of local governmental unit), this .... day of ...., .... (year)
.... ....
(Mayor, President, Chairperson)
Countersigned:
.... ....
Clerk, (name of local governmental unit)
ASSIGNMENT RECORD
Assigned by .... .... (Original Contractor) to .... .... (Name of Assignee) of .... (Address of Assignee) .... .... (Date and signature of clerk)
Wis. Stat. § 66.0713