30-Doc 00 65 19.13 - CONTRACTORS AFFIDAVIT.pdf

PDF 132 KB Posted

Attached to
Bristol Township 2026 Road Paving, Inlet Replacement, and Curb Ramp Program
Solicitation number
Not on record
Issued by
Bucks County, Pennsylvania

About this file

This is a Contractor's Affidavit document associated with Bristol Township's 2026 Road Paving, Inlet Replacement, and Curb Ramp Program (Contract #25-01237) located in Bristol, Pennsylvania. The affidavit serves as a sworn statement certifying that all labor, materials, outstanding claims, and indebtedness arising from the performance of work under the agreement have been satisfied and paid in full. The document is executed by an individual, partner, or duly authorized representative of the corporate contractor before a notary public and includes spaces for identification of the contractor, the agreement date, and the notary's certification. This affidavit is a standard closing document required upon completion of the contracted work.

The underlying contract covers a comprehensive roadway improvement project involving base bid and alternate bid options for milling, base repair, leveling course, manhole rim adjustments, inlet design and replacements, and wearing course work across multiple roads within Bristol Township. The project also includes the installation of ADA and PennDOT-compliant curb ramps with associated sidewalk, curbing, utility adjustments, and sign relocation or installation at designated locations. All materials, labor, and equipment must conform to PennDOT Publication 408 and Township Standards, with specific roadway, inlet structures, and quantities detailed in the contract exhibits.

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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 #25-01237: 2026 ROAD PAVING, INLET REPLACEMENT, AND CURB RAMP PROGRAM Between Bristol Township, 2501 Bath Road, 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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