7-Subcontractors Statement of Satisfaction.pdf.pdf
PDF 118 KB Posted
- Solicitation number
- IFB-26-00363
- Issued by
- Hillsborough County, Florida
About this file
This is a Subcontractor's Statement of Satisfaction form used by Hillsborough County, Florida for the Roadway Resurfacing Repair and Preservation Districts 3&4 project. The form serves as an attachment to a General Contractor's Application for Payment, beginning with the second application submission. The document requires a subcontractor to certify under oath that all monies due from the prior Application for Payment have been received from the General Contractor. The statement must be notarized in Hillsborough County, Florida, and includes fields for the project number, project name, general contractor identification, application for payment number, work period dates, and the notary public's credentials.
The Roadway Resurfacing Repair and Preservation Districts 3&4 project, for which this form applies, is estimated at $16,000,000.00 and requires qualified contractors to perform roadway resurfacing, preservation, and repair work throughout Hillsborough County Districts 3 and 4. Work scope includes milling and resurfacing using Superpave Asphaltic Concrete, preservation treatments, and Full Depth Reclamation methods at various locations. The solicitation includes a 5% Small Business Enterprise (SBE) subcontractor participation goal.
View the file
Other files
Show all 32
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
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 .