36-Doc 00 65 19.13 ContractorsAffidavit.pdf
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- Bucks County, Pennsylvania
About this file
This is a Contractors Affidavit form for the Borough of Doylestown related to Contract 2400754 for Fanny Chapman Memorial Pool Main Pool Repairs. The affidavit serves as a sworn declaration by the contractor certifying that all labor, materials, outstanding claims, and indebtedness arising from the performance of work under the contract—including all approved change orders—have been satisfied and paid in full. The document requires the contractor or an authorized representative to appear before a notary public and attest to the completion of financial obligations associated with the pool repair project located at 10 Doyle Street, Doylestown, Pennsylvania 18901.
The affidavit is a standard completion document executed upon the conclusion of contract work. It requires the contractor's signature, company seal if applicable, and the signatures and dates of the notary public witnessing the sworn statement. This form is part of the final documentation required to close out the contract and release any remaining retainage or final payments, ensuring all workers and suppliers have been compensated and no outstanding liabilities remain from the project.
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Text version
Borough of Doylestown 00 65 19.13 Contractors Affidavit 2400754 - Fanny Chapman - Main Pool Repairs Page 1 of 1
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF BUCKS
ss. Doylestown Borough
Fanny Chapman Memorial Pool - Main Pool Repairs
Before me, the undersigned, a Notary Public in and for said County and State, personally appeared
(Individual, Partner or 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 associated with Contract 2400754: Borough of Doylestown - Fanny Chapman Memorial Pool - Main Pool
Repairs between the Owner Borough of Doylestown, 10 Doyle Street, Doylestown, PA 18901 and the Contractor
(Contractor, Name and Address) has 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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