Attachment_5_Release_of_Claims.pdf
PDF 26 KB Posted
- Attached to
- LOCK 19 - UADS REPAIR and or REMOVAL
- Solicitation number
- 140G0225R0002
About this file
This document is a template for a Release of Claims form to be completed by a contractor upon completion of a federal contract. The form requires the contractor to release the government from all claims and liabilities related to the contract, except for any exceptions noted. The form must be executed by an authorized representative of the contractor, and if the contractor is a corporation, certified by an officer of the corporation.
The related federal contract opportunity is for MAINTENANCE OF SOUND BAR IN LOCK 19 WITH AN OPTION FOR REMOVAL, solicitation number 140G0225R0002. This is a Request for Quote (RFQ) issued by the U.S. Department of the Interior (DOI), U.S. Geological Survey, using simplified acquisition procedures for commercial items. The award will be made to the vendor whose quote is determined to be the most advantageous to the government. A site visit is required, and all quotes and questions must be submitted via email.
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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 .