EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Solicitation number
- PS144500
- Issued by
- California
About this file
This is a Release of Claims form required by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for contractors performing work under state and local contracts in California. The document serves as a formal release wherein the contractor waives and discharges LACMTA, its officers, directors, agents, employees, and authorized representatives from all liabilities, obligations, claims, and demands arising from the contract. The contractor acknowledges that payment received from LACMTA constitutes full and final compensation for work performed, with the exception of any claims specifically reserved and listed on the form with LACMTA's concurrence. The document includes fillable fields for the contract number, project name, contractor name, date of execution, and reserved claims information.
The form requires certification by a corporate officer when the contractor is a corporation, with the certifying officer attesting to the signatory's authority and that execution of the release was duly authorized by the corporation's governing body and falls within its corporate powers. A corporate seal must be affixed to the certification section. This standard administrative document is utilized across LACMTA contracts to establish final settlement and prevent future disputes related to contract performance and compensation.
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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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