B12 Release of Claims DI-137.doc

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)