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

PDF 189 KB Posted

Attached to
Skid Steer Loaders
Solicitation number
DR140202
Issued by
California

About this file

This is a Payment Certification form for continuous services under a contract with the Los Angeles County Metropolitan Transportation Authority (LACMTA). The document serves as a certification mechanism for contractors to attest that services performed comply with contract terms, that all subcontractors and suppliers have been paid their proportionate shares of previous LACMTA payments, and that no amounts are being withheld or retained in violation of subcontract terms. The certification requires the contractor's principal to confirm their current eligibility status, including that they are not debarred, suspended, or ineligible from government transactions, and that they have not experienced termination for cause, fraud convictions, or criminal charges related to public transactions within the past three years.

The certification explicitly warns signatories of their obligations under both federal and California False Claims Acts, establishing that knowingly submitting false claims for payment constitutes a violation subject to civil and criminal penalties. The signatory must certify under penalty of perjury that all statements are true and correct, with "knowingly" defined to include actual knowledge, deliberate ignorance, or reckless disregard for the truth or falsity of information. The form requires completion by an authorized certifying official, including firm name, signature, title, date of execution, and contract number, with the certification explicitly stating that submission does not constitute final acceptance of contractor or subcontractor performance.

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EXHIBIT A.1 - TECHNICAL REQUIREMENTS.pdf PDF
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FORM 3 - BUSINESS DATA SHEET.pdf PDF
FORM 2 - AFFIDAVIT.pdf PDF
EXHIBIT 4 - LIST OF CERTIFIED FIRMS (RESERVED).pdf PDF
EXHIBIT B - PRICING AGREEMENT.pdf PDF
EXHIBIT E-2 - PAYMENT CERTIFICATION (FINAL).pdf PDF
EXHIBIT C - WORK-COMPLETION_DELIVERABLE SCHEDULE (RESERVED).pdf PDF
EXHIBIT 12 - MISCELLANEOUS (RESERVED).pdf PDF
EXHIBIT 7 - LIST OF COMPLETED CONTRACTS - LAST FIVE (5) YEARS.pdf PDF
EXHIBIT 9 - GENERAL CERTIFICATIONS.pdf PDF
IFB No. DR140202.pdf PDF
EXHIBIT 8 - ETHICS DECLARATION.pdf PDF
EXHIBIT 10 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf PDF
EXHIBIT 11 - NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER.pdf PDF
FORM 6 - SBE-DVBE DEALER-DISTR AFFIRMATION.pdf PDF
FORM 4 - SBE-DVBE AFFIRMATION.pdf PDF
EXHIBIT 2 - SCHEDULE OF QUANTITIES AND PRICES.pdf PDF
EXHIBIT 6 - LIST OF CURRENT CONTRACTS - BACKLOG.pdf PDF
EXHIBIT A - SCOPE OF SERVICES.pdf PDF
EXHIBIT G - APPROVED SUBCONTRACTORS AND SUPPLIERS.pdf PDF
EXHIBIT D - DEOD CONTRACT COMPLIANCE MANUAL(Non-Fed).pdf PDF
EXHIBIT 5 - BID LETTER.pdf PDF
FORM 5 - BIDDERS LIST FORM.pdf PDF
FORM 1 - SBE-DVBE SUBS & SUPPLIERS.pdf PDF
EXHIBIT 3 - RESERVED.pdf PDF
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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.

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

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