EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Solicitation number
- OP1421678370
- Issued by
- California
About this file
This is a Release of Claims form template for the Los Angeles County Metropolitan Transportation Authority (LACMTA). The document serves as a contractual release agreement wherein a contractor agrees to remise, release, waive, and discharge LACMTA, its officers, directors, agents, employees, and Authorized Representatives from all liabilities, obligations, claims, and demands arising from or related to a specified contract. The form includes placeholder fields for the contractor's name, contract number, date of execution, and a section permitting the contractor to reserve specific claims with LACMTA's concurrence, which must be explicitly listed on the document. The template requires certification by a corporate officer when executed by a corporation, including attestation of the signatory's authority and corporate authorization.
The release constitutes full and final payment for amounts due under the contract, excluding any specifically reserved claims listed by mutual agreement. For corporate entities, the form mandates completion of a certificate section wherein a corporate officer certifies the signatory's authority, the proper authorization by the corporation's governing body, and that execution is within the corporation's powers. The document includes designated signature lines, corporate seal placement, and fillable fields for attestor and signatory information.
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Text version
EXHIBIT F - RELEASE OF CLAIMS
Name of Contractor:
Date:
Pursuant to the terms of Contract # [insert Contract number here] (hereinafter the “Contract”) and in consideration of the monies, which are to be paid under the Contract to [insert Contractor’s full legal (hereinafter “Contractor”) or its assignees, if any, the Contractor hereby does remise, release, waive and discharge the Los Angeles County Metropolitan Transportation Authority (hereinafter “LACMTA”), its officers, directors, agents, employees, and Authorized Representatives (as defined in the Contract) of and from all liabilities, obligations, claims and demands whatsoever arising out of or under this Contract, except for those claims specifically reserved with the concurrence of LACMTA and listed here:
Contractor acknowledges that the consideration of monies provided by LACMTA in exchange for this release of claims shall be full and final payment for the amount due exclusive of the specifically reserved claims listed above.
(Note in the case of a corporation, the certificate below must be completed.)
Certificate
I ____________________________, certify that I am the ______________________________ of the corporation named as Contractor herein; that ______________________, who signed said release on behalf of the Contractor was the ________________ of said Corporation; that said release was duly signed for and in behalf of corporation by authority of its governing body and is within the scope of its corporate powers.
Corporate Seal
Signature
| Project Name: Project Name |
| Date: |
| Fillable Field 5: |
| Fillable Field 6: Attestor Name |
| Fillable Field 7: Attestor Title |
| Fillable Field 8: Signatory Name |
| Fillable Field 9: Signatory Title |
| Contractor Name: Contractor Name |
| Contract Number: Contract Number |
File details come from the government source that posted it. Updated .