EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Attached to
- Employee Assistance Program
- Solicitation number
- PS141248
- Issued by
- California
About this file
This is a Release of Claims form established by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for use in state and local contracts. The document serves as a formal agreement whereby the contractor releases LACMTA, including its officers, directors, agents, employees, and authorized representatives, from all liabilities, obligations, claims, and demands arising from the contract. The form includes provisions for the contractor to specifically reserve certain claims with LACMTA's concurrence, which are to be listed on the document. The release is executed in consideration of monies paid under the contract and constitutes full and final payment for amounts due, excluding any specifically reserved claims.
The form requires certification by a corporate representative when executed by a corporation, with the certifying officer confirming their position within the company, the signatory's authority and title, and that the release was duly signed in accordance with the corporation's governing body authorization and corporate powers. The document contains fillable fields for contract number, project name, contractor name, attestor information, and signatory details. This standardized form is designed to protect LACMTA by securing a comprehensive waiver of claims upon contract completion while allowing contractors to preserve any disputed claims through explicit reservation and mutual agreement.
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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 |
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