ࡱ> 130_ bjbjڿڿ ;-b-bXXXXXlll8l.(8884666666$jZX88888ZXX4o8RXX484BZ*j 0X8888888ZZ8888888888888888B :  WILLIAM & MARY AFFIDAVIT OF PAYMENT OF CLAIMS By: Project Name: _______________________________________________ Project Code: _____________________________________________ This day personally appeared before me, , a Notary Public in and for the City (County) of , and, being by me first duly sworn, states that all subcontractors and suppliers of labor and materials have been paid all sums due them for work performed or materials furnished in the performance of the Contract between the Commonwealth of Virginia, _____________________________________________________________ ______________, Owner, and______________________________________________ , Contractor, dated ,20 , for the construction of or arrangements have been made by the Contractor satisfactory to such subcontractors and suppliers with respect to payments of such sums as may be due them by the Contractor. Typed Contractor Name By: Signature Typed Name &Title of Person Signing Subscribed and sworn to before me this day of , 20 . My commission expires on the day of , 20 . Notary Public cc: John Rodriguez, Procurement Manager Project Manager of Record     DGS-30-108 HECO-13 91Ƭ, VIMS Rev 2/01 Page  PAGE 1 of  NUMPAGES 1  ./04 . U k t g  . / 45KO4^ksżՑ΄}}}ՑՑ h)6CJ h~;CJ h)6CJh)6>*CJh'h)CJh'h)>*CJh~;h)CJ h'CJh~;h~;CJh+h)CJ h)>*CJ h)CJ h+CJh) h)5CJ h f5CJ hLm5CJ h)CJ1/0k H 5KL456  ` ` 0 0dhgd~;dh$a$Niw{}޹~~hp! h~;J h vJ h fJh fhLmh~;h~;h~;5 h~;5hg(jhg(U h+5CJ h7sRCJ hmCJ hp!CJ hLmCJ h #jCJ h+CJ h)CJh)6>*CJ h)>*CJ h)CJ06wxyz{gd f @P" %gd^$ ^`a$gd+ ^  dh$ ^`a$gd+$a$  $HAgd f  $HAgd~; ƿ h+5CJhg(jh f5UaJ*hLm5mHnHu* h f5jh f5UaJhh fh v90PBP/ =!"#$% Dps666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH D`D Normal1$CJ_HhmH sH tH DA D Default Paragraph FontViV 0 Table Normal :V 44 la (k ( 0No List <& < Footnote Reference4@4  f0Header  H$6/6  f0 Header CharCJh4 @"4  f0Footer  H$6/16  f0 Footer CharCJhHBH  f0 Balloon TextCJOJQJ^JaJR/QR  f0Balloon Text CharCJOJQJ^JaJhPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w<   6 !@ @H 0(  0(  B S  ? { 33 .x  p!c9'w'g(~;4>rA7sRbene f #jbm4pffq: >mh v)^LmE+:Y'M@ @UnknownG.[x Times New Roman5Symbol3. .Cx Arial5. .[`)TahomaA$BCambria Math" h h hZO|O|! 2Q HP $P:Y2!xx8 GBenjamin F. WebbRodriguez, Juan Oh+'0|   , 8 D P\dltGBenjamin F. WebbNormalRodriguez, Juan2Microsoft Office Word@@~,@'Z*@'Z*O| ՜.+,0 hp|  DGS G Title !"#$%&')*+,-./2Root Entry F@ZBZ*41TableWordDocument;SummaryInformation( DocumentSummaryInformation8(CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q