EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Solicitation number
- PS140683(2)
- Issued by
- California
About this file
This is a Release of Claims form for contracts with the Los Angeles County Metropolitan Transportation Authority (LACMTA). The document serves as a formal release agreement executed by contractors upon receiving payment for services rendered under a specific contract. The form requires contractors to remise, release, waive, and discharge LACMTA, along with its officers, directors, agents, employees, and authorized representatives, from all liabilities, obligations, claims, and demands arising from the contract. Contractors may reserve specific claims with LACMTA's concurrence, which must be explicitly listed on the form before execution.
The payment provided by LACMTA constitutes full and final consideration for the release of claims, excluding any specifically reserved claims documented in the agreement. For corporate contractors, the form requires certification by a corporate officer confirming the signatory's authority to execute the release on behalf of the corporation and that execution falls within the corporation's governing powers. The document includes designated fields for the contractor's name, contract number, project name, signatory information, and attestor details to ensure proper documentation and legal validity of the release 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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