Fillable Unconditional Waiver And Release On Progress Payment Form

Unconditional Waiver And Release On Progress Payment Form - California

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UNCONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT

(CALIFORNIA CIVIL CODE SECTION 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, purusant 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: ______________________________________________________________

Unconditional Waiver And Release On Progress Payment Form - California

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