"Subcontractor/Subvendor Final Release and Lien Waiver Form"

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SUBCONTRACTOR/SUBVENDOR FINAL RELEASE AND LIEN WAIVER
The undersigned represents and warrants that it has been paid and has received (or that it will be paid and will
receive via proceeds from this pay application) $__________ as full and final settlement under the contract/agreement
dated ______________ (including any amendments or modifications thereto) (the “Contract”) between the undersigned
and _______________________________ (“Contractor/Vendor”) for the ____________________________________
Project owned by ___________________________ (“Owner”). In consideration for this final payment, and other good
and valuable consideration, receipt of which is acknowledged, the undersigned makes the following representations and
warranties:
1.
The undersigned and Owner have fully settled all terms and conditions of the Contract (including any amend-
ments or modifications thereto), as well as any other written or oral commitments, agreements, and/or under-
standings in connection with the Project.
2.
The undersigned has been paid in full (or it will be paid in full via proceeds from this pay application) for the
labor, services, and materials in connection with the Contract, including all work performed or any materials
provided by its subcontractors, vendors, suppliers, materialmen, laborers, or other persons or entities.
3.
The undersigned has paid in full (or it will pay in full via proceeds from this pay application) all its subcontrac-
tors, vendors, suppliers, materialmen, laborers, and other person or entity providing services, labor, or materials
to the Project; there are no outstanding claims, demands, or rights to liens against the undersigned, the Project,
or the Owner in connection with the Contract on the part of any person or entity; and no claims, demands, or
liens have been filed against the undersigned, the Project, or the Owner relating to the Contract.
4.
The undersigned releases and discharges Contractor/Vendor and Owner from all claims, demands, or causes of
action (including all lien claims and rights) that the undersigned has, or might have, under any present or future
law, against either of them in connection with the Contract. The undersigned hereby specifically waives and re-
leases any lien or claim or right to lien in connection with the Contract against Contractor/Vendor, Owner,
Owner’s property, and the Project, and also specifically waives, to the extent allowed by law, all liens, claims,
or rights of lien in connection with the Contract by the undersigned’s subcontractors, materialmen, laborers, and
all other persons or entities furnishing services, labor, or materials in connection with the Contract.
5.
The undersigned shall indemnify, defend, and hold harmless Contractor/Vendor and Owner from any action,
proceeding, arbitration, claim, demand, lien, or right to lien relating to the Contract, and shall pay any costs,
expenses, and/or attorneys’ fees incurred by Contractor/Vendor and/or Owner in connection therewith.
The undersigned makes the foregoing representations and warranties with full knowledge that Contractor/Ven-
dor and Owner shall be entitled to rely upon the truth and accuracy thereof.
DATED:
(Subcontractor/Subvendor company name)
By:
Title:
STATE OF
COUNTY OF
I, a Notary Public for the above County and State, certify that ___________________________ personally
came before me this day and acknowledged that he/she is __________ [title] of ___________________________ [com-
pany name], and that he/she, as __________ [title], being authorized to do so, executed the foregoing on behalf of
___________________________ [company name]. Witness my hand and official seal this ____ day of __________,
20___.
Notary Public
My Commission Expires:
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.
Page 1 of 1
WB20061231
Print Form
SUBCONTRACTOR/SUBVENDOR FINAL RELEASE AND LIEN WAIVER
The undersigned represents and warrants that it has been paid and has received (or that it will be paid and will
receive via proceeds from this pay application) $__________ as full and final settlement under the contract/agreement
dated ______________ (including any amendments or modifications thereto) (the “Contract”) between the undersigned
and _______________________________ (“Contractor/Vendor”) for the ____________________________________
Project owned by ___________________________ (“Owner”). In consideration for this final payment, and other good
and valuable consideration, receipt of which is acknowledged, the undersigned makes the following representations and
warranties:
1.
The undersigned and Owner have fully settled all terms and conditions of the Contract (including any amend-
ments or modifications thereto), as well as any other written or oral commitments, agreements, and/or under-
standings in connection with the Project.
2.
The undersigned has been paid in full (or it will be paid in full via proceeds from this pay application) for the
labor, services, and materials in connection with the Contract, including all work performed or any materials
provided by its subcontractors, vendors, suppliers, materialmen, laborers, or other persons or entities.
3.
The undersigned has paid in full (or it will pay in full via proceeds from this pay application) all its subcontrac-
tors, vendors, suppliers, materialmen, laborers, and other person or entity providing services, labor, or materials
to the Project; there are no outstanding claims, demands, or rights to liens against the undersigned, the Project,
or the Owner in connection with the Contract on the part of any person or entity; and no claims, demands, or
liens have been filed against the undersigned, the Project, or the Owner relating to the Contract.
4.
The undersigned releases and discharges Contractor/Vendor and Owner from all claims, demands, or causes of
action (including all lien claims and rights) that the undersigned has, or might have, under any present or future
law, against either of them in connection with the Contract. The undersigned hereby specifically waives and re-
leases any lien or claim or right to lien in connection with the Contract against Contractor/Vendor, Owner,
Owner’s property, and the Project, and also specifically waives, to the extent allowed by law, all liens, claims,
or rights of lien in connection with the Contract by the undersigned’s subcontractors, materialmen, laborers, and
all other persons or entities furnishing services, labor, or materials in connection with the Contract.
5.
The undersigned shall indemnify, defend, and hold harmless Contractor/Vendor and Owner from any action,
proceeding, arbitration, claim, demand, lien, or right to lien relating to the Contract, and shall pay any costs,
expenses, and/or attorneys’ fees incurred by Contractor/Vendor and/or Owner in connection therewith.
The undersigned makes the foregoing representations and warranties with full knowledge that Contractor/Ven-
dor and Owner shall be entitled to rely upon the truth and accuracy thereof.
DATED:
(Subcontractor/Subvendor company name)
By:
Title:
STATE OF
COUNTY OF
I, a Notary Public for the above County and State, certify that ___________________________ personally
came before me this day and acknowledged that he/she is __________ [title] of ___________________________ [com-
pany name], and that he/she, as __________ [title], being authorized to do so, executed the foregoing on behalf of
___________________________ [company name]. Witness my hand and official seal this ____ day of __________,
20___.
Notary Public
My Commission Expires:
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.
Page 1 of 1
WB20061231