Affdavit_of_Release_and_Guarantee.pdf
PDF 73 KB Posted
- Attached to
- STAR Center AHU -104, -161, -162 Replacement
- Solicitation number
- 26-0306-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is an Affidavit of Release and Guarantee form used by Pinellas County, Florida for contractor final payment applications. The affidavit serves as a legal document in which a contractor certifies that all charges for labor, materials, supplies, lands, licenses, and other project expenses related to a specific bid have been fully satisfied and paid or will be promptly paid upon receipt of contractor payment. The contractor agrees to fully indemnify, defend, and hold harmless the Board of County Commissioners of Pinellas County from all demands, suits, actions, claims of lien, and other charges filed in connection with the project. The affidavit applies to the period from the date of agreement execution through the date of final payment acceptance and is submitted in conjunction with the contractor's application for final payment.
The contractor acknowledges awareness of all contractual warranty and guarantee provisions contained in the General Conditions of the agreement and confirms that such provisions remain in full force and effect regardless of this affidavit's execution. The contractor, on behalf of itself, its subcontractors, suppliers, material men, successors, and assigns, releases and waives all claims, demands, damages, costs, and expenses against Pinellas County relating to performance or payment under the agreement. The county's remedies under the contract are not limited by this affidavit but are in addition to any other remedies provided by law. The document requires notarization and identification verification before a person authorized to take acknowledgements and must be completed for the related STAR Center AHU replacement project in Pinellas County.
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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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