EXHIBIT F - RELEASE OF CLAIMS.pdf

PDF 396 KB Posted

Attached to
Disadvantage and Small Business Enterprise Certification Services
Solicitation number
PS143910
Issued by
California

About this file

Exhibit F is a Release of Claims form used by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for contract administration purposes. This document serves as a formal release mechanism whereby contractors acknowledge receipt of full and final payment for services rendered under a specified contract and waive all claims and demands arising from the contract execution, with the exception of any claims specifically reserved and listed on the form with LACMTA's concurrence. The form requires completion of contractor identification information, contract number, project name, and attestation details, with particular provisions for corporate entities to provide certification of signatory authority and governing body approval.

The document functions as a standard closeout instrument that confirms the contractor has received complete compensation in exchange for releasing LACMTA, its officers, directors, agents, and employees from all liabilities and obligations related to contract performance. The form includes designated spaces for listing any specifically reserved claims that are excluded from the general release, allowing for disputes or outstanding matters to be preserved outside the scope of final payment. For corporate contractors, the form mandates a certificate section wherein an authorized corporate officer must verify the signatory's authority and confirm that the release was executed in accordance with the corporation's governing authority and within its corporate powers.

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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 .