12-Contractors Affidavit for Payment of Debts and Claims 02.18.2026.pdf

PDF 543 KB Posted

Attached to
Northwest Transfer Station Community Collection Center (NWTS CCC) Floor Upgrades
Solicitation number
IFB-26-00265
Issued by
Hillsborough County, Florida

About this file

This is a Contractor's Affidavit of Payment of Debts and Claims document prepared for the Hillsborough County Board of County Commissioners in Florida related to the Northwest Transfer Station Community Collection Center (NWTS CCC) Floor Upgrades project. The affidavit serves as a certification requirement that contractors must complete to confirm all bills for labor, services, and materials furnished by the contractor and its suppliers and subcontractors have been paid in full or otherwise satisfied. The document is a notarized statement that must be executed by the contractor's authorized representative, with the notarization occurring before a Florida Notary Public either by physical presence or online notarization. The affidavit addresses the agreement between the County and the contractor concerning the designated project and requires certification of all known indebtedness and claims for damages arising from contract performance.

The affidavit includes provisions for the contractor to list any exceptions to full payment of debts and claims, with instructions to note "None" if there are no exceptions or to attach a detailed list if exceptions exist. This document is a standard administrative requirement in the bid award and contract closeout process, ensuring the County has documented evidence that the contractor has satisfied all financial obligations associated with the project before final payment and contract completion. The affidavit must be completed with specific dates, contractor identification, and notarial certification to be valid.

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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 .