Atch_4_-_DI_-_137_Release_of_Claims.pdf
PDF 26 KB Posted
- Attached to
- REPAIR WEST PARKING LOT - UMESC
- Solicitation number
- 140G0225R0006
About this file
This is a Department of Interior Release of Claims form (DI-137, Rev. 8/96) that contractors must complete prior to receiving final payment on a contract. The form requires contractors to discharge the United States government, its officers, agents, and employees from all debts, dues, liabilities, obligations, accounts, claims, and demands related to the contract, except for any specifically noted exceptions.
The form includes fields for the contract number, date, contract description, contractor information, and final payment amount. It requires contractor signature and designation of business type (Corporation, Joint Venture, Partnership, or Individual). For corporate contractors, an additional certification section must be completed by a corporate officer attesting that the signer had authority to execute the release on behalf of the corporation. This form is associated with a US Geological Survey solicitation (#140G0225R0006) for repair work on the West parking lot at UMESC.
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Text version
DI-137
(Rev. 8/96)
UNITED STATES
DEPARTMENT OF THE INTERIOR
RELEASE OF CLAIMS
Contract Number
Date
WHEREAS, by the terms of the above contract for
, entered into by the United States of America, hereinafter referred to as the United
States, and the contractor
, it is provided that after completion of all work, and prior to final payment, the contractor will furnish the United States with a release of all claims;
NOW, THEREFORE, in consideration of the above premises and the payment by the United States to the contractor of the amount now due under the contract, to wit, the sum of dollars ($ ), the contractor hereby remises, releases and forever discharges the United States, its officers, agents and employees, of and from all manner of debts, dues, and liabilities, obligations, accounts, claims, and demands whatsoever, in law and in equity, under or by virtue of the said contract, except:
IN WITNESS WHEREOF, the contractor has executed this release this day of , 20 .
__________________________________________________ By ________________________________________________________
(Contractor) (Signature)
Corporation Joint Venture
Partnership Individual ______________________________________________________
(Name)
(Street Number or R.F.D) (Title)
(City) (State) (Zip Code)
COMPLETE ONLY IF CONTRACTOR IS A CORPORATION
I, _________________________________________________, CERTIFY That I am the __________________________________________ of the corporation named as contractor herein; that ____________________________________________________________________, who signed this release on behalf of the corporation, was then _____________________________________________ of said corporation; and that said release was duly signed for and on behalf of said corporation by authority of its governing body.
[SEAL] ___________________________________________________________
(Signature)
File details come from the government source that posted it. Updated .