B08_Attachment_7_Form_DI-137_Release_of_Claims.pdf

PDF 36 KB Posted

Attached to
CERC C3 Chiller Replacement Federal contract opportunity
Solicitation number
140G0126Q0086
Issued by
Department of the Interior US Geological Survey Office of Acquisitions and Grants

About this file

This is a Release of Claims form (DI-137) issued by the United States Department of the Interior for use in federal contracts. The form is a template to be completed upon contract completion and prior to final payment, serving as a legal document whereby the contractor relinquishes all claims against the United States government related to the contract.

The form requires the contractor to remise, release, and discharge the United States, its officers, agents, and employees from all debts, dues, liabilities, obligations, accounts, claims, and demands arising under or by virtue of the contract, in exchange for final payment of the amount due. The contractor must complete standard identification information including contract number, date of execution, payment amount in dollars, and business entity type (Corporation, Partnership, Joint Venture, or Individual). For corporate contractors, an officer must certify that the signatory was authorized to execute the release on behalf of the corporation by its governing body. The form includes spaces for contractor signature, name, title, address (street, city, state, zip code), and execution date. The certification section for corporations requires the corporate officer's signature and seal. Notably, the form contains a blank exception clause allowing for carve-outs from the general release of claims as may be negotiated between the parties.

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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.

Contractor:
Corporation: Off
Partnership: Off
Joint Venture: Off
Individual: Off
Street Number or RFD:
City:
State:
Zip Code:
Title:
Contract Number:
Date:
Sum:
Dollars:
Day:
month:
year:
Name:
Text1:
Text2:
Text3:
Text4:
Name2:
Text5:
Text6:
Text7:

File details come from the government source that posted it. Updated .