Encl. 1 - Attachment 5 Final Release of Claims dated 6-7-24.pdf
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- Solicitation number
- SJ472268
- Issued by
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Department of Energy Office of Science
About this file
This is a Final Release of Claim form (AMS-FORM-031, Revision 2.0) from Brookhaven National Laboratory's Procurement and Property Management Division, effective June 7, 2024. The form is used to document the completion of contract work and release all parties from liabilities and claims related to the contract.
The form requires the contractor to release Brookhaven Science Associates, LLC (BSA), its officers, agents, and employees, as well as the Government of the United States and its agents and employees, from all liabilities, obligations, claims, and demands arising from or connected with the contract work. In exchange, the contractor receives total payment on the contract account in a specified amount from BSA. The contractor also agrees to indemnify and hold BSA and the Government harmless from any claims by third parties related to the contract or work performed. The form must be signed and dated by an authorized representative of the contractor, including their typed name and title. Certain exceptions to the release may be noted on the form, though these are not detailed in the template provided.
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PROCUREMENT AND PROPERTY MANAGEMENT DIVISION
BROOKHAVEN NATIONAL LABORATORY
Managed by Brookhaven Science Associates, LLC, under contract to the U.S. Department of Energy
ACQUISITION MANAGEMENT SYSTEM FORM
Form No. AMS-FORM-031
Revision No. 2.0
Effective Date: June 7, 2024
APPROVED BY:
Sergio Martinez / 6/7/24
FINAL RELEASE OF CLAIM
CONTRACT NO: PRIME CONTRACT NO.: DE-SC0012704
Contractor:
Address:
The work under the said contract between the above-named Contractor and Brookhaven Science Associates, LLC (BSA), has been completed. In consideration of the total payment on the Contract account in the sum of ($ ) made by BSA, the undersigned Contractor hereby releases Brookhaven Science Associates, LLC, its officers, agents, and employees, and the Government of the United States, its agents, and employees, of and from all liabilities, obligation, claims, and demands whatsoever under or arising from the said contract or in connection with the work required to be performed thereunder, and hereby agrees to indemnify BSA and the Government of the United States against, and to hold each of them harmless from, any claims by any person arising out of or in any way connected with the Contract or the work hereunder. The following are excepted from the foregoing release and agreement:
THIS RELEASE has been executed on , 20
Signature:
Typed Name:
Title:
File details come from the government source that posted it. Updated .