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Unconditional Waiver And Release On Progress Payment Form

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UNCONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT

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:

Retentions.

Extras for which the claimant has not received payment.

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

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