Affidavit And Release Of Lien Partial Form printable pdf download

EXHIBIT H

Affidavit and Release of Lien

PARTIAL

The undersigned is a subcontractor (referred to herein as “Subcontractor”) who has furnished labor and/or material under

a subcontract agreement with DENCO CONSTRUCTION SPECIALISTS (referred to herein as “Contractor”) to a project

known as:

(referred to herein as the “Project”) and located at:

, in the City of

and the County of

in Texas (referred to herein as the “Property”).

For and in consideration of PREVIOUS PAYMENTS TOTALING $

AND A CURRENT PAYMENT

OF $

, representing PARTIAL payment, on the above-referenced Project, Subcontractor

hereby acknowledges complete satisfaction of, and forever waives and releases, any and all claims of every kind against

the owner of the referenced property, the Project, the Property, Contractor and its surety or sureties, if any, including, but

not limited to, all statutory or constitutional mechanic’s and/or materialman’s liens, all contract liens that the undersigned

may be entitled to in connection with the furnishing of labor and/or material in connection with the work or any other

provision of any agreement, regulation or law which may entitle Subcontractor to any other additional reimbursement,

payment or compensation.

In consideration for payments made, the undersigned Subcontractor agrees to indemnify and hold harmless the

Contractor from all liens, claims and demand including attorneys fees arising out of or related to work, labor and/or

material provided by or through Subcontractor or to Subcontractor for use on the Project.

Subcontractor further represents and warrants that they have not assigned and will not assign any claim for payment,

account receivable, any right to perfect a lien claim, or any contractual, statutory or constitutional lien against the Project

in connection with the above-described work.

Subcontractor further warrants and represents that all bills, claims or liabilities against it or the Project arising out of labor

and/or material provided by or through the Subcontractor to the Project, or purchased by Subcontractor for use on the

Project have been paid and satisfied.

No payment or provision of this document shall in any way release Subcontractor from any obligation, contractual or

otherwise, to Contractor including, but not limited to, additional work on the Project or warranties.

All provisions of this document shall be fully binding to the undersigned and other parties referred to herein and should

inure to the benefit of any such persons, their successors, legal representatives, assigns and heirs. The person signing

this document represents that they are duly authorized to do so on behalf of the undersigned Subcontractor.

Company:

Date:

(Subcontractor)

Signature: ______________________________

By: ____________________________________

Title: __________________________________

STATE OF TEXAS

COUNTY OF __________

This instrument was acknowledged and signed before me

on this ___________ day of __________________,______.

______________________________________

Notary Public

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Affidavit And Release Of Lien Partial Form

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