Transcription of Progress Payment Distribution by Subcontractor - …
1 Statutory Declarationof Progress Payment Distribution by SubcontractorTo be made by the Subcontractor prior to Payment when required as acondition for either: second and subsequent Progress payments ; orrelease of last application for Progress Payment for which theDeclarant has received Payment is the _____ day of _____,in the year of DeclarantI solemnly declare that, as of the date of this declaration, I am an authorized signing officer, partner or sole proprietor of the Subcontractornamed in the Subcontract identified above, and as such have authority to bind the Subcontractor , and have personal knowledge of the factthat all accounts for labour, subcontracts, products, services, and construction machinery and equipment which have been incurred directlyby the Subcontractor in the performance of the work as required by the Subcontract.
2 And for which the Contractor might in any way be heldresponsible, have been paid in full as required by the Subcontract up to and including the latest Progress Payment received, as identifiedabove, except for:1) holdback monies properly retained,2) payments deferred by agreement, or3) amounts withheld by reason of legitimate dispute which have been identified to the party or parties, from whom Payment has make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made before me in _____City/Town and Provincethis _____ day of _____copyright. Use of this form with a CCDC 9 copyright seal demonstrates that itis intended by the parties to be an accurate and unamended version of CCDC9B - Construction DocumentCCDC 9B - 2001 Name of Subcontract (Location and description of the Work as it appears in the Subcontract Documents)Date of Contract.
3 _____ _____ _____Day Month YearIdentification of SubcontractName of ContractorName of SubcontractorName of DeclarantPosition or Title (of office held with Subcontractor )DeclarationThe making of a false or fraudulent declaration is a contraventionof the Criminal Code of Canada, and could carry, upon conviction,penalties including fines or imprisonment. Copyright 2001 Canadian Construction Documents CommitteeApply a CCDC 9copyright seal of this form without a CCDC 9 copyright seal constitutes an infringement ofSignature of Declarant(A Commissioner for Oaths, Notary Public, Justice of the Peace, etc.), in the year
