J12 Release of Claims.docx
DOCX document 14 KB Posted
- Attached to
- Rosebud Lift Station Construction
- Solicitation number
- 75H70127R00007
About this file
This is a Release of Claims document related to the Rosebud Lift Station Construction project (Solicitation Number 75H70127R00007) issued by the Department of Health and Human Services Indian Health Service.
The document appears to be a standard contractual release of claims form that would be executed as part of the lift station construction contract. This file type is typically used to document the resolution of disputes, claims, or potential liabilities between the Government and the contractor upon project completion or settlement of outstanding matters. While the specific claims being released are not detailed in the file name alone, such documents generally serve to establish that both parties have resolved any outstanding disputes related to contract performance, payment, differing site conditions, delays, or other potential claim issues associated with the construction project. The release would typically be required as a condition of final payment or contract closeout for the lift station replacement work at the Rosebud complex.
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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 .