6-Contractors Affidavit for Payment of Debts and Claims.pdf.pdf
PDF 707 KB Posted
- Attached to
- Roadway Resurfacing and Repair Contract
- Solicitation number
- IFB-25-00314
- Issued by
- Hillsborough County, Florida
About this file
This document is a Contractor's Affidavit of Payment of Debts and Claims from the Hillsborough County Board of County Commissioners in Florida. The form is designed to certify that the contractor has paid in full all bills for labor, services, and materials related to a specific project, and has satisfied all known indebtedness and claims for damages that could potentially involve the county.
The document provides a standardized template for contractors to formally attest that they have met all financial obligations associated with a contract, including payments to subcontractors and suppliers. It requires notarization and includes spaces for the contractor to note any exceptions, sign the document, and have their signature witnessed by a notary public in Hillsborough County, Florida. The form was revised on 03.06.2020 and is intended to provide financial transparency and accountability in county contract work.
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Text version
CONTRACTOR’S AFFIDAVIT OF
PAYMENT OF DEBTS AND CLAIMS
The undersigned hereby certifies that except as noted below all bills for labor, services and materials furnished by the CONTRACTOR and all suppliers and/or subcontractors of the CONTRACTOR under and pursuant to the provisions of the Agreement dated the ________ day of _______________, 20_____, between the Hillsborough County Board of County Commissioners (COUNTY) and _________________________________________ (CONTRACTOR) concerning that certain project designated as __________________________________________________________ have been paid in full or otherwise satisfied including all known indebtedness and all claims for damages against said CONTRACTOR arising in any manner in connection with the performance of the Agreement referenced above for which the COUNTY might in any way be held responsible.
Exceptions: ________ (If none, write “None”.)
__________ (If yes, write “Yes” and attach list.)
Certified this ________ day of _________________, 20 ______.
CONTRACTOR:
BY:
Title
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 ___________, 2020, 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 ______________________
Revised 03.06.2020
CONTRACTOR’S AFFIDAVIT OF
File details come from the government source that posted it. Updated .