Release And Waiver Of Lien Rights Conditional Upon Final Payment

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Release and Waiver of Lien Rights Conditional Upon Final Payment
PROJECT:
Subcontract No.
(the “Project”)
PROPERTY: State of
; Address ___________ _______________
__(the “Property”)
The undersigned certifies that it has properly performed all work, services, labor, materials, fuel, and equipment furnished for the
Project of the specified quantity and quality pursuant to applicable plans and specifications and in a good and workmanlike manner,
full and completely. The undersigned certifies that the last day it provided work, services, labor, materials, fuel or equipment for the
Project and/or the Property was
___
20 _ . The undersigned certifies that for and in consideration of prior payments
received and contingent upon receipt of $_______________ (the anticipated and final payment) it has been paid in full for all work,
services, labor, materials, fuel and equipment furnished for the Project and/or the Property. As such, the undersigned releases all
claims, demands, liens, rights of liens, bond rights, and any rights under applicable laws related to claim or payment rights
(collectively, “Claims”) for all work, services, labor, materials, fuel, and equipment furnished for the Project and/or the Property,
except for disputed claims in the amount of $____________ (if none, state none; if any, describe below). Upon the receipt of the
anticipated final payment and resolution of any disputed amounts, the undersigned agrees to sign an Unconditional Release and
Waiver of Lien.
The undersigned certifies that it has paid for all work, services, labor, materials, fuel, equipment, and associated amounts due, it has
used or supplied for the Property or the Project. The undersigned further certifies that, unless otherwise noted, the lien waivers
attached hereto include all entities that have provided work, services, labor, materials, fuel, and equipment furnished for the Project
on behalf of the undersigned through the above date.
The undersigned agrees that it is not aware of any outstanding Claims by any laborer, subcontractor, suppliers, or sub consultants, of
any tier, related to the Project or the Property. The undersigned agrees that if after the date hereof there shall be evidence of any
Claims by any laborer, subcontractor, supplier or sub consultants of the undersigned, of any tier, which, if established, might
encumber the Project or title to the Property, the undersigned shall promptly discharge same and shall indemnify Stewart Richey
Construction, Inc. for any and all expense it may incur associated with such claims. The undersigned acknowledges that Stewart
Richey Construction, Inc. will rely upon on Release to take certain actions. The person signing this Release certifies that he/she is
duly authorized and empowered to sign and execute this Release on behalf of the company or business for which he/she is signing.
State of
__________________
(Company Name)
County of ____________________
Address: ________________________________________________
I, undersigned, a Notary Public in and for said
________________________________________________
State hereby certify that this instrument was
voluntarily acknowledged before me on the date
identified below by the person identified herein
By:
________________________________________________
and who has the title identified herein.
(Signature)
____________________________
_______________________________________________
Name of Notary
(Type/Print Name and Title)
My Commission Expires
My Commission Number
_
Dated:
_ _____________________________________________
(Notarial Seal)

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