Submission of Final Invoice. Pursuant to contract number entered into between the State of California Department of Health Services (DHS) the Contractor (identified below), the Contractor does acknowledge that final payment has been requestedvia invoice , in the of $ and dated If necessary, enter “See Attached“ in the appropriate blocks and attach a list of invoice numbers, dollar amounts and invoice dates. By signing this form, and upon receipt of the amount specified in the invoice referenced above, the Contractor does hereby release and discharge the State, its officers, agents and employees of and from any and all liabilities, obligations, claims, and demands whatsoever arising from the above referenced contract. Repayments Due to Audit Exceptions I Record Retention By signing this form, Contractor acknowledges that expenses authorized for reimbursement does not guarantee final allowability of said expenses. Contractor agrees that the amount of any sustained audit exceptions resulting from any subsequent audit made afler final payment, will be refunded to the State. All expense and accounting records related to the above referenced contract must be maintained for audit purposesfor no less than three years beyond the date of final payment, unless a longer term is stated in said contract. By signing this form, Contractor certifies under penalty of perjury that a percentage (0% to 100%) of the materials, goods, supplies or products offered or used in the performance of the above referenced contract meets or exceeds the minimum percentage of recycled material, as defined in Public Contract Code Sections 12161 and 12200. (Applies only if equipment was provided by DHS or purchased with or reimbursed by contract funds) Unless DHS has approved the continued use and possession of State equipment (as defined in the above referenced contract) for use in connection with another DHS agreement, Contractor agrees to promptly initiate arrangements to account for and return said equipment to DHS, at DHS’s expense, if said equipment has not passed its useful life expectancy as defined in the above referenced contract. Patents I Other Issues By signing this form, Contractor further agrees, in connectionwith patent matters and with any claims that are not released as set forth above, that it will comply with all of the provisions contained in the above referenced contract, including, but not limited to, those provisions relating to notification to the State and related to the defense or prosecution o...
Submission of Final Invoice. Pursuant to contract number 08-85026 entered into between the Department of Health Care Services (DHCS) and the Contractor (identified below), the Contractor does acknowledge that final payment has been requested via invoice
Submission of Final Invoice. Final invoices must be received by OTF within 60 days of the date of final performance or termination of this agreement. OTF reserves the right to deny payment of any invoice that is received after the 60-day period closes.
Submission of Final Invoice. Pursuant to contract number entered into between the State of California Department of Health Services (CDHS) and the Contractor (identified below), the Contractor does acknowledge that final payment has been requested via invoice number(s) , in the amount of $ and dated If necessary, enter “See Attached” in the appropriate blocks and attach a list of invoice numbers, dollar amounts and invoice dates. By signing this form, and upon receipt the amount specified in the invoice number(s) referenced above, the Contractor does hereby release and discharge the State, its offices, agents and employees of and from any and all liabilities, obligations, claims, and demands whatsoever arising from the above referenced contract. By signing in this form, Contractor acknowledges that expenses authorized for reimbursement does not guarantee final allowability of said expenses. Contractor that the amount of any sustained audit exceptions resulting from any subsequent audit made after final payment will be refunded to the State. All expense and accounting records related to the above referenced contract must be maintained for audit purposes for no less than three years beyond the date of final payment, unless a longer term is stated in said contract. By signing this form, Contractor certifies under penalty of perjury that a minimum 0% unless otherwise specified in writing of post consumer material, as defined in the Public Contract Code Section 12200, in products, materials, goods, or supplies offered or sold to the State regardless of whether it meets the requirements of Public Contract Code Section 12209. Contractor specifies that printer or duplication cartridges offered or sold to the State comply with the requirements of Section 12516(e).
