16-015 Certificate of Payment.pdf
PDF 78 KB Posted
- Solicitation number
- 27000031
- Issued by
- Mason County, Texas
About this file
This is a Certificate of Payment form issued by the State of Texas, County of Midland, for Phase III of the Sinclair Avenue & Westridge Loop 250 Deceleration Lane project. The certificate serves as a formal attestation that the general contractor has completed all work in a workmanlike manner, paid all debts and expenses incurred by the contractor and its subcontractors for labor, materials, and other project costs, and fulfilled all warranty obligations associated with the work performed. The contractor executing this certificate agrees to indemnify and hold harmless the City of Midland, its officers, agents, and employees from all claims, suits, damages, and expenses arising from the contractor's work, materials supplied, or labor performed. Additionally, the contractor waives any claims against the City associated with the work performed at the project premises.
The certificate requires the contractor's signature, printed name, title, and company name, along with notarization by a notary public in the State of Texas. Upon execution and notarization, the contractor releases and relinquishes any lien claims upon the referenced property in exchange for full payment from the City of Midland for performance of the work described. The form was revised in September 2026 and includes designated spaces for the date of execution and the notary's commission expiration date. This document functions as a prerequisite for final payment authorization under the project contract.
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Text version
CP 1
CERTIFICATE OF PAYMENT
THE STATE OF TEXAS §
COUNTY OF MIDLAND §
_____________Phase III Sinclair Avenue & Westridge Loop 250 Deceleration Lane_________________
The undersigned states that all debts, bills, and expenses that were incurred by the undersigned, his agents, or subcontractors employed by him, for labor, wages, materials and other purposes furnished for the above project have been paid and satisfied in full.
The undersigned, as general contractor for the above described project agrees to indemnify, hold harmless and defend the City, its officers, agents, and employees, from and against all claims and suits for damages, expenses, including court costs and attorney fees, arising out of or resulting from the undersigned contractor, his agents or subcontractors employed by him for expenses, warranties for items furnished, or labor performed and for any party that has supplied materials in connection with the repair or construction of the above referenced premises.
The undersigned contractor agrees to waive any and all claims it may have against the City, associated with, resulting from or arising out of the work performed at the above premises.
Further, the undersigned states that all labor performed by the undersigned, his agents, and subcontractors employed by him, has been completed in the usual and customary workmanlike manner and all work performed is accompanied with the usual and appropriate warranties for such work or repair, absent any disclaimer previously approved by the City of Midland.
I, the undersigned, release and relinquish unto the City of Midland, and their assigns the above described lien upon the above referenced property and hereby certify that all debts, bills, and expenses incurred by the undersigned, his agents, or subcontractors employed by him in connection with work done at the above
CP 2
premises have been fully paid, in exchange for payment in full to be made by the City of Midland for the performance on the above described premises.
WITNESS MY HAND on this _______ day of _______________________, 20______.
Signature
Typed or Printed Name
Title
Name of Company
SUBSCRIBED AND SWORN to before me on the _______ day of ________________________, 20______.
Notary Public, State of Texas
Typed or printed name
My Commission expires:
Form Revised September 2026
CERTIFICATE OF PAYMENT
File details come from the government source that posted it. Updated .