16 Attachment 3 Contractor Release Form.doc
DOC document 72 KB Posted
- Attached to
- Jacumba CA Geotechnical and Drilling Services Federal contract opportunity
- Solicitation number
- 6973GH-24-R-00237
About this file
This document is a Contractor's Release form for a federal contract. It outlines the terms under which a contractor agrees to remit, release, and discharge the government from all liabilities, obligations, claims, and demands related to the contract, with the exception of any specified claims, patent-related claims, and claims for reimbursement of certain costs incurred by the contractor. The form requires the contractor's signature and attestation by the corporate secretary, if applicable.
The related federal contract opportunity is for geotechnical and drilling services to support the United States Border Patrol near Jacumba, CA. The Department of Transportation's Federal Aviation Administration Logistics Center requires technical design, engineering, geophysical, and geotechnical services to provide up to twelve boreholes, assist with camera and sensor installation, and pour concrete of various compressive strengths. The work must be completed at specific locations within 2 miles of Jacumba, CA as directed by USBP personnel.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 16 6973GH-24-R-00237.pdf | ||
| 16 Attachment 6 Past Experience Form.docx | DOCX document | |
| 16 Attachment 1 Statement of Work.pdf | ||
| 16 Attachment 5 Performance Bond.pdf | ||
| 16 Attachment 4 Payment Bond.pdf | ||
| 16 Attachment 2 Wage Determination.pdf |
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Text version
DEPARTMENT OF TRANSPORTATION
CONTRACTOR'S RELEASE
CONTRACTOR (Name and Address)
CONTRACT NO.
ENTER SUM OF TOTAL OF AMOUNTS PAID AND PAYABLE
Pursuant to the terms of the above numbered contract and in consideration of the sum stated above, which has been paid or is to be paid to the Contractor, or its assignees, the Contractor, upon payment of the said sum by the UNITED STATES OF AMERICA (hereinafter called the Government), does remise, release, and discharge the Government, its officers, agents, and employees, of and from all liabilities, obligations, claims, and demands whatsoever under or arising from the said contract, except:
1. Specified claims in stated amounts or in estimated amounts where the amounts are not susceptible of exact statement by the Contractor, as follows: (or state "None")
2. Claims, together with reasonable expenses incidental thereto, based upon the liabilities of the Contractor to third parties arising out of the performance of this contract, which are not known to the Contractor on the date of the execution of this release and of which the Contractor gives notice in writing to the Contracting Officer within the period specified in the said contract; and
3. Claims for reimbursement of costs (other than expenses of the Contractor by reason of his indemnification of the Government against patent liability) including reasonable expenses incidental thereto, incurred by the Contractor under any provisions of the said contract relating to patents.
The Contractor agrees, in connection with patent matters and with claims which are not released as set forth above, that it will comply with all provisions of the said contract, provisions of the said contract, including without limitation those provisions relating to notification to the Contracting Officer and relating to the defense or prosecution of litigation.
IN WITNESSES WHEREOF, this release has been executed this _______ day of ___________________, 19 ___.
| WITNESSES |
| _______________________ |
(Contractor)
| BY |
| _______________________ |
| ____________________________________ |
| TITLE |
| _______________________ |
NOTE: In the case of a corporation, witnesses are not required but the below statement must be completed.
I, _________________________________, am the _______________________ secretary of the corporation named as Contractor in the foregoing release; that _____________________ who signed said release on behalf of the Contractor was then _______________________ of said corporation; release was duly signed for and in behalf of said corporation by authority of its governing body and is within the scope of its corporate powers.
Signature
Form DOT F 4220.4 (Rev. 5/05) (word)
PREVIOUS EDITION OBSOLETE
AUTHORIZED FOR LOCAL REPRODUCTION
File details come from the government source that posted it. Updated .