EXHIBIT E-1 - PAYMENT CERTIFICATION (CONTINUOUS).pdf

PDF 189 KB Posted

Attached to
Financial Products and Card Services for Transportation Subsidy Programs On-Call
Solicitation number
PS136749
Issued by
California

About this file

This is a Payment Certification form (Exhibit E-1) for continuous payment processing under contracts with the Los Angeles County Metropolitan Transportation Authority (LACMTA). The document serves as a certification by the contractor that services performed comply with contract terms, that all subcontractors and suppliers have been paid their proportionate share of previous LACMTA payments, and that no amounts are being withheld or retained from subcontractors or suppliers contrary to subcontract terms. The certification must be executed by an authorized firm representative and submitted under penalty of perjury.

The certification requires the contractor to attest to its eligibility and compliance status, including confirmation that the contractor and its principals are not debarred, suspended, or ineligible; have not had public transactions terminated for cause or default within the past three years; have not been convicted of fraud, criminal offenses, or antitrust violations; and are not presently indicted or charged with such offenses. The form explicitly acknowledges the contractor's understanding of federal and California False Claims Act violations, which prohibit knowingly presenting false claims for payment or using false records to obtain payment, with penalties applicable under both acts in addition to other remedies available to LACMTA. The certification is not construed as final acceptance of contractor or subcontractor performance.

View the file

Other files

File Type Posted
Exhibit B Post-Assessment Form.pdf PDF
EXHIBIT 5 - BIDDERS LIST FORM.pdf PDF
EXHIBIT D -DEOD CONTRACT COMPLIANCE MANUAL (FHWA).pdf PDF
EXHIBIT 8 - LIST OF COMPLETED CONTRACTS - LAST FIVE (5) YEARS.pdf PDF
EXHIBIT C - WORK-COMPLETIONDELIVERABLE.docx DOCX document
EXHIBIT 9 - ETHICS DECLARATION.pdf PDF
FORM C - SELECTED WORK CATEGORIES.pdf PDF
EXHIBIT 2 - FORM 60 - PROFESSIONAL SERVICES COST_PRICE SUMMARY.xls XLS spreadsheet
PS136749.pdf PDF
DEOD Forms.pdf PDF
Exhibit A Pre-Assessment Form.pdf PDF
FORM A - SAMPLE ADVERTISEMENT.pdf PDF
FORM 3 - DBE BUSINESS DATA SHEET.pdf PDF
SUBCONTRACTOR LIST.pdf PDF
EXHIBIT 11 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf PDF
EXHIBIT 12 - CERT OF COMPLIANCE WITH FED LOBBYING REQ (49 CFR PART 20).pdf PDF
EXHIBIT 2 - SCHEDULE OF QUANTITIES AND PRICES.doc DOC document
FORM E - SOLICITATION FOLLOW-UP LOG.pdf PDF
EXHIBIT A - SCOPE OF SERVICES.docx DOCX document
EXHIBIT 3 - EVALUATION CRITERIA.docx DOCX document
FORM 1 - DBE SUBS AND SUPPLIERS.pdf PDF
EXHIBIT 13 - CERT OF PROSPECTIVE CONTRACTOR AND LOWER TIER PARTICIPANT.pdf PDF
EXHIBIT 4 - LIST OF CERTIFIED FIRMS.docx DOCX document
EXHIBIT B - PRICING AGREEMENT.pdf PDF
EXHIBIT 7 - LIST OF CURRENT CONTRACTS - BACKLOG.pdf PDF
EXHIBIT G - APPROVED SUBCONTRACTORS AND SUPPLIERS.pdf PDF
FORM 4 - DBE AFFIRMATION.pdf PDF
FORM 2 - DBE AFFIDAVIT.pdf PDF
EXHIBIT 10 - GENERAL CERTIFICATIONS.pdf PDF
EXHIBIT H - SAMPLE PERFORMANCE & PAYMENT BOND.pdf PDF
EXHIBIT F - RELEASE OF CLAIMS.pdf PDF
EXHIBIT 6 - PROPOSAL LETTER.pdf PDF
FORM 5 - BIDDERS LIST FORM.pdf PDF
EXHIBIT E-2 - PAYMENT CERTIFICATION (FINAL).pdf PDF
FORM B - NEWSPAPER ADVERTISEMENT LOG.pdf PDF
Show all 35

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

EXHIBIT E-1 - PAYMENT CERTIFICATION (CONTINUOUS)

A. I hereby certify to the best of my knowledge and belief that:

1. This Payment Certification represents a true and correct statement of the Services performed;

2. The Services completed to date under this Contract are in full accordance with the terms of the Contract Documents;

3. All Subcontractors and/or Suppliers who have performed Services on the project through the closing date of the prior Payment Request have been paid their proportionate share of all previous payments from LACMTA;

4. This Payment Certification does not include any amounts which the Contractor intends to withhold or retain from a Subcontractor or Supplier in accordance with the terms and conditions of the subcontract; and

5. The Contractor and its principals, (i) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any governmental department or agency (federal, state, or local); (ii) have not in the past three years had one or more public transactions (federal, state, or local) terminated for cause or default; (iii) have not within the past three years been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, local) transaction or contract under a public transaction, violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and (iv) are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, local) with commission of any of the offenses listed in Section (A)(5)(iii) above.

B. This Payment Certification is not to be construed as final Acceptance of the Contractor's, and any Subcontractor's or Supplier's performance.

C. I understand that it is a violation of both the federal and California False Claims Acts to knowingly present or cause to be presented to LACMTA a false claim for payment or approval. A claim includes a demand or request for money. It is also a violation of the False Claims Acts to knowingly make use of a false Record or statement to get a false claim paid. The term "knowingly" includes either actual knowledge of the information, deliberate ignorance of the truth or falsity of the information, or reckless disregard for the truth or falsity of the information. Proof of specific intent to defraud is not necessary under the False Claims Acts. I understand that the penalties under the Federal False Claims Act and State of California False Claims Act are non-exclusive, and are in addition to any other criminal and/or civil remedies which LACMTA may have either under contract or law.

I certify under penalty of perjury, under the laws of the State of California, that the foregoing is true and correct

Firm:

Signature:

Name of Certifying Official:

Title:

Date of Execution:

Firm:
Name of Certifying Official:
Title:
Date of Execution:
Contract Number: Contract Number
Project Name: Project Name

File details come from the government source that posted it. Updated .