Unconditional Waiver And Release On Progress Payment Form

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UNCONDITIONAL WAIVER AND RELEASE ON
PROGRESS PAYMENT
(CA CIVIL CODE §8134)
NOTICE TO CLAIMANT: THIS DOCUMENT WAIVES AND RELEASES LIEN, STOP PAYMENT NOTICE, AND
PAYMENT BOND RIGHTS UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE
RIGHTS. THIS DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID.
IF YOU HAVE NOT BEEN PAID, USE A CONDITIONAL WAIVER AND RELEASE FORM.
Identifying Information:
Name of Claimant: _____________________________________________________________________________________
Name of Customer: ____________________________________________________________________________________
Job Location: _________________________________________________________________________________________
Owner: ______________________________________________________________________________________________
Through Date: ________________________________________________________________________________________
Unconditional Waiver and Release
This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the
customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that
has been fully executed by the parties prior to the date that this document is signed by the claimant, are waived and released by this document, unless listed as an Exception below. The
claimant has received the following progress payment:
$ _______________________________________________________________________________________________
Exceptions
This document does not affect any of the following:
(1)
Retentions.
(2)
Extras for which the claimant has not received payment.
(3)
Contract rights, including:
(A) a right based on rescission, abandonment, or breach of contract, and
(B) the right to recover compensation for work not compensated by the payment.
SIGNATURE
Claimant’s Signature:
_______________________________________________
Claimant’s
Title:
_______________________________________________
Date
of Signature: _______________________________________________

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