5-Subcontractors Statement of Satisfaction.pdf.pdf
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- Solicitation number
- IFB-26-00401
- Issued by
- Hillsborough County, Florida
About this file
This is a Subcontractor's Statement of Satisfaction form attachment for the Hillsborough County Facilities Management and Real Estate Services Department's R3M Miscellaneous Facilities Construction Term Contract 11 in Florida. The form serves as a sworn statement that must be completed by subcontractors and attached to the General Contractor's Application for Payment beginning with the second application. The document certifies that all monies due to the subcontractor from the prior Application for Payment have been paid in full by the General Contractor. The statement requires identification of the subcontractor, the project details, application period, and notarization by a Florida notary public, with options for physical presence or online notarization.
The form is a compliance and payment verification mechanism for the term contract, which covers miscellaneous facilities construction projects valued at up to $16,500,000.00. The contract encompasses interior and exterior building repairs and renovations, re-roofing, site work, utilities, landscaping, and electrical, mechanical, and plumbing work across various Hillsborough County facilities. The contract includes a 10 percent Small Business Enterprise (SBE) subcontractor participation goal. The document was updated April 9, 2020, and applies to all subcontractors whose work appeared on prior Applications for Payment for which the General Contractor has received payment.
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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 .