6-Subcontractors Statement of Satisfaction.pdf.pdf

This is a Subcontractor's Statement of Satisfaction form used by Hillsborough County, Florida in connection with the Lenwood Lane/1st Avenue NW/4th Avenue SE Culvert Replacements project. The form serves as an attestation that subcontractors have received full payment for work completed during a specific Application for Payment period submitted by the general contractor. The statement must be notarized and attached to each Application for Payment beginning with the second submission. It applies to all subcontractors whose work appeared on the prior Application for Payment for which the general contractor has received payment. The form requires completion of project information, including the Project Number, Project Name, General Contractor identification, Application for Payment Number, and the work period covered.

The document is a standardized compliance tool designed to ensure transparency in payment distribution throughout the project delivery process. Subcontractors must swear under oath that all monies owed to them by the general contractor from the specified Application for Payment have been paid in full. The statement requires notarization before a Florida notary public and must include the notary's commission information and identification method used to verify the subcontractor's identity. This form is integral to the payment certification process for the culvert replacement project, estimated at $1,958,866.12, with a 6% Small Business Enterprise (SBE) subcontractor participation goal.