Unconditional Waiver And Release Upon Progress Payment Form


Nevada Lien Waiver and Release Form
Unconditional Waiver and Release upon Progress Payment
Property Name: _
Property Location: _
Undersigned Customer:
Invoice/Payment Application Number: __
Payment Amount: __
Payment Period: __
The undersigned has been paid and has received a progress payment in the above
referenced Payment Amount for all work, materials and equipment the undersigned furnished
to his Customer for the above described Property and does hereby waive and release any
notice of lien, any private bond right, any claim for payment and any rights under any similar
ordinance, rule or statute related to payment rights that the undersigned has on the above
described Property to the following extent:
This release covers a progress payment for the work, materials and equipment furnished by
the undersigned to the Property or to the Undersigned's Customer which are subject of the
Invoice or Payment Application, but only to the extent of the Payment Amount or such portion
of the Payment Amount as the undersigned is actually paid, and does not cover any retention
withheld, any items, modifications or changes pending approval, disputed items and claims,
or items furnished that are not paid. The undersigned warrants that he either has already
paid or will use the money he receives from this progress payment promptly to pay in full all
his laborers, subcontractors, material men, and suppliers for all the work, materials or
equipment that are the subject of this waiver and release.
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 been paid, use a conditional
release form.
Signed By: ____________________________ Dated: ___________________
Title: ________________________________


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