Unconditional Waiver And Release On Progress Payment Form
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1CIVIL CODE SECTION 8134
UNCONDITIONAL WAIVER AND RELEASE
ON PROGRESS PAYMENT
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: _________________________________________________
Names 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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