PSA-16-R-0012_-_Contractor's_Release_Statement-_Attachment_VII.pdf

PSA-16-R-0012

ATTACHMENT VII

CONTRACTOR’S RELEASE STATMENT

Contractor’s Release Statement

Pursuant to the terms of contract No. _____________________, and in consideration of the sum of

_____________________________________________ dollars and ______/100 cents ($____________), which has been paid under the contract to _________________________________________, located at

__________________________________________________________, hereinafter called “the contractor” or its assignees, if any, the Contractor, upon payment of the sum by the UNITED STATES

OF AMERICA, hereinafter called “the Government”, does remise, release and discharge the Government, its officer, agents and employees, of and from all liabilities, obligations, claims and demands whatsoever arising under or arising from said contract.

The contractor certifies that all his/her employees and workers performing services, bills for materials and equipment, subcontracts and other indebtedness connected with the work from said contract has been paid or otherwise satisfied.

The contractor agrees in connection with patent matters, that he/she will comply with all of the 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 WITNESS WHEROF, this Release has been executed this _________ day of _____________, 20___.

Signature

WITNESSED BY:

Signature Title

NOTE: In the case of a corporation, a witness is not required, but the following certificate must be completed.

CERTIFICATE

I, certify that I am the (official title) of the corporation named as Contractor in the foregoing Release; that ____________________who signed said contract on behalf of the Contractor was then (official title) of said corporation; that said contract 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: _____________________________________________________

CORPORATE SEAL: