Release of Claim Form.pdf
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- Solicitation number
- 33330225RT0010018
- Issued by
-
Smithsonian Institution
About this file
The document is a Smithsonian Institution Release of Claims form (OCon FORM ROC-1, Revised January 2001) used for releasing claims under a fixed-price construction contract. The form is designed to be completed by a contractor, releasing the Smithsonian Institution from any claims arising from a specific contract, in accordance with FAR Clause 52.232-5. The form requires the contractor's signature, two witness signatures, and provides space to itemize any specific claims or amounts still due. A note indicates that a separate release is required if the contractor's claim has been assigned under the Assignment of Claims Act of 1940.
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Text version
OCon FORM ROC-1 Revised January 2001
SMITHSONIAN INSTITUTION
WASHINGTON, D.C. 20560
RELEASE OF CLAIMS
(For payment under a Fixed Price Construction Contract)
The undersigned Contractor under Contract No.________________ dated _________________, 20___ between the Smithsonian Institution and said Contractor for the _____________________________________, in accordance with FAR Clause 52.232-5, paragraph h, sub-paragraph (3), which is applicable to said contract, hereby releases the Smithsonian Institution from any and all claims arising under or by virtue of said contract or any modification or change thereof except as follows:
(Itemize claims and any amounts due. If none, so state.)
Witness the signature and seal of the undersigned this ______day of _______________, 20___.
WITNESSES:
(Two witnesses are required)
(Name)
____________________________________ __________________(Seal) (Address)
____________________________________ By_____________________ (Name) (Name)
(Address) (Official Title)
(NOTE: A separate Release is required from assignee if Contractor’s claim to amounts payable under this contract has been assigned under the Assignment of Claims Act of 1940 (31 U.S.C. 3727 and 41 U.S.C. 15.)
33330220CF0010363 - 09/18/2020 - Page 265 of 265
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