Attachment K - CONTRACTOR DECLARATION.pdf
PDF 32 KB Posted
- Attached to
- Restroom Remodel at Macomb Corners Park
- Solicitation number
- RFP# 25-001
- Issued by
- Macomb County, Mcbride Village, Michigan
About this file
This document is a Contractor's Declaration form for the Restroom Remodel at Macomb Corners Park project (Contract No. 25-001), issued by Macomb Township in Michigan. The form serves as a periodic certification by the contractor to the township, confirming that during the contract period, the contractor has not incurred any additional work, material costs, losses, damages, or delays beyond the original contract terms that would warrant extra compensation or time extensions.
The declaration requires the contractor to explicitly state whether they are submitting any claim letters for additional compensation or time extensions. By signing the document, the contractor affirms that they are not seeking additional funds or contract modifications beyond what was originally agreed upon, except for any previously submitted claim letters. This document appears to be a standard administrative form used during the progress of a municipal construction project to manage potential scope changes and financial adjustments.
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Text version
Macomb Township Attachment K
CONTRACTOR'S DECLARATION
(To be attached to the Contractor's periodic Request for Payment)
Project Name: Restroom Remodel at Macomb Corners Park
Contract No.: 25-001
Contract Date:
Contractor:
Owner: Macomb Township
Certification Period (From the Date of the Contract to the Date of this Declaration)
I hereby certify that I have not, during the above noted certification period, performed any work, furnished any material, sustained any loss, damage or delay for any reason, or otherwise done anything for which I shall ask, demand, sue for, or claim compensation from the Owner or its agents, in addition to the regular items set forth in the above noted Contract (and executed Change Orders thereto) executed between the Contractor and the Township, except as the Contractor hereby claim for additional compensation and/or extension of time as described in previously submitted claim letters to the Township dated:
Attached Summary, Dated
(Contractor to check this box if no claim letters are submitted to date)
CONTRACTOR
By:
(Authorized Signature)
Name:
(Print Name)
Title:
Date:
File details come from the government source that posted it. Updated .