B08_Attachment_5_Form_DI-137_Release_of_Claims.pdf
PDF 36 KB Posted
- Attached to
- CERC A3 Main Building Stabilization Federal contract opportunity
- Solicitation number
- 140G0121R0030
About this file
This document is a release of claims form for a construction contract with the United States Department of the Interior. The contractor will execute this form after completing all work and prior to final payment to release the United States, its officers, agents, and employees from any further claims, debts, obligations, or demands under the terms of the contract. The contract is for stabilization work at the CERC A3 Main Building. The solicitation number for this opportunity is 140G0121R0030 and was issued by the Department of the Interior's US Geological Survey Office of Acquisitions and Grants. The form includes fields for the contractor's name, signature, business type, address, title, and the contract number and date. A corporate officer must also certify the contractor's authority if it is a corporation.
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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 .