Bid Package 08 North Well Field - Garney Construction

SELLER'S CERTIFICATE
THAT ALL CLAIMS PAID TO MATERIALMEN, ETC.
THE STATE OF TEXAS
COUNTY OF WARD
Contract Dated:
RE: Job No.
Description: Vertical Turbine Submersible
Pumping Units
Ward County North Well Field
Seller:
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS, the City of Amarillo has heretofore contracted with the undersigned Seller as to the above
described job and contract; and
WHEREAS, such above described job has been completed according to its terms and provisions and the
said Seller desires payment from the City of Amarillo upon the final estimates under the contract; and
WHEREAS, before final payment the City of Amarillo desires evidence and assurance that all outstanding
claims have been paid by said Seller;
NOW, THEREFORE, the undersigned hereby certifies that all claims hereunder have been paid and that
there are no outstanding claims of labor, materialmen, subcontractors, or any other claims arising out of the
performance of the above referred to contract, which might be asserted against the City of Amarillo. The undersigned
does further agree and bind himself (themselves), his (theirs) heirs, executors, administrators, assigns and
successors to indemnify and save harmless said City of Amarillo from any such claims arising out of said contract.
IN WITNESS THEROF the undersigned has signed and sealed this instrument on the_________ day of
__________________, A.D., 20______.
SELLER:
BY: ____________________________________ ATTEST: ______________________________
TITLE: _________________________________
THE STATE OF TEXAS
ACKNOWLEDGEMENT
COUNTY OF ____________________________
BEFORE ME, the undersigned authority, personally appeared the above named person and before me, duly
sworn on oath, deposed and says that he is the person above named, that he has the authority to sign such
instrument, that he is the person and officer so stated, that he has read the foregoing certificate by him subscribed in
his official capacity and that all matters and all things therein stated are true and correct.
SUBSCRIBED and sworn before me this ______ day of ______________, A.D., 20______.
Notary Public in and for
_________________County, Texas