CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT
(MAINE)
Upon receipt by the undersigned of a check from _______________________________ in the
sum of _______________________________ DOLLARS ($_____________) made payable to
_____________________________________, and when the aforesaid check has been properly
endorsed and has been paid by the bank upon which it is drawn, this document shall become
effective to release any mechanic’s lien, stop notice, or bond right which the undersigned has on
the job of ________________________________________________ (the “Owner”) located at
_____________________________________________________________________________.
This release covers the final payment for labor, services, equipment, or material furnished on the
job, except for disputed claims for additional work in the amount of $_____________________.
Before any recipient of this document relies on it, that party should verify evidence of payment
to the undersigned.
DATED at ____________________ this _____ day of ______________, _______.
Name of Company
By:
Print name
Title:
This instrument was prepared by:
Name
Address
City State Zip
-2-
Acknowledgement
STATE OF MAINE )
)
COUNTY OF ___________________________, SS: )
On the _____ day of __________________, _________,
______________________________________________ personally appeared before me, the
undersigned Notary Public, personally known to me (or satisfactorily proven) to be the person
whose name is subscribed to the within instrument, and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies), and by his/her/their signature(s) on
the within instrument, the person(s), or the entity(ies) on behalf of which the person(s) acted,
executed the within instrument.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal, on
the day set forth above.
(SEAL)
Notary Public
My Commission expires:
JOB COMPLETION CERTIFICATE
The undersigned hereby certifies that all work, equipment, and materials covered by the contract
between _________________________________________________ and the undersigned dated
the _____ day of ______________________, _________ has been satisfactorily completed and
said work, equipment, and materials have been inspected by the undersigned.
_________________________________ ____________________________________
Customer’s Signature Date
_________________________________ ____________________________________
Customer’s Signature Date
NOTICE: Do not sign this certificate until you are satisfied that the work, equipment, and
materials (as specified in the contract) have been satisfactorily completed.
CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT
(MAINE)
Upon receipt by the undersigned of a check from _______________________________ in the
sum of _______________________________ DOLLARS ($_____________) made payable to
_____________________________________, and when the aforesaid check has been properly
endorsed and has been paid by the bank upon which it is drawn, this document shall become
effective to release any mechanic’s lien, stop notice, or bond right which the undersigned has on
the job of ________________________________________________ (the “Owner”) located at
___________________________________________, to the following extent:
This release covers a progress payment for labor, services, equipment, or material furnished to
the Owner through ____________________________ [date] only and does not cover any
retentions retained before or after the release date; extras furnished before the release date for
which payment has not been received; extras or items furnished after the release date. Rights
based upon work performed or items furnished under a written change order which has been
fully executed by the parties prior to the release date are covered by this release unless
specifically reserved by the claimant in this release. This release of any mechanic’s lien, stop
notice, or bond right shall not otherwise affect the contract rights, including rights between
parties to the contract based upon a rescission, abandonment, or breach of the contract, or the
right of the undersigned to recover compensation for furnished labor services, equipment, or
material covered by this release if that furnished labor, services, equipment, or material was not
compensated by the progress payment. Before any recipient of this document relies on it, that
party should verify evidence of payment to the undersigned.
DATED at ____________________ this _____ day of ______________, _______.
Name of Company
By:
Print name
Title:
This instrument was prepared by:
Name
Address
City State Zip
-5-
Acknowledgement
STATE OF MAINE )
)
COUNTY OF ___________________________, SS: )
On the _____ day of __________________, _________,
______________________________________________ personally appeared before me, the
undersigned Notary Public, personally known to me (or satisfactorily proven) to be the person
whose name is subscribed to the within instrument, and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies), and by his/her/their signature(s) on
the within instrument, the person(s), or the entity(ies) on behalf of which the person(s) acted,
executed the within instrument.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal, on
the day set forth above.
(SEAL)
Notary Public
My Commission expires:
UNCONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT
(MAINE)
The undersigned has received a check from
______________________________________________, in the amount of
$_______________________