14-Contractors Affidavit for Payment of Debts and Claims 02.18.2026.pdf
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- Solicitation number
- IFB-26-00398
- Issued by
- Hillsborough County, Florida
About this file
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 Intersection Improvements for East County Line Road at Grand Hampton Drive project. The affidavit certifies that the contractor has paid in full all bills for labor, services, and materials furnished by the contractor and its suppliers and subcontractors under the project agreement, and that all known indebtedness and claims for damages arising from the performance of the contract have been satisfied. The form includes space for documenting any exceptions to full payment, requires certification by the contractor with signature and title, and must be notarized by a Florida notary public with recorded date and notary identification.
The affidavit serves as a final compliance document confirming that no outstanding financial obligations remain that could create liability for the County. This form is typically submitted upon contract completion as part of the final payment process, ensuring that all third parties involved in the project have been compensated and releasing the County from potential claims related to unpaid contractor debts or subcontractor disputes.
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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 .