1253.204 Administrative matters. The following forms are prescribed for use in the closeout of applicable contracts, as specified in (TAR) 48 CFR 1204.804-570: (a) Form DOT F 4220.4, Contractor's Release. (See (TAR) 48 CFR 1204.804570.) Form DOT F 4220.4 is authorized for local reproduction and a copy is furnished for this purpose in Part 1253 of the loose-leaf edition of the (TAR) 48 CFR chapter 12. (b) Form DOT F 4220.45, Contractor's Assignment of Refunds, Rebates, Credits, and Other Amounts. (See (TAR) 48 CFR 1204.804-570.) Form DOT F 4220.45 is authorized for local reproduction and a copy is furnished for this purpose in Part 1253 of the loose-leaf edition of the (TAR) 48 CFR chapter 12. (c) Form DOT F 4220.46, Cumulative Claim and Reconciliation Statement. (See (TAR) 48 CFR 1204.804–570.) Form DOT F 4220.46 is authorized for local reproduction and a copy is furnished for this purpose in Part 1253 of the loose-leaf edition of the (TAR) 48 CFR chapter 12. (d) DD Form 882, Report of Inventions and Subcontracts. (See (TAR) 48 CFR 1204.804-570.) DD Form 882 is authorized for local reproduction and a copy is furnished for this purpose in Part 1253 of the loose-leaf edition of the (TAR) 48 CFR chapter 12. 1253.222 Application of labor laws to Government acquisitions. The following form is prescribed for use in connection with the application of labor laws, as specified in (TAR) 48 CFR 1222.406-9: Form DOT F 4220.7, Employee Claim for Wage Restitution. (See (TAR) 48 CFR 1222.406-9(c)(1).) Form DOT F 4220.7 is authorized for local reproduction and a copy is furnished for this purpose in Part 1253 of the loose-leaf edition of the (TAR) 48 CFR chapter 12. 1253.227-70 Conveyance of invention rights acquired by the Government. The following form is prescribed for including a means for contractors to report inventions made in the course of contract performance, as specified in 1227.305-4: DD Form 882, Report of Inventions and Subcontracts. (See (TAR) 48 CFR 1227.305-4.) DD Form 882 is authorized for local reproduction and a copy is furnished for this purpose in Part 1253 of the loose-leaf edition of the (TAR) 48 CFR chapter 12. 1253.245-70 Report of Government property. The following form is prescribed for use by contractors to report Government property, as specified in (TAR) 48 CFR 1245.505–14: Form DOT F 4220.43, Contractor Report of Government Property. (See (TAR) 48 CFR 1245.505–14.) Form DOT F 4220.43 is authorized for local reproduction and a copy is furnished for this purpose in Part 1253 of the loose-leaf edition of the (TAR) 48 CFR chapter 12. Subpart 1253.3-Illustration of Forms 1253.303 Agency forms. This subpart contains illustrations of DOT and other agency forms specified by the TAR for use in DOT acquisitions. Pursuant to the terms of the above numbered contract and in consideration of the sum stated above, which has been paid or is to be paid to the 1. Specified claims in stated amounts or in estimated amounts where the amounts are not susceptible of exact statement by the Contractor, as follows: (or state "None") 2. Claims, together with reasonable expenses incidental thereto, based upon the liabilities of the Contractor to third parties arising out of the performance of this contract, which are not known to the Contractor 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 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 it will comply with all provisions of the said contract, 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. release; that am the secretary of the corporation named as Contractor in the foregoing ̧ who signed said release on behalf of the Contractor was then of said corporation; 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. Form DOT F 4230.4 (REV. 2/97) (EXCEL) (CORPORATE SEAL) PREVIOUS EDITION OBSOLETE AUTHORIZED FOR LOCAL REPRODUCTION DEPARTMENT OF TRANSPORTATION EMPLOYEE CLAIM FOR WAGE RESTITUTION OMB Control No. 2105-0517 Expiration Date: 4/30/97 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat (VRS), Office of Federal Acquisition and Regulatory Policy, GSA, Washington, D.C. 20405; and to the Office of Management and Budget, Paperwork Reduction Project (2105-0517), Washington, D.C. 20503. This claim constitutes the total amount claimed due and unpaid for the period of employment indicated. ADDRESS OF EMPLOYEE SIGNATURE OF EMPLOYEE Form DOT F 4220.7 (REV.10/94) (EXCEL) PREVIOUS EDITION OBSOLETE AUTHORIZED FOR LOCAL REPRODUCTION OTE: This report shall include all Government property (i.e., property furnished by the Government, or acquired or fabricated by 0. Typed Name of Contractor Property Administrator Form DOT F 4220.43 (2/97) (EXCEL) PREVIOUS EDITION OBSOLETE 11. Signature and Date AUTHORIZED FOR LOCAL REPRODUCTION CONTRACTOR'S ASSIGNMENT OF REFUNDS, REBATES, CREDITS, AND OTHER AMOUNTS OMB Central No.: 2105-8517 Expiration Date: 4/30/97 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions searching Pursuant to the terms of Contract No. and in consideration of the reimbursement of costs and payment of fee, as provided in the said contract and any assignment thereunder, (hereinafter called the Contractor) does hereby: 1. Assign, transfer, set over the release to the UNITED STATES OF AMERICA (hereinafter called the 2. 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 UNITED STATES TREASURER 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. 3. 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, application, power of attorney or other papers in connection with; and to permit the Government to represent it at any hearing, trial, or other proceeding arising out out of such claim or suit. |