15-Doc 00 65 19.13 - CONTRACTORS AFFIDAVIT.pdf

PDF 134 KB Posted

Attached to
2026 Bristol Borough CDBG Curb Ramp Program
Solicitation number
Not on record
Issued by
Bucks County, Brodheadsville CDP, Pennsylvania

About this file

This is a Contractor's Affidavit document required for Contract #26-00117, the Bristol Borough 2026 CDBG Design/Build Curb Ramp Project, located in Bristol Borough, Pennsylvania (250 Pond Street, Bristol, PA 19007). The affidavit serves as a sworn statement to be completed and notarized by the contractor upon project completion, certifying that all labor, materials, and outstanding claims or indebtedness arising from the performance of work—including all approved change orders—have been satisfied and paid in full. The document requires the contractor to identify their company name, provide authorized representative signature, and include corporate seal if applicable. The affidavit must be notarized by a Notary Public in the state and county where the contractor executes the document.

This affidavit is a standard contract closeout requirement, typically submitted as part of final payment and project completion documentation. The form confirms financial settlement of all project obligations and serves as evidence of satisfactory contract performance from a financial standpoint. The document does not specify pricing, funding amounts, or other financial terms, as those details would be contained in the underlying contract and bid documents. The affidavit applies to the design and construction of ADA/PennDOT compliant curb ramps with sidewalks, curbing, and sign relocation/installation throughout Bristol Borough, with work performed in accordance with PennDOT Publication 408 and Borough Standards under Community Development Block Grant (CDBG) funding.

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Text version

CONTRACTOR'S AFFIDAVIT

00 65 19.13-1

DOCUMENT 00 65 19.13

CONTRACTOR'S AFFIDAVIT

STATE OF______________________________:

COUNTY OF ____________________________:

Before me, the undersigned, a Notary Public in and for said County and State personally appeared

(Individual/Partner/Duly Authorized Representative of Corporate Contractor) who being duly sworn according to law deposes and says that all labor, material and outstanding claims and indebtedness of whatever nature arising out of the performance of the Work including all approved change orders under an Agreement dated __________________________, 20___________ associated with

Contract #26-00117: Bristol Borough 2026 CDBG Design/Build Curb Ramp Project Between

Bristol Borough, 250 Pond Street, Bristol, PA 19007 (Owner, Name and Address) and

(Contractor, Name and Address) have been satisfied and paid in full.

CONTRACTOR

Company:

(Corp. Seal) Signature:_________________________________ (Individual, Partner or Duly Authorized Representative of Corporate Contractor)

Name and Title:

Sworn and subscribed before me this

_____day of ________________,20___.

END OF DOCUMENT

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