J07 Release of Claims Pryor Clinic Constr.docx
DOCX document 14 KB Posted
- Attached to
- Pryor Clinic Expansion Construction in Pryor
- Solicitation number
- 75H70126R00024
About this file
This is a Final Release of Claims form template for federal construction contracts. The document serves as a legal instrument whereby a contractor releases the U.S. Government, including its officers, agents, and employees, from all liabilities, obligations, claims, and demands arising from a specific contract upon receipt of payment. The form includes designated spaces for the contract number, contractor identification, payment amount, execution date, and signature blocks for both the contractor and witnesses. The template preserves all other terms and conditions of the underlying contract in full force and effect.
The release form includes a corporate certification section for use when the contractor is a corporation, requiring the certifying officer to verify their corporate position, the signatory's authority, and confirmation that the release was executed with proper corporate authority and within the scope of corporate powers. The form is specifically associated with Contract No. 75H70126R00024 for the Pryor Clinic Expansion Construction project in Pryor, Montana—an Indian Health Service construction solicitation valued between $5,000,000 and $10,000,000 for renovation of approximately 8,655 square feet of existing clinic space. This release document would be executed upon final payment to the contractor upon project completion.
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Text version
FINAL RELEASE OF CLAIMS
Pursuant to the terms of Contract No: __________________________________and in consideration of the monies, which have been or are to be paid under the said contract to _________________ (hereinafter called the Contractor) or its assignees, if any, the Contractor, upon payment of the said sum by the UNITED STATES OF AMERICA (hereafter 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 arising out of or under this contract, subject only to specified claims in stated amounts, or in estimated amounts where the amounts are not susceptible of exact statement by the contractor, as follows:
1. Other Specific Claims ________________________
All other terms and conditions of the above-mentioned contract remain in full force and effect.
IN WITNESS WHEREOF, this release has been duly executed this __________ day of _____________________________, 202___.
Witness: Contractor:
Signature Signature
Printed Name and Title Printed Name and Title
Address
(Note in the case of a corporation. Witnesses are not required, but the certificate below must be completed.)
Certificate
I ____________________________, certify that I am the ______________________________ of the corporation names as Contractor in the foregoing release: that ______________________, who signed said release on behalf of the Contractor was the ________________ of said Corporation; that said release was duly signed for and in behalf of aid corporation by authority of its governing body and is within the scope of its corporate powers.
Signature Corporate Seal
File details come from the government source that posted it. Updated .