4-Subcontractors Statement of Satisfaction.pdf.pdf
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- Solicitation number
- IFB-26-00399
- Issued by
- Hillsborough County, Florida
About this file
This is a Subcontractor's Statement of Satisfaction form issued by Hillsborough County, Florida in connection with the Miscellaneous Parking Lot Repaving Services Term Contract B. The form serves as an attestation document that must be attached to each Application for Payment submitted by the General Contractor beginning with the second application. The statement certifies that all monies due to subcontractors from the prior Application for Payment have been paid in full. The form requires the subcontractor to provide their name, address, and title, and must be notarized before a Florida notary public, with the notarization occurring either through physical presence or online notarization.
The contract opportunity involves Hillsborough County Facilities Management and Real Estate Services Department's procurement for parking lot restoration services at multiple county facilities and park sites, with an estimated contract value of $6,000,000.00. The solicitation establishes a Small Business Enterprise (SBE) subcontracting goal of 5%. Questions and requests for interpretation regarding the solicitation must be submitted no later than 14 calendar days following the later of the solicitation issuance date, site visit, or pre-bid conference, as specified in the Contract Terms and Conditions Document.
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Subcontractors Statement of Satisfaction updated 4.9.2020
SUBCONTRACTOR'S STATEMENT OF SATISFACTION
(Attachment to General Contractor's Application for Payment No. )
Note: The General Contractor shall attach this statement to each Application for Payment beginning with the second Application for Payment. This statement is applicable to each subcontractor whose work appeared on the prior Application for Payment for which the General Contractor has been paid.
KNOW ALL MEN BY THESE PRESENTS, That, (Name) representing whose address is with the title of , who after being first duly sworn, upon oath, deposes and says that pursuant to the provisions of the contract for:
Project No.
Project Name:
General Contractor:
that all monies due him/her from the General Contractor's Application for Payment No.
(Period of work: to ) have been paid to him/her.
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
Sworn to (or affirmed) and subscribed before me by means of physical presence or online notarization, this ____ day of ___________, 20___, by____________________________, (Name of person making statement)
(Signature of Notary Public - State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known or Produced Identification
Type of Identification Produced ______________________
File details come from the government source that posted it. Updated .