B08_Attachment_8_Form_DI-137_Release_of_Claims.pdf

PDF 36 KB Posted

Attached to
CERC A3 Boiler Upgrade Federal contract opportunity
Solicitation number
140G0126Q0117
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) used by the United States Department of the Interior for federal contract closeout purposes. The form is executed by the contractor prior to receiving final payment under a completed contract and serves as a legal document whereby the contractor relinquishes all claims, debts, liabilities, obligations, accounts, and demands against the United States government, its officers, agents, and employees arising from or related to the contract. The contractor acknowledges receipt of final payment in the specified dollar amount in exchange for executing this release.

The form requires the contractor to provide identifying information including the contract number, execution date, contractor name and address, and the signatory's name and title. For corporate contractors, an additional certification section must be completed by a corporate officer attesting to the signatory's authority and that the release was executed on behalf of the corporation by proper governing authority. The form accommodates various business entity types including corporations, partnerships, joint ventures, and individuals, with checkboxes for designation of the contractor's organizational structure.

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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 .