Conditional Partial Lien Waiver printable pdf download

Conditional Partial Lien Waiver

SUBCONTRACTOR CONDITIONAL PARTIAL WAIVER OF LIEN

SUBCONTRACTOR:

ADDRESS:

CITY, STATE, ZIP:

PHONE NUMBER:

AMOUNT

1 ORIGINAL CONTRACT

2 TOTAL CHANGE ORDERS

3 REVISED CONTRACT(Line 1 Plus Line 2)

4 COMPLETED TO DATE

5 RETAINAGE

6 TOTAL PREVIOUS PAYMENTS

7 NET DUE (Line 4 minus Line 5 & 6)

TO:

________________________

the Owner and Magnolia Construction(Contractor) on the

____ _________________

project, upon which the undersigned has performed work and/or supplied labor, equipment and/or material.

FOR AND IN CONSIDERATION OF THE SUM OF

the undersigned does hereby WAIVE, RELEASE AND FOREVER DISCHARGE any and all liens, claims or rights of lien on or

against the premises described above for and on account of all work performed and labor, equipment and/or material supplied to

date

at or in connection with construction or improvement of the premises described above.

________________

Anything herein contained to the contrary notwithstanding, it is understood that the effect and enforceability of this Partial Waiver of

Lien shall be conditioned only upon receipt of the undersigned of the partial payment in the amount of

_____________

from Line 7

, and this waiver is given by the undersigned and is accepted by

__ _________________________________

subject

above

to such understanding.

Name

Title

Date

Subscribed to before me in my presence. Witness, my hand and seal given this _____________ day of

__________________, 20___ , City of ______________________ , (State/Province)

____.

Notary Public

My Commission Expires

Conditional Partial Lien Waiver