FORM 73401
2/09
RELEASE OF CLAIMS BY SELLER
The work and services provided for under Purchase Order No. __________ dated ___________, as
amended between the Seller __________________________and Bechtel Marine Propulsion Corp.
(Bettis) under a Prime Contract between Bechtel Marine Propulsion Corp. and the U. S. Government
having been completed and finally accepted and all matters with respect to the administration of said
purchase order have been satisfactorily and finally settled pursuant to the terms thereof, and in
consideration of the sum of $__________, and other good and valuable considerations, the Seller, for
itself, its successors, and assigns, hereby releases and forever discharges Bechtel Marine Propulsion
Corp. and the United States Department of Energy, the United States of America, and each of their
respective officers, agents, employees, successors, and assigns from any and all liabilities, claims,
demands, actions, or causes of action of whatever kind or character arising under and by virtue of this
order.
Executed on this _______day of ____________, 20___,
By __________________________
Signature
_____________________
Printed Name
_________________________
Title
I, _______________________________, certify that I am the ____________________ Secretary of
the corporation named as Seller in this Release; that ______________________________________,
who signed this Release on behalf of the Seller was then ___________________________________
of the 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 Signature
__________________________
Typed Name