S02 - Attachment_9_ Release of Claim (ROC) Form DB_672-21-000_(2 Pages).doc
DOC document 44 KB Posted
- Attached to
- Z2DA--Hurricane Recovery Project Phase 2
- Solicitation number
- 36C24822R0038
About this file
This document includes a contractor's release of claims form and information about a related federal contract opportunity for hurricane recovery project phase 2 services.
The release of claims form is a standard template to be filled out by the contractor upon completion of contract number 672-21-000. It releases the government from further liability or claims relating to the contract in exchange for final payment, except for specified claims, claims based on contractor liabilities to third parties of which the government is notified within six years, and claims for patent reimbursement costs.
The federal contract opportunity is a pre-solicitation notice from the Department of Veterans Affairs Network Contracting Office for design-build services. The purpose is to repair damages from Hurricanes Irma and Maria in 2017 at the VA Caribbean Healthcare System facilities in Puerto Rico. The requirement is set aside solely for Service-Disabled Veteran-Owned Small Businesses. The estimated value is between $5-10 million. The solicitation will be issued on December 29, 2021 via beta.SAM.gov and responses are due January 28, 2022 at 4:30pm Atlantic Time.
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Text version
ATTACHMENT: 9
CONTRACTOR’S RELEASE OF CLAIMS
CONTRACT NO. _______________________
Pursuant to the terms of Contract No. ______________________________ and in consideration of the sum of Dollars ($ __________________), which has been or is to be paid under the said contract to____________________________ (hereinafter called the Contractor) or its assignees, if any, 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 arising out of or under this contract, subject only to the following exceptions:
1. Specified claims in stated amounts, or in estimated amounts where the amounts are not susceptible of exact statement by the contractor, as follows:
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 not more than six (6) years after the date of the release or the date of any notice to the Contractor that the Government is prepared to make final payment, whichever is earlier; 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 the provisions of the contract relating to patents.
The Contractor agrees, in connection with patent matters and with claims which are not released as set forth above, to comply with all of the provisions of the said contract, including without limitation those provisions relating to notification to the Contracting Officer and relating to the defense of prosecution and of litigation.
This release of claims is effective this ___________ day of__________________ 20____.
[Contractor Name]
BY:
TITLE:
CERTIFICATE
I, _________ [name], certify that I am the ________________________________ [official title] of the corporation named as Contractor in the foregoing release; that ______________________ [name], who signed said release on behalf of the Contractor was the ______________________ [official title] of said Corporation; that said 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.
Signed: ____________________________
(CORPORATE SEAL)
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