Fillable Subcontractor Affidavit Template (Page 2 of 3) in pdf

Subcontractor Affidavit Template Page 2

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Subcontractor Affidavit

Page 2

If your company fabricated any items (i.e. steel, ducting, concrete, cabinetry etc.)

for the job, what was the total price charged to the GC for all fabricated

materials/items (raw materials + fabrication labor) used by your company for this

project? $___________

What was the manufactured total price of fixtures or equipment* (other than

construction materials in G. above) used or sold by your company for this

project? (If you are a manufacturer/fabricator, fabrication labor must be included

in the total cost of the materials). $_____________

*(Examples of fixtures and equipment that are not building materials are: appliances, carpeting,

cabinetry, window coverings, temporary fencing, specialty equipment, furniture and décor items,

art & sculptures, made to order manufacturing equipment, and any other similar items that can be

removed without substantial damage to the building structure).

Amount of Boulder City & County Sales Tax only

(not state of RTD

taxes) paid to

vendors on the above materials. $___________ (If Boulder City or County tax

was paid on invoices, please submit copies of invoices.

Amount of Boulder Use Tax reported, for materials in H. above, to the City of

Boulder on your company’s Use Tax Return. $___________

City of Boulder Business License No. ______________

(not contractor

license)

Was any construction equipment owned by your company and costing at least

$2,500 (excluding automotive vehicles) used to perform the above contract?

Yes

. If yes, please complete and submit a Construction

Equipment Declaration for each separate project on which the equipment is used

in Boulder. Filing of construction equipment declarations is required under

Boulder Revised Code sections3-2-2(9) through 3-2-2(14). The declaration form

and instructions are available on the city’s web site at:

https://bouldercolorado.gov/tax-license/construction-equipment-declarations

I CERTIFY, UNDER PENALTY OF PERJURY, THAT THE ABOVE AMOUNTS ARE

ACCURATE:

SIGNATURE

DATE ______________

PRINT NAME

_______________________

Phone No. _______________________

EMAIL ADDRESS _______________________________________________________

(CONTINUE TO PAGE 3 IF YOUR COMPANY HIRED SUBCONTRACTORS)

1777 BROADWAY P.O. BOX 791 BOULDER, CO 80306 303/441-3288

Subcontractor Affidavit Template Page 2

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