7-Subcontractors Statement of Satisfaction.pdf.pdf
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- Solicitation number
- IFB-26-00286
- Issued by
- Hillsborough County, Florida
About this file
This is a Subcontractor's Statement of Satisfaction form for use by the Hillsborough County Engineering and Operations Department in Florida related to the Stormwater CRRP Construction WORCS Contract CDBG-DR North. The document serves as an attestation that subcontractors have received all monies due from the General Contractor's Application for Payment. The statement must be notarized and attached to each Application for Payment beginning with the second application. The form requires identification of the subcontractor, their address, title, the project number and name, the general contractor's name, the application for payment number, and the period of work covered. The statement must be sworn before a notary public in the State of Florida, with the notary certifying whether the person was personally known or produced identification.
The underlying contract involves culvert repair and replacement work at various locations throughout Hillsborough County's stormwater infrastructure network, with work primarily located north of I-4 and I-275, though work may be assigned throughout the county on an as-needed basis. The contract has an estimated total value of $18,258,390.04, with work to be ordered by the County as needed over the contract term.
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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 .