B08_Attachment_4_Form_DI-137_Release_of_Claims.pdf
PDF 36 KB Posted
- Attached to
- DREDGING OF SETTLING POND& CHLORINE BASIN
- Solicitation number
- 140G0125Q0017
About this file
This is Form DI-137, a Release of Claims form from the Department of the Interior dated March 2017. It is a standard template used when contractors need to provide a release of all claims prior to receiving final payment on a contract.
The form requires contractors to acknowledge receipt of final payment and release the United States government from any future claims related to the contract, except for specifically noted exceptions. It includes fields for the contract number, date, contractor information (with checkboxes to indicate if the contractor is a corporation, partnership, joint venture, or individual), and signature blocks. For corporate contractors, there is an additional certification section that must be completed by an authorized corporate officer. The form was electronically produced by Elite Federal Forms, Inc. This appears to be a blank template attachment associated with a USGS dredging services solicitation.
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Text version
Contract Number
Date
UNITED STATES
DEPARTMENT OF THE INTERIOR
RELEASE OF CLAIMS
DI-137
(March 2017)
WHERE AS, by terms of the above contract for
, entered into by the United States of America, hereinafter also 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, 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 .
(Contractor) (Signature)
By
(Name)
Corporation
Partnership
Joint Venture
Individual
(Street Number or R.F.D.)
(City) (State) (Zip Code)
(Title)
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.
(Signature)
[SEAL]
This form was electronically produced by Elite Federal Forms, Inc.
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File details come from the government source that posted it. Updated .