Common use of Submission of Final Invoice Clause in Contracts

Submission of Final Invoice. Pursuant to contract number entered into between the State of California Department of Health Services (DHS) and the Contractor (identified below), the Contractor does acknowledge that final payment has been requested via 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. Release of all Obligations 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. 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 resultingfrom 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 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. Reminder to Return State (If Applicable) (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 expense, if said equipment has not passed its useful life expectancy as defined in the above referenced contract. By signing this form, Contractor further agrees, in connection with patent matters and with any claims that are not specifically 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 of litigation. Contractor’s Legal Name (As on contract): Signature of Contractor or Official Designee: Date: Printed of Person Signing: DHS Distribution: Accounting (Original) Program CMU contract file Department of Health Services The following rate policy is to be applied for reimbursing the travel expenses of persons under contract.

Submission of Final Invoice. Pursuant to contract number entered into between the State of California Department of Health Services (DHS) and the Contractor (identified below), the Contractor does acknowledge that final payment has been requested via 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. Release of all Obligations 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 resultingfrom resulting from any subsequent audit made after 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 purposes for 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. Reminder to Return State (If Applicable) (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 connection with connectionwith patent matters and with any claims that are not specifically 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 of litigation. Contractor’s Legal Name (As on contract): Signature of Contractor or Official Designee: Date: Printed of Person Signing: DHS Distribution: Accounting (Original) Program CMU contract file Department of Health Services The following rate policy is to be applied for reimbursing the travel expenses of persons under contract.0312 Exhibit G