13-Contractors Affidavit for Payment of Debts and Claims 02.18.2026.pdf
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- Solicitation number
- IFB-26-00250
- Issued by
- Hillsborough County, Florida
About this file
This document is a Contractor's Affidavit of Payment of Debts and Claims required by the Hillsborough County Board of County Commissioners for the Stormwater Countywide Ditch and Side-Drain Restoration Contract. The affidavit serves as a certification form that contractors must complete and have notarized to verify payment of all bills, labor costs, materials, and claims associated with work performed under their agreement with the County. The form requires the contractor to document that all indebtedness and damage claims arising from contract performance have been satisfied, with space provided to list any exceptions to full payment. The document must be sworn before a Florida notary public and submitted as part of the final contract close-out process.
The affidavit is a standard administrative requirement with no specific pricing, set-asides, or funding information contained within the form itself. It functions as a compliance document rather than a substantive contract element and does not establish payment terms, amounts, or scheduling requirements. The form is blank and designed for completion by individual contractors upon contract conclusion, requiring certification of payment status and notarization before submission to 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 .