EXHIBIT F - RELEASE OF CLAIMS.pdf
PDF 396 KB Posted
- Solicitation number
- OP145870
- Issued by
- California
About this file
This is a Release of Claims form utilized by the Los Angeles County Metropolitan Transportation Authority (LACMTA) as part of its standard contract administration procedures. The document serves as a contractual instrument through which contractors acknowledge receipt of final payment and release LACMTA, along with its officers, directors, agents, and employees, from all liabilities, obligations, claims, and demands arising from the contract. The form includes provisions for contractors to reserve specific claims with LACMTA's concurrence, which would be listed and excluded from the general release. The document requires completion with the contract number, contractor's full legal name, date of execution, and identification of any reserved claims that remain outside the scope of the release.
The form includes certification requirements for corporate contractors, mandating that an authorized corporate officer attest to the signatory's authority to execute the release on behalf of the corporation and confirm that execution falls within the corporation's governing authority and corporate powers. Contractors are required to acknowledge that the monetary consideration provided by LACMTA constitutes full and final payment for amounts due under the contract, exclusive of any specifically reserved claims. The document contains fillable fields for attestor name and title, signatory name and title, contractor name, contract number, project name, and designated fields for reserved claims, facilitating standardized administration across multiple LACMTA contracts.
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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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