Affdavit_of_Release_and_Guarantee.pdf
PDF 73 KB Posted
- Attached to
- Infrastructure Repair Work Order Contract
- Solicitation number
- 26-0208-ITB-C
- Issued by
- Pinellas County, Florida
About this file
This is an Affidavit of Release and Guarantee form for Pinellas County, Florida, required as part of the final payment application process for infrastructure repair work order contracts. The affidavit serves as a contractual document wherein the contractor certifies that all charges for labor, materials, supplies, lands, licenses, and other expenses related to the bid have been fully satisfied and paid or will be paid upon receipt of payment from the County. The contractor agrees to indemnify, defend, and hold harmless the Board of County Commissioners of Pinellas County from all demands, suits, actions, claims of lien, and other charges related to contract performance or payment. On behalf of itself and all subcontractors, suppliers, material men, successors, and assigns, the contractor releases and waives all claims, demands, damages, costs, and expenses against the County covering the period from contract execution through acceptance of final payment.
The affidavit acknowledges that contractual provisions for warranties and guarantees contained in the General Conditions of the agreement remain in full force and effect and that the County's remedies are not limited by the affidavit but are in addition to all other remedies provided by law. The document requires the affiant's sworn statement before a notary public or authorized official and must be completed and submitted in connection with the contractor's application for final payment. The form includes required signature blocks for the affiant, the person taking acknowledgment, and the notary public, along with fields for identifying information such as bid title, bid number, county, and date of execution.
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Text version
AFFIDAVIT OF RELEASE AND GUARANTEE
AFFIDAVIT OF RELEASE AND GUARANTEE
STATE OF FLORIDA
COUNTY OF ________
Before me, the undersigned authority, personally appeared ___________________________________________________________ who after being duly sworn, deposes and says:
All charges for labor, materials, supplies, lands, licenses and other expenses arising from
Bid Title: _________________________________________________________________________________________
Bid No: __________ for which a lien or a demand against any payment bond might be filed, have been fully satisfied and paid or will be fully satisfied and paid promptly upon receipt of payment by the Contractor. The Contractor will fully indemnify, defend and save harmless the County from all demands, suits, actions, claims of lien or other charges filed or asserted against the County in connection with matters certified to herein.
On behalf of itself and its subcontractors, suppliers, material men, successors and assigns, the Contractor releases and waives all claims, demands, damages, costs and expenses, against the Board of County Commissioners of Pinellas County, relating in any way to the performance or payment of the above-numbered Agreement, for the period from the date of execution of the Agreement through and including the date of acceptance of Final Payment.
The Contractor is aware of contractual provisions for warranties and guarantees contained in the General Conditions of the above numbered Agreement, and acknowledges that those provisions shall have the same force and effect as if this Affidavit had not been executed, and understands that the County’s remedies are not limited by same but are in addition to any other remedies provided by law.
This Affidavit is given in connection with the Contractors application for Final Payment.
FURTHER AFFIANT SAYETH NAUGHT.
(Affiant)
STATE OF FLORIDA
COUNTY OF __________
The foregoing instrument was acknowledged before me this
By _________________________ who is Personally known to me and/or has produced
______________________________ As identification.
Signature of Person Taking Acknowledgement
Name of Acknowledger Types, Printed or Stamped
| Bid Title: |
| Affiant: |
| As identification: |
| Name of Acknowledger Types Printed or Stamped: |
| Witness: |
| Bid Number: |
| County: |
| Date: |
| Personally known to me: |
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