FS-2400-73 MRCTA Liability Waiver and Request for Index Change

USDA Forest Service FS-2400-73 (Rev. 10/2008)

OMB 0596-0212 (12/2011)

Request for Producer Price Index Change and Release of Liability Statement

Market-Related Contract Term Addition

36 CFR 223.52(a)(2)

Timber Sale Name:	     
Contract Number:	     
In accordance with 36 CFR 223.52(a)(2) I,		     	(Purchaser):

(1) Release the United States (acting by and through the U.S. Forest Service) from all liability, including further consideration or compensation, resulting from changing the Producer Price Index specified in the sample contract.

(2) I further release the United States (acting by and through the U.S. Forest Service) from all liability, including further consideration or compensation, resulting from the Forest Service’s decision not to change the Producer Price Index specified in the sample contract pursuant to 36 CFR 223.52(c)(3) as requested by me.

(3) I acknowledge that the contract for which I have requested relief under 36 CFR 223.52(c)(3) remains in effect until the contract is modified, and that if the requirements for modification are not met, the contract must be performed under the original terms of the contract.

(4) I further agree pursuant to 36 CFR 223.52(a)(2) to provide the Forest Service with a list of products by volume that I intend to produce or expect will be produced from the timber on this sale.

			     
[Purchaser]			Date
By:	     
Title:	     

BURDEN AND NONDISCRIMINATION STATEMENTS

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