Partial Release Of Lien printable pdf download

EXHIBIT B

SUBCONTRACTOR'S AFFIDAVIT OF PAYMENT,

PARTIAL RELEASE OF LIEN AND RELEASE

WHEREAS, _________________________ ("Subcontractor") and Fitts and Goodwin, Inc.

("Contractor") have heretofore entered into a certain subcontract dated ______________________ (the

"Subcontract") relating to the furnishing of materials, labor and/or equipment in connection with a contract

being performed by Contractor for ___________________ ("Owner") with regard to a project known as

________________________ (the "Project").

NOW, THEREFORE, in consideration and upon payment of the sum of ______________

($______________) by Contractor to Subcontractor, which sum represents the progress payment due under

Subcontractor's payment request no. _____________ dated ___________submitted to Contractor under and

pursuant to the above referenced Subcontract, Subcontractor does hereby:

Certify to Contractor that all persons, firms, associations, corporations, or other entities

furnishing labor, materials, equipment, or supplies to Subcontractor with respect to the Subcontract have been

paid all amounts justly due for labor, materials, equipment and supplies provided and for which previous

payments have been received by Subcontractor from Contractor, including any and all applicable Federal,

State, and local sales, use, excise, or similar taxes or import duties, licenses and royalties.

Release, waive and forever relinquish any and all manner of liens, claims, demands and

causes of action whatsoever against Contractor and Owner, their respective employees, officers, directors,

agents, representatives, insurers, sureties (including any payment and performance bonds), guarantors,

divisions, parent, subsidiary or affiliated corporations, if any, successors and assigns, which Subcontractor

had or now has through the date of the above referenced payment request arising under or out of the

Subcontract or otherwise pertaining to labor, materials, equipment or services provided for the Project except

for: (i) any retainage being withheld by Contractor under the terms of the Subcontract and (ii) the unresolved

change orders and claims specifically identified as follows:

_______________________________________________________________________________________

Agree to indemnify and save harmless Contractor and Owner, their successors and assigns,

against all loss, cost, damage or expense by reason of any and all manner of liens, claims or demands which

anyone may have for labor performed, or for material or equipment furnished under the Subcontract

provided Contractor has paid Subcontractor all amounts justly due.

IN WITNESS WHEREOF, Subcontractor has duly caused these presents to be signed and attested

by its duly authorized owner, partner or officer on the ____ day of _________________, 20__.

SWORN to BEFORE me this

SUBCONTRACTOR:

____ day of ____________, 20__.

_________________________ (SEAL)

___________________________________

Notary Public for South Carolina

My Commission Expires: __________.

By:________________________________

Title:______________________________

Partial Release Of Lien