Release of Claim Form.pdf

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Smithsonian Astrophysical Observatory Fred Lawrence Whipple Observatory (FLWO) Dormitory Replacement
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33330225RF0010020
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The document is a Smithsonian Institution Release of Claims form (OCon FORM ROC-1, Revised January 2001) for a fixed-price construction contract. This standard form is used to release the Smithsonian Institution from any claims arising under a contract, with provisions for the contractor to itemize any remaining claims or amounts due. The form requires two witnesses and allows for the release of claims in accordance with Federal Acquisition Regulation (FAR) Clause 52.232-5, paragraph h, sub-paragraph (3). A note indicates that a separate release is required if the contractor's claim has been assigned under the Assignment of Claims Act of 1940.

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Text version

OCon FORM ROC-1 Revised January 2001

SMITHSONIAN INSTITUTION

WASHINGTON, D.C. 20560

RELEASE OF CLAIMS

(For payment under a Fixed Price Construction Contract)

The undersigned Contractor under Contract No.________________ dated _________________, 20___ between the Smithsonian Institution and said Contractor for the _____________________________________, in accordance with FAR Clause 52.232-5, paragraph h, sub-paragraph (3), which is applicable to said contract, hereby releases the Smithsonian Institution from any and all claims arising under or by virtue of said contract or any modification or change thereof except as follows:

(Itemize claims and any amounts due. If none, so state.)

Witness the signature and seal of the undersigned this ______day of _______________, 20___.

WITNESSES:

(Two witnesses are required)

(Name)

____________________________________ __________________(Seal) (Address)

____________________________________ By_____________________ (Name) (Name)

(Address) (Official Title)

(NOTE: A separate Release is required from assignee if Contractor’s claim to amounts payable under this contract has been assigned under the Assignment of Claims Act of 1940 (31 U.S.C. 3727 and 41 U.S.C. 15.)

33330220CF0010363 - 09/18/2020 - Page 265 of 265

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