Contractor Release Form.pdf
PDF 11 KB Posted
- Attached to
- HVAC Replacement Erie PA Federal contract opportunity
- Solicitation number
- 6973GH-23-Q-00279
About this file
This document is a contractor release form used by the Department of Transportation to discharge contractors' liabilities and claims arising from Contract Number 6973GH-23-Q-00279 for HVAC Replacement services in Erie, Pennsylvania. Upon final payment of $ENTER SUM, the contractor remises, releases and discharges the government from all liabilities and claims under the contract, except for specified claims, liabilities to third parties not known at release execution, and patent reimbursement claims. The contractor agrees to comply with all contract provisions relating to notification of the contracting officer and litigation related to patent matters and non-released claims.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| ERI-1504445-IFC.pdf | ||
| Experience Information Form.pdf | ||
| Technical Specifications for the ERI ASR HVAC System Upgrade 4-11-2023.pdf | ||
| ERI ASR HVAC SOW 05-23-2023.pdf | ||
| WAGE DETERMINATION.pdf | ||
| 6973GH-23-Q-00279.pdf | ||
| SF-1413 Statement and Acknowledgement of Contractor.pdf |
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Text version
Form DOT F 4220.4 (Rev. 5/05) PREVIOUS EDITION OBSOLETE AUTHORIZED FOR LOCAL REPRODUCTION
DEPARTMENT OF TRANSPORTATION
CONTRACTOR'S RELEASE
CONTRACTOR (Name and Address)
CONTRACT NO.
ENTER SUM OF TOTAL OF AMOUNTS PAID AND PAYABLE
Pursuant to the terms of the above numbered contract and in consideration of the sum stated above, which has been paid or is to be paid to the Contractor, or its assignees, the Contractor, upon payment of the said sum by the UNITED STATES OF AMERICA (hereinafter called the Government), does remise, release, and discharge the Government, its officers, agents, and employees, of and from all liabilities, obligations, claims, and demands whatsoever under or arising from the said contract, except:
1. Specified claims in stated amounts or in estimated amounts where the amounts are not susceptible of exact statement by the Contractor, as follows: (or state "None")
2. Claims, together with reasonable expenses incidental thereto, based upon the liabilities of the Contractor to third parties arising out of the performance of this contract, which are not known to the Contractor on the date of the execution of this release and of which the Contractor gives notice in writing to the Contracting Officer within the period specified in the said contract; and
3. Claims for reimbursement of costs (other than expenses of the Contractor by reason of his indemnification of the Government against patent liability) including reasonable expenses incidental thereto, incurred by the Contractor under any provisions of the said contract relating to patents.
The Contractor agrees, in connection with patent matters and with claims which are not released as set forth above, that it will comply with all provisions of the said contract, provisions of the said contract, including without limitation those provisions relating to notification to the Contracting Officer and relating to the defense or prosecution of litigation.
IN WITNESSES WHEREOF, this release has been executed this
WITNESSES (Contractor)
BY
TITLE
NOTE: In the case of a corporation, witnesses are not required but the below statement must be completed.
secretary of the corporation who signed said release on behalf of said corporation; release was duly signed for and in behalf of said corporation by authority of its governing body and is within the scope of its corporate powers.
Signature day of , 20
I, , am the named as Contractor in the foregoing release; that of the Contractor was then
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