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00930. FORM OF FINAL RECEIPT:
[The following form will be used to show receipt of final payment for this Contract.]
FINAL RECEIPT FOR CONTRACT NO.
Received this day of , 20 , from City
of Miami, Florida, the sum of Dollars
($ ) as full and final payment to CONTRACTOR for all work and materials
for the Project described as:
This sum includes full and final payment for all extra work and material and all
incidentals.
CONTRACTOR hereby indemnifies and releases CITY from all liens and claims
whatsoever arising out of the Contract and Project.
CONTRACTOR hereby certifies that all persons doing work upon or furnishing
materials or supplies for the Project have been paid in full. In lieu of this certification
regarding payment for work, materials and supplies, CONTRACTOR may submit a
consent of surety to final payment in a form satisfactory to CITY.
CONTRACTOR further certifies that all taxes imposed by Chapter 212, Florida
Statutes (Sales and Use Tax Act), as amended, have been paid and discharged.
[If incorporated sign below.]
ATTEST:
CONTRACTOR
(Name of Corporation)
By:
(Secretary) (Signature)
(Corporate Seal) (Print Name and Title)
158
day of 20
[If not incorporated sign below,]
WITNESSES:
•
By:
159
CONTRACTOR
(Name of Firm)
(Signature)
(Print Name and Title)
day of 20