Nc Form - Unconditional Waiver And Release Upon Final Payment
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1
2NC FORM
Subcontractor
UNCONDITIONAL WAIVER AND RELEASE
UPON FINAL PAYMENT
STATE OF NORTH CAROLINA
COUNTY OF ______________
The undersigned mechanic and/or materialman has been employed by Benning Construction
Company to furnish _____________________________________________________ for the construction of
(describe materials and/or labor)
improvements known as _______________________________________________________ which is located
(title of the project or building)
in the City of __________________________, County of ____________________________, and is owned by
_________________________________________ and more particularly described as follows:
(Name of Owner)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
(DESCRIBE THE PROPERTY UPON WHICH THE IMPROVEMENTS WERE MADE BY USING
EITHER A METES AND BOUNDS DESCRIPTION, THE LAND LOT DISTRICT, BLOCK AND LOT
NUMBER, OR STREET ADDRESS OF THE PROJECT.)
In consideration of having received the sum of $___________________ and having been paid all other
amounts due and owing under the Subcontract, the undersigned hereby certifies and warrants that it has
provided all work required by the Subcontract as a condition of final payment and the undersigned waives
and releases any and all liens or claims of liens or any right against any labor and/or material payment bond
it has upon the foregoing described property, including any claims for changes to the Work which were not
detailed by Subcontractor in a change order request as of the date of this document and which were based on
improvements actually provided by the undersigned through the date of this document.
Given under hand and seal this ____ day of _______________________, _______.
*Company Name:_______________________
By: ITS AUTHORIZED REPRESENTATIVE
_____________________________(Seal)
Name:_______________________________
________________________
Title:________________________________
(Witness)
*Benning
may
rely
on
the
statement
of
authorization in taking action based on this
document.
________________________
(Address)
NOTICE: THIS DOCUMENT WAIVES 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 YET
BEEN PAID, USE A CONDITIONAL RELEASE FORM.
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