EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Attached to
- LIQUID WASTE REMOVAL SERVICES
- Solicitation number
- OP145195
- Issued by
- California
About this file
Exhibit F is a Release of Claims form required by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for use in conjunction with contract performance. The document serves as a legal instrument by which contractors acknowledge receipt of full and final payment under their respective contracts and release LACMTA, including its officers, directors, agents, employees, and authorized representatives, from all liabilities, obligations, claims, and demands arising from contract performance. The form provides space for contractors to reserve specific claims with LACMTA's concurrence, which would be listed and excluded from the general release. The document includes fields for contract identification, contractor name, date of execution, and any reserved claims.
The release operates as consideration for monies paid by LACMTA and represents full settlement of all contract obligations except those specifically reserved and mutually agreed upon. For corporate contractors, the form requires certification by an authorized corporate officer confirming that the signatory possessed proper authority to execute the release on behalf of the corporation and that execution was within the scope of corporate powers. The document includes spaces for notarization through a corporate seal and requires attestation by the certifying officer, with fillable fields designated for contractor name, contract number, project name, attestor details, and signatory information.
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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 .