EXHIBIT F - RELEASE OF CLAIMS.pdf
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- Attached to
- Full-Size SUV (6)
- Solicitation number
- DR144127
- Issued by
- California
About this file
This is a Release of Claims form executed between a contractor and the Los Angeles County Metropolitan Transportation Authority (LACMTA). The document serves as a formal release whereby the contractor relinquishes all liabilities, obligations, claims, and demands arising from the contract in exchange for payment of monies due under the contract. The form permits contractors to reserve specific claims with LACMTA's concurrence, which are listed separately on the document. The release applies to LACMTA and its officers, directors, agents, employees, and Authorized Representatives as defined in the underlying contract. For corporate entities, the form requires certification by an authorized corporate officer attesting that the release was properly executed with appropriate corporate authority and within the scope of corporate powers, including affixing of the corporate seal where applicable.
The document functions as a final settlement instrument acknowledging that LACMTA's monetary payment constitutes full and final consideration for the release of all claims except those specifically reserved. The form is templated to accommodate insertion of the contractor's legal name, contract number, project name, and relevant dates. Signatory fields require completion by an authorized representative of the contractor, with corporate certification requirements including the attestor's name and title along with the signatory's name and title for verification purposes.
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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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