Contractors_release.doc

U.S. DEPARTMENT OF STATE

CONTRACT NO.

CONTRACTOR'S RELEASE

CONTRACTOR (name and address)

SUM OF

DOLLARS

In consideration of the sum stated above, which has been paid or is to be paid to the Contractor, or his Assignees, the Contractor, upon payment of the said sum by the UNITED STATES OF AMERICA (hereinafter 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 under or arising from the said contract, except:

1. In Specified claims in stated amounts or in estimated amounts where the amounts are not susceptible Of exact statement by the Contractor as follows (if none, state none):

2. Claims, together with reasonable expenses incidental thereto, based upon the liabilities of the Con- Tractor to third parties arising out of the performance of this contract, which are not known to the Con- Tractor on the date of the execution of this release and of which the Contractor gives notice in writing to The Contracting Officer within the period specified in the said contract; and

3. Claims for reimbursement of costs (other than the expenses of the Contractor by reason of his indemnification of the Government against patent liability), including reasonable expenses incidental thereto, Incurred by the Contractor under any provisions of the said contract relating to patents.

The Contractor agrees, in connection with patent matters and with claims which are not released as Set forth above, that he will comply with all 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 WHEREOF, this release has been executed this _______ day of _____________, 20__.

WITNESSES

(CONTRACTOR)

NOTE: In the case of a corporation, witnesses are not required but the certification below must be completed.

CERTIFICATE

I, ______________________ , certify that I am the _____________________________ secretary

Of the corporation named as Contractor in the foregoing release; that _______________________ who

Signed said release on behalf of the Contractor was then __________ __________ of said corporation;

That said release 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.

(CORPORATE SEAL)

Reference DOSAR 604.804-70 (d)(4)

CONTRACTOR’S ASSIGNMENT OF REFUNDS, REBATES AND CREDITS

Contract Number:

Pursuant to the terms of Contract Number ________________and in consideration of the reimbursement of costs, as provided in the said contract and any assignment thereunder, contractor name and address ______________________________________

__________________________________________________{hereinafter called the Contractor) does hereby:

Assign, transfer, set over and release to the UNITED STATES OF AMERICA {hereinafter called the Government}, all rights, title, and interest to all refunds, rebates, credits, or other amounts (including any interest thereon) arising out of the performance of the said contract, together with all of the rights of action accrued or which may hereafter accrue thereunder.

Agree to take whatever action may be necessary to effect prompt collection of all refunds, rebates, credits, or other amounts (including any interest thereon) due or which may become due, and to promptly forward to the Contracting Officer checks (made payable to the Treasurer of the United States) for any proceeds so collected. The reasonable costs of any such action to effect collection shall constitute allowable costs when approved by the Contracting Officer as stated in the said contract and may be applied to reduce any amounts otherwise payable to the Government under the terms hereof.

Agree to cooperate fully with the Government as to any claim or suit in connection with refunds, rebates, credits, or other amounts due (including any interest thereon); to execute any protest, pleading, applications, power of attorney or other papers in connection therewith; and to permit the Government to represent it at any hearing, trial, or other proceeding arising out of such claim or suit.

IN WITNESS THEREOF, this assignment has been executed this __________ day of _______________________, 20____.

(Contractor)

BY: ____________________________

TITLE: ______________________________________________________________