EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Solicitation number
- PS136577(3)
- Issued by
- California
About this file
This is a Release of Claims form template for the Los Angeles County Metropolitan Transportation Authority (LACMTA) that contractors must execute upon contract completion. The document serves as a formal discharge of all liabilities, obligations, claims, and demands arising from the contract between the contractor and LACMTA, except for those claims specifically reserved and mutually agreed upon by both parties. The form requires the contractor to acknowledge that payment received from LACMTA constitutes full and final settlement for all work performed under the contract, with the exception of any explicitly listed reserved claims. For corporate entities, the form includes a certification section requiring an authorized officer to verify the signatory's authority and the release's corporate validity.
The form contains standard fillable fields for contract identification, dates, contractor information, and attestor details. No pricing, set-asides, incumbency information, or funding sources are specified in this template document, as it functions as a standard release instrument applicable across LACMTA contracts regardless of contract value or type. The contractor's execution of this release is a condition precedent to final payment and contract closure.
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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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