UNCONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT
The undersigned has received a check from
______________________________________________, in the amount of
_______________________________ DOLLARS ($_____________) and made payable to
_______________________________________, which covers the final payment (except for any
disputed claims in the amount of $___________________) for labor, services, equipment, or
material furnished on the job of _________________________________________ [name of
property owner] to the following described property:
[Enter Description of Property]
The undersigned hereby releases and waives any mechanics’ lien, stop notice, or bond right
he/she/it has on the said job. The undersigned warrants that he/she/it either has already paid or
will use the money he receives from this final payment to promptly pay in full all his/her/its
laborers, subcontractors, materialmen and suppliers for all work, materials and equipment that
are the subject of this waiver and release.
DATED at ____________________ this _____ day of ______________, _______.
Name of Company
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 HAVE SIGNED IT, EVEN IF YOU HAVE
NOT BEEN PAID. IF YOU HAVE NOT BEEN PAID, YOU SHOULD USE A
CONDITIONAL RELEASE FORM.
This instrument was prepared by:
City State Zip