Subcontractor Final Release Of Lien

 

SUBCONTRACTOR   F INAL   R ELEASE   O F   L IEN  

 

State   o f     _________________________    

County   o f     ________________________    

 

 

I,   _ ____________________________________________,   c ontracted   w ith   R .   P .   M urray,   I nc.,   b eing   d uly   s worn,  

disposes   a nd   s ays:   t hat   u nder   d ate   o f   _ ____________________________   t o   p erform   c ertain   c onstruction  

and/or   i nstallation   w ork   a t  

_______________________________________________________________________,  

and   t hat   a ll   o f   t he   w ork   d one   u nder   s aid   C ontract   h as   b een   c ompleted;   t hat   a ll   l aborers   p erforming   w ork,   a ll  

materialmen   f urnishing   m aterials,   a nd   a ll   S ubcontractors   e mployed   u nder   s aid   C ontract   h ave   b een   p aid   i n   f ull   o r  

that   f unds   a re   i n   h and   t o   d ischarge   s uch   l iabilities   w hen   d ue,   t hat   t here   i s   n ot   d ue   a nd   o wing   a ny   s um   o f   m oney  

to   l aborers   o r   m aterialmen,   i n   c onnection   w ith   s aid   C ontract;   t hat   t his   a ffidavit   i s   m ade   t o   o btain   f inal   p ayment  

in   a ccordance   w ith   s aid   C ontract.     D eponent,   u pon   r eceipt   o f   c heck   f or   f inal   p ayment,   d oes   h ereby   w aiver  

release,   a nd   r elinquish   a ny   a nd   a ll   c laims,   d emands,   a nd   r ight   o f   l ien   f or   a ll   w ork,   l abor,   m aterial,   m achinery,   a nd  

other   g oods,   e quipment,   a nd   s ervices   d one,   p erformed,   a nd   f urnished   i n   a nd   f or   t he   c onstruction   o f  

_______________________________________________________________________.  

 

 

  ___________________________________  

 

 

 

Name:  

  ___________________________________  

 

 

 

Title  

 

 

Subscribed   a nd   s worn   t o   b efore   m e  

this   _ ____   d ay   o f   _ ______________,   2 0___  

 

  _ ___________________________________    

Name:  

 

Notary   P ublic   i n/and   f or   t he  

County   o f     ___________________________    

State   o f     ____________________________    

My   c ommission   e xpires   _ _______________    

MAILING   A DDRESS  

 

STREET   A DDRESS  

PO   B ox   1 103  

(o)   3 36-­‐996-­‐2000  

1314   E   M ountain   S t  

Kernersville,   N C   2 7284  

(f)   3 36-­‐996-­‐0543  

Kernersville,   N C   2 7285