12-Contractors Affidavit for Payment of Debts and Claims 02.18.2026.pdf
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- Attached to
- Tree Trimming and Removal Services
- Solicitation number
- RFP-2026-01-0-2027/AB
- Issued by
- Brevard County, Florida
About this file
This is a Contractor's Affidavit of Payment of Debts and Claims form used by the Hillsborough County Board of County Commissioners in Florida. The affidavit serves as a certification document that contractors must complete and submit to verify that all bills for labor, services, and materials furnished under a specific agreement have been paid in full or otherwise satisfied. The form requires the contractor to declare that all suppliers, subcontractors, and known indebtedness related to the project performance have been resolved and that no claims for damages exist that could hold the county responsible. The document includes spaces for the contractor to identify the agreement date, project designation, and to note any exceptions to full payment, with instructions to list any outstanding obligations if applicable.
The affidavit must be notarized before a Florida notary public and signed by an authorized representative of the contractor, with the notary certifying the execution through either physical presence or online notarization. This document functions as a contractual requirement ensuring financial clearance before final payment release and project closeout, protecting the county from potential liability arising from unpaid contractor obligations. The form is a standard administrative instrument used to confirm satisfactory completion of all financial obligations associated with service or construction contracts with Hillsborough County.
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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 .