EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Solicitation number
- PS143903
- Issued by
- California
About this file
This document is a Release of Claims form used by the Los Angeles County Metropolitan Transportation Authority (LACMTA) as part of its standard contracting procedures. The form serves as a legal instrument through which contractors acknowledge receipt of payment under a contract and release LACMTA, its officers, directors, agents, and employees from all liabilities, obligations, claims, and demands arising from the contract performance. The contractor may reserve specific claims with LACMTA's concurrence, which must be listed on the designated lines within the document. The form requires completion of contractor name, contract number, project name, and relevant dates to establish the agreement between the parties.
The Release of Claims form includes certification requirements for corporate contractors, necessitating completion of a certificate section that verifies the signatory's authority to execute the release on behalf of the corporation and confirms that execution falls within the corporation's governing authority and corporate powers. The document treats the monies provided by LACMTA as full and final payment for amounts due, exclusive of any specifically reserved claims. This exhibit represents a standard administrative requirement in LACMTA's contracting process and must be executed prior to final payment and contract closeout.
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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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