C05_Attachment_4_-_DI-137_Release_of_Claims.pdf

PDF 161 KB Posted

Attached to
PARKER SERVICE STATION ROOF REHAB
Solicitation number
140R3025R0011
Issued by

About this file

The document is a DI-137 Release of Claims form from the United States Department of the Interior, specifically tied to Solicitation 140R3025R0011 for the "PARKER SERVICE STATION ROOF REHAB" project. This standard federal contract release form is designed to be completed by a contractor after project completion and before final payment, serving as a legal document that releases the United States government from further claims related to the specific contract.

The form requires the contractor to provide details such as the contract number, date, contractor information, and a comprehensive release of all potential legal claims against the United States, its officers, agents, and employees. The form includes sections for different types of business entities (corporation, partnership, joint venture, or individual) and has a specific certification section for corporate contractors. Once signed, the document serves as a formal acknowledgment that the contractor has received payment and relinquishes the right to pursue additional claims related to the contract, with any specific exceptions to be noted on the form.

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Other files

File Type Posted
C06_Q_A_on_solicitiation_0001.pdf PDF
Sol_140R3025R0011_Amd_0001.pdf PDF
C05_140R3025R0011__RFP.pdf PDF
C05_Attachment_1_SOW.pdf PDF
C05_Attachment_2_Wage_Determination.pdf PDF
Sol_140R3025R0011.pdf PDF
C05_Attachment_3_Bonds.pdf PDF

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Text version

Request for Proposal 140R3025R0011

Attachment 04

DI-137 Release of Claims

Request for Proposal 140R3025R0011

This page intentionally left blank

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.

Solicitation 140R305R0011 Attachment 4

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

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