Attachment_5_-_Release_of_Claims.pdf

PDF 25 KB Posted

Attached to
MFB-ROOF REPLACEMENT Federal contract opportunity
Solicitation number
140G0221R0013
Issued by
Department of the Interior US Geological Survey Office of Acquisitions and Grants

About this file

This document contains a release of claims form to be signed by a contractor upon completion of work under a Department of the Interior contract. The form releases the United States, its officers, agents, and employees from all debts, obligations, claims, and demands arising from the contract, with the exception of any items explicitly listed by the contractor. The contractor must sign and date the form, and if a corporation, an officer must also certify the contractor's and signer's identities and authorities.

The related federal contract opportunity is a solicitation from the US Geological Survey to replace the roof on an MFB facility. The solicitation number, estimated award date, and response due date are not provided. The solicitation is for roof replacement services and is being conducted by the Department of the Interior.

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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 .