EXHIBIT E-2 - PAYMENT CERTIFICATION (FINAL).pdf

PDF 118 KB Posted

Attached to
Grease Interceptor Services
Solicitation number
OP137196(3)
Issued by
California

About this file

This is a Final Payment Certification form used by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for contract completion and payment processing. The document serves as a formal attestation by the contractor that all services have been performed in accordance with contract terms, that the work is complete, and that all subcontractors and suppliers have been paid in full for their proportionate share of previous payments. The certification requires the contractor to confirm that all warranties remain in effect, that no outstanding claims exist between parties, and that no claims have been withheld from subcontractors or suppliers. The contractor must also verify that neither they nor their principals are currently debarred, suspended, or ineligible to conduct business with government entities, and that they have not been terminated for cause, convicted of fraud or criminal offenses, or been the subject of antitrust violations within the past three years.

The certification document includes specific language regarding compliance with both federal and California False Claims Acts, establishing that contractors understand the prohibition against knowingly submitting false claims for payment and the associated penalties for violation. The form requires signature and certification under penalty of perjury under California law, with spaces for the contractor's firm name, certifying official's signature and title, date of execution, and contract and project numbers. This final payment certification is not to be construed as final acceptance of contractor performance but serves as a prerequisite condition for release of final payment under the contract.

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EXHIBIT A.pdf PDF
EXHIBIT 8 - ETHICS DECLARATION.pdf PDF
EXHIBIT 10 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf PDF
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EXHIBIT E-2 - PAYMENT CERTIFICATION (FINAL)

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

1. This Payment Certification (Final) represents a true and correct statement of the Services performed and that the services have been completed in full;

2. The Services completed 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 have been paid their proportionate share of all previous payments from LACMTA, in full;

4. This Payment Certification (Final) 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;

5. The Contractor, Subcontractors and/or Suppliers have no outstanding Claims related to any unreserved (settled) Claims. Further, Contractor releases and waives all unreserved (settled) Claims against LACMTA, its officers, directors, employees and Authorized Representatives;

6. Contractor has no reason to believe that any party has a valid Claim against the Contractor or LACMTA, which has not been communicated in writing by the Contractor to LACMTA as of the date of this Payment Certification (Final);

7. All warranties are in full force and effect;

8. Releases and warranties shall survive final payment; and

9. 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 the 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 Number: Project Number

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