EXHIBIT E-1 - PAYMENT CERTIFICATION (CONTINUOUS).pdf
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- Attached to
- Community Relations Services Bench
- Solicitation number
- PS145468
- Issued by
- California
About this file
This is a Payment Certification form for continuous services under a Community Relations Services Bench contract administered by the Los Angeles County Metropolitan Transportation Authority (LACMTA) in California. The form serves as a certification document that contractors must submit to request payment for services rendered. The contract, identified as RFP No. PS145468, establishes a multi-disciplinary bench to provide on-call professional services supporting community engagement, research, public affairs, digital engagement, training, facilitation, and related activities for capital projects, operational initiatives, and agency-wide programs. The certification form requires completion and execution by an authorized representative of the contractor, with fields for firm name, certifying official's name and title, date of execution, and contract number.
The Payment Certification requires contractors to attest 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 from subcontractors or suppliers except as permitted by subcontract terms. Contractors must also certify their eligibility to perform public work by confirming they are not debarred, suspended, or ineligible; have not had prior public contracts terminated for cause or default within three years; have no criminal convictions or civil judgments related to fraud or public contract performance; and are not subject to current criminal or civil charges for specified offenses. The form explicitly warns that submission of false claims violates both federal and California False Claims Acts and subjects violators to penalties in addition to other available remedies, with certification required under penalty of perjury under California law.
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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.
RFP No. PS145468 Community Relations Services Bench
RFP No. PS145468 Exhibit E-1- Payment Certification (Continuous) Date: 9.28.26
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:
RFP No. PS145468 Community Relations Services Bench
RFP No. PS145468 Exhibit E-1- Payment Certification (Continuous) Date: 9.28.26
| Firm: |
| Name of Certifying Official: |
| Title: |
| Date of Execution: |
| Contract Number: Contract Number |
| Project Name: Project Name |
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