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

This is a Contractor's Affidavit of Payment of Debts and Claims form required by the Hillsborough County Board of County Commissioners in Florida for the Bearss Avenue at Florida Avenue Intersection Improvements project, estimated at $1,263,856.86. The affidavit serves as a certification document that contractors must complete and submit to confirm that all bills for labor, services, and materials furnished under the project agreement have been paid in full. The form requires the contractor to certify that all suppliers, subcontractors, and related indebtedness have been satisfied and that no claims for damages exist against the contractor that could hold the County responsible. The affidavit must be completed with the specific agreement date, project designation, contractor name, and execution date, and includes space to note any exceptions to full payment.

The affidavit must be notarized before a Florida Notary Public, with the notary required to document the date of notarization and method of verification (physical presence or online notarization). The contractor must sign the document with title and company information, and the notary must provide their commissioned name and identification verification details. Any exceptions to full payment must be listed separately, or the contractor must indicate "None" if all debts and claims have been fully satisfied. This document is typically required as a condition of final payment or project closeout to ensure the County is protected from contractor-related liability and ensures all project-related obligations have been fulfilled.