5-Subcontractors Statement of Satisfaction.pdf.pdf
PDF 118 KB Posted
- Solicitation number
- IFB-26-00250
- Issued by
- Hillsborough County, Florida
About this file
This is a Subcontractor's Statement of Satisfaction form issued by Hillsborough County, Florida for use with the Countywide Stormwater Ditch and Side-Drain Restoration Contract. The form serves as an attestation document that general contractors must attach to each Application for Payment beginning with the second submission. 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's name, address, title, project number, project name, general contractor identification, application for payment number, and work period dates. The document must be notarized before a Florida notary public and can be executed through either physical presence or online notarization.
The Subcontractor's Statement of Satisfaction is a critical compliance requirement for the stormwater restoration contract, which carries an estimated value of $4.938 million with an initial one-year term and two optional one-year renewals. The form ensures payment transparency and protects subcontractors by creating a formal record of compensation status. Given that the contract includes an 8% Small Business Enterprise (SBE) subcontractor participation goal, this statement becomes particularly important for documenting that SBE and other subcontractors receive timely payment from the general contractor. The notarization requirement adds legal weight to the payment certifications and protects both the County and the subcontracting community from payment disputes.
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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 .