5-Subcontractors Statement of Satisfaction.pdf.pdf
PDF 118 KB Posted
- Attached to
- Public Defender First Floor Security Lobby
- Solicitation number
- IFB-26-00263
- Issued by
- Hillsborough County, Florida
About this file
This document is a Subcontractor's Statement of Satisfaction form for the Public Defender First Floor Security Lobby project in Hillsborough County, Florida. The form serves as an attachment to a General Contractor's Application for Payment, beginning with the second application. The statement confirms that all monies due to subcontractors from the prior Application for Payment have been paid in full. The form requires notarization in Hillsborough County, Florida, and must include the project number, project name, general contractor name, application for payment number, and work period dates.
The document functions as a payment verification mechanism requiring subcontractor affidavits sworn under oath. It applies to each subcontractor whose work appeared on the previous Application for Payment for which the General Contractor received payment. The form must be completed and notarized by the subcontractor or their representative before submission with each subsequent payment application. The related project is a $823,000 interior construction project in Tampa, Florida, involving approximately 2,910 square feet of space expansion and renovation at 700 E. Twiggs Street, with a 10% Small Business Enterprise (SBE) subcontractor participation goal.
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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 .