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

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Full-Size SUV (6)
Solicitation number
DR144127
Issued by
California

About this file

This is a Payment Certification (Final) form for the Los Angeles County Metropolitan Transportation Authority (LACMTA). The document serves as a final payment request and certification that all services contracted under a specific project have been completed in full accordance with the contract terms and conditions. The certifying contractor must confirm that all work has been performed satisfactorily, all subcontractors and suppliers have been paid in full from previous LACMTA payments, and no amounts are being withheld or retained contrary to subcontract agreements.

The certification requires the contractor to attest to several critical conditions, including that no outstanding claims exist against LACMTA or any parties involved, all project warranties remain in full force and effect post-payment, and the contractor maintains debarment-free status with no history of contract terminations for cause, fraud convictions, or criminal charges within the past three years. The certifying official must also acknowledge understanding of penalties under both federal and California False Claims Acts for submitting false claims, with penalties being non-exclusive and available in addition to other remedies LACMTA may pursue. The form requires signature and date execution from the authorized firm representative, along with the associated contract and project numbers for identification and tracking purposes.

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Other files

File Type Posted
EXHIBIT A - SCOPE OF SERVICES.pdf PDF
EXHIBIT E-1 - PAYMENT CERTIFICATION (CONTINUOUS).pdf PDF
EXHIBIT C - WORK-COMPLETION_DELIVERABLE SCHEDULE.pdf PDF
EXHIBIT H - MISCELLANEOUS (RESERVED).pdf PDF
EXHIBIT F - RELEASE OF CLAIMS.pdf PDF
EXHIBIT 12 - MISCELLANEOUS (RESERVED).pdf PDF
EXHIBIT 7 - LIST OF COMPLETED CONTRACTS - LAST FIVE (5) YEARS.pdf PDF
EXHIBIT 11 - NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER.pdf PDF
Exhibit A Pre-Assessment Form.pdf PDF
FORM 1 - SBE-DVBE SUBS & SUPPLIERS.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 B - PRICING AGREEMENT.pdf PDF
EXHIBIT G - APPROVED SUBCONTRACTORS AND SUPPLIERS (RESERVED).pdf PDF
EXHIBIT D - DEOD CONTRACT COMPLIANCE MANUAL (Non-Fed).pdf PDF
EXHIBIT J - 29 CFR 5.5.pdf PDF
EXHIBIT I - RESERVED.pdf PDF
EXHIBIT C - WORK-COMPLETION_DELIVERABLE SCHEDULE (RESERVED).pdf PDF
EXHIBIT 8 - ETHICS DECLARATION.pdf PDF
FORM 3 - BUSINESS DATA SHEET.pdf PDF
FORM 5 - BIDDERS LIST FORM.pdf PDF
DR144127.pdf PDF
Thumbs.db —
SUBCONTRACTOR LISTING FORM.pdf PDF
FORM 2 - AFFIDAVIT.pdf PDF
Exhibit B Post-Assessment Form.pdf PDF
EXHIBIT 3 - RESERVED.pdf PDF
EXHIBIT 6 - LIST OF CURRENT CONTRACTS - BACKLOG.pdf PDF
EXHIBIT A-1 TECHNICAL SPECIFICATIONS.pdf PDF
EXHIBIT 10 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf PDF
EXHIBIT 5 - BID LETTER.pdf PDF
EXHIBIT 9 - GENERAL CERTIFICATIONS.pdf PDF
EXHIBIT 4 - LIST OF CERTIFIED FIRMS (RESERVED).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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