EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Solicitation number
- DR135523
- Issued by
- California
About this file
This is a Release of Claims form used by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for contract closeout purposes. The document serves as a contractual instrument through which a contractor acknowledges receipt of final payment and releases LACMTA, along with its officers, directors, agents, employees, and authorized representatives, from all liabilities, obligations, claims, and demands arising from the contract. The form permits contractors to reserve specific claims with LACMTA's concurrence, which must be listed on the document. The release is binding upon execution and represents full and final payment for amounts due, exclusive of any reserved claims. For corporate entities, the form requires certification from an officer attesting that the signatory possessed proper authority from the corporation's governing body to execute the release and that the action falls within the corporation's corporate powers.
The document contains fillable fields for essential contract information, including the contract number, contractor name, project name, attestor name and title, and signatory name and title. A corporate seal space is provided for organizational signatories. This form is typically completed at contract conclusion as a condition precedent to final payment and represents standard contract administration practice for state and local procurement activities in California.
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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 .