Attachment 5 Release of Claims.pdf
PDF 218 KB Posted
- Attached to
- Cheyenne River CT Renovation
- Solicitation number
- 75H70125Q00006
About this file
This is a Release of Claims form (Form OES-03) used by the Department of Health & Human Services Indian Health Service, Division of Engineering Services. The form serves as a legal document where contractors release the U.S. Government, its officers, agents, and employees from all liabilities, demands, obligations, and claims arising from a specific contract, subject to any explicitly excepted claims.
The form requires the contractor to provide the contract number, task order number, contractor name/address, project number, and project details. For any excepted claims, contractors must either write "NONE" or provide specific details including: (a) dollar amounts, (b) nature of claims, and (c) claim descriptions as defined in FAR Clause 52.233-1. The form must be signed and dated by an authorized representative with their title. This appears to be a standard template form dated 12/15 that would be used as part of contract closeout procedures.
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Text version
DEPARTMENT OF HEALTH & HUMAN SERVICES
Indian Health Service
Division of Engineering Services
RELEASE OF CLAIMS
Contract No. ___________________________
Task Order No. _________________________
Name and Address of Contractor:
Number, Name and Location of Project:
Project No. _________________________
Pursuant to the terms of the above numbered contract, but subject to any claims as may be specifically excepted below, the Government of the United States, its officers, agents and employees, are hereby released and discharged from all liabilities, demand, obligations, and claims arising under or by virtue of said contract.
EXCEPTED CLAIMS*
SIGNATURE TITLE
DATE
* Write NONE or (a) state the dollar amount of each excepted claim, (b) describe specifically the nature of each excepted claim, and (c) describe the claim in the same manner in which a “claim” is defined in FAR Clause 52.233-1, Disputes. (Attach additional pages if necessary.)
OES-03 (12/15)
File details come from the government source that posted it. Updated .