15-DOC 00 65 19.13 CONTRACTORS AFFIDAVIT.pdf
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- Solicitation number
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- Montgomery County, Pennsylvania
About this file
This is a Contractor's Affidavit form issued by Montgomery Township, located at 1001 Stump Road, Montgomeryville, PA 18936, for the supply and installation of front power take-off (PTO), front 3-point hitch, and an 11-foot or 12-foot plow for a John Deere 6120M tractor. The affidavit serves as a sworn statement confirming that all labor, materials, and outstanding claims or indebtedness arising from the performance of work under an agreement have been satisfied and paid in full, including all approved change orders. The document requires execution before a Notary Public and must be signed by an individual, partner, or duly authorized representative of the contractor, with the contractor's company seal affixed where applicable.
The affidavit is a standard closing document requirement for the contract and does not contain pricing terms, funding information, or other contract specifics. It functions as a lien release and final payment certification, establishing that the contractor has resolved all financial obligations related to the project. The form is a template with blank spaces for the state and county, agreement date, contractor name and address, notary information, and execution date. Completion and submission of this affidavit is a prerequisite for final contract settlement and payment release by Montgomery Township.
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Text version
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
Supply and Installation of Front PTO, Front 3-Point Hitch, and 11-Foot or 12-Foot Plow for John
Deere 6120M Tractor
Between Montgomery Township, 1001 Stump Road, Montgomeryville, PA 18936-9605 (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
CONTRACTOR'S AFFIDAVIT
00 65 19.13-1
File details come from the government source that posted it. Updated .