6-Subcontractors Statement of Satisfaction.pdf.pdf
PDF 118 KB Posted
- Solicitation number
- IFB-26-00005
- Issued by
- Hillsborough County, St. Petersburg City, Florida
About this file
This document is a Subcontractor's Statement of Satisfaction form for a construction or contracting project in Hillsborough County, Florida, dated 4.9.2020. The form is designed to be an attachment to a General Contractor's Application for Payment, specifically to be submitted beginning with the second payment application. It serves as a sworn statement by a subcontractor confirming receipt of payment for work completed during a specified period.
The form requires detailed documentation including the subcontractor's name, address, title, project number, project name, general contractor, and specific payment application details. It includes a notarization section for official validation in the State of Florida, with options for physical presence or online notarization. The document provides spaces for recording personal identification and requires the subcontractor to affirm under oath that all monies due for the referenced work period have been paid in full.
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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 .