Subcontractor'S Affidavit Of Release Of Lien Form - Rpr Construction

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SUBCONTRACTOR’S AFFIDAVIT OF RELEASE OF LIEN
PROJECT:
OWNER:
_____________________________________
____________________________________
LOCATION:
CONTRACTOR:
_____________________________________
____________________________________
Subcontractor/Vendor: ______________________________________________________
On _________________, in the State of Texas, County of Smith, RPR Construction Company, Inc., entered into
contract with the undersigned _____________________________ to furnish labor, and/or materials, and/or
equipment in connection with certain improvements to real property located in __________________ County,
Texas, more specifically located at ________________________________________________________________
and Owned by ________________________________________ such improvements being known as
______________________________________________ for which RPR Construction Company, Inc. is the General
Contractor.
The labor, and/or materials, and/or equipment furnished by the undersigned are described as
___________________ and referred to hereinafter as the “work”.
Contingent upon receipt of final payment of_________________________________________________________,
($______________) for the work furnished, the sufficiency of which is acknowledged, the undersigned does hereby
waive and release any mechanic’s lien or materialmen’s lien or claims of lien, including any constitutional lien or
claim thereto, property and/or improvements thereon account of any work furnished or to be furnished by the
undersigned, its materialmen, suppliers and subcontractors.
The undersigned further certifies and warrants that all outstanding bills, claims, charges and obligations incurred by
the undersigned with materialmen, laborers, subcontractors or other persons who would be entitled to assert a claim
under applicable law against the real property have been paid in full or will, by these proceeds, be paid in full for
work done or materials furnished through date of this release. The undersigned agrees to indemnify and hold RPR
Construction Company, Inc. and Owner harmless from any and all claims, liens actions or causes of action arising
out of or having to do with the failure of the undersigned to make the payments called for under this paragraph or for
any portion of this paragraph that is untrue. The undersigned acknowledges that Company is relying upon the
representations contained in this Release and would not have released the funds identified in this Release to the
undersigned but for this Final Release of Lien.
_____________________________________________
______________________________________
Authorized Signature:
Title:
______________________________________________
______________________________________
Printed Name:
Date:
Subscribed and sworn before me this ____________ day of ______________________________ 20_____.
Notary Public: ___________________________________
My Commission Expires: ________________
(Notary Seal)
301 SSE LOOP 323
TYLER, TEXAS 75702-8645
PHONE: (903) 592-7166
FAX: (903) 592-2349

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