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

PDF 118 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 Final Payment Certification form issued by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for contract completion and payment processing. The certification serves as the contractor's attestation that all services have been fully performed in accordance with contract terms and that all subcontractors and suppliers have been paid their proportionate shares of previous LACMTA payments. The contractor certifies that the work is complete, complies with contract documents, and that no amounts are being withheld from subcontractors or suppliers contrary to subcontract terms. The form requires certification by an authorized official of the contracting firm and includes signature blocks for both the contractor and LACMTA, along with designated spaces for contract and project numbers, firm name, certifying official title, and execution date.

The certification includes comprehensive representations regarding the contractor's eligibility and compliance status, including verification that the contractor and its principals are not debarred, suspended, or ineligible with any governmental entity, and have not been terminated for cause, convicted of fraud, or charged with criminal offenses related to public contracting in the past three years. The contractor releases and waives all unreserved claims against LACMTA and certifies that no outstanding claims exist from any party. The form explicitly warns of penalties under federal and California False Claims Acts for knowingly presenting false claims, including civil and criminal remedies available to LACMTA, with certification made under penalty of perjury under California law. This final payment certification does not constitute final acceptance of contractor performance but serves as a prerequisite document for final payment processing.

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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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