11-Contractors Affidavit for Payment of Debts and Claims 02.18.2026.pdf
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- Attached to
- Public Defender First Floor Security Lobby
- Solicitation number
- IFB-26-00263
- Issued by
- Hillsborough County, Florida
About this file
This is a Contractor's Affidavit of Payment of Debts and Claims form issued by the Hillsborough County Board of County Commissioners for a construction project designated as Public Defender First Floor Security Lobby. The affidavit certifies that the contractor has paid all bills for labor, services, and materials furnished by the contractor and all suppliers and subcontractors under the project agreement. The form requires the contractor to document any exceptions to full payment or confirm that none exist, and must be completed and notarized by a Florida notary public upon project completion or at a specified time as determined by the contract terms.
The Public Defender First Floor Security Lobby project involves construction of approximately 2,910 square feet of interior space at 700 E. Twiggs Street, Tampa, Florida, with an estimated project value of $823,000.00. The scope includes expansion of the lobby area, installation of a new storefront at the elevator lobby, creation of new offices, a security room, expansion of existing offices, and related demolition in the Southeast area of the first floor. A Small Business Enterprise (SBE) subcontractor participation goal of 10% has been established for this solicitation and resulting contract.
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Text version
CONTRACTOR’S AFFIDAVIT OF
PAYMENT OF DEBTS AND CLAIMS
The undersigned hereby certifies that except as noted below all bills for labor, services and materials furnished by the CONTRACTOR and all suppliers and/or subcontractors of the CONTRACTOR under and pursuant to the provisions of the Agreement dated the ________ day of _______________, 20_____, between the Hillsborough County Board of County Commissioners (COUNTY) and _________________________________________ (CONTRACTOR) concerning that certain project designated as __________________________________________________________ have been paid in full or otherwise satisfied including all known indebtedness and all claims for damages against said CONTRACTOR arising in any manner in connection with the performance of the Agreement referenced above for which the COUNTY might in any way be held responsible.
Exceptions: ________ (If none, write “None”.)
__________ (If yes, write “Yes” and attach list.)
Certified this ________ day of _________________, 20 ______.
CONTRACTOR:
BY:
Title
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
Sworn to (or affirmed) and subscribed before me by means of physical presence or online notarization, this ____ day of ___________, 20__, by____________________________, (Name of person making statement)
(Signature of Notary Public - State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known or Produced Identification
Type of Identification Produced ______________________
File details come from the government source that posted it. Updated .