Conditional Waiver And Release On Progress Payment

Conditional Waiver And Release On Progress Payment - Arizona

ONDITIONAL

AIVER AND

ELEASE ON

ROGRESS

AYMENT

)

RIZONA

1 F

- (Pursuant to A.R.S. §33-1008(d)(1))

YPE

ORM

Project:

Job No.:

Upon receipt by the undersigned of a check from

(Maker of Check)

in the sum of $________________ payable to

(Amount of Check)

(Payee or Payees of Check)

and when the check has been properly endorsed and has been paid by the bank on which it was drawn,

this document becomes effective to release any mechanics’ lien, any state or federal statutory bond right,

any private bond right, any claim for payment, any stop notice or bonded stop notice, and any rights

under any similar ordinance, rule or statute related to claim or payment rights for persons in the

undersigned’s position that the undersigned has on the job of

(Owner)

located at

(Job Description and/or Location)

to the following extent. This release covers a progress payment for all labor, services, equipment or

materials furnished to the jobsite or to

(Person with whom Undersigned Contracted)

through

________________________

only

and

does

not

cover

any

retention,

pending

(Date)

modifications, changes or other items furnished after that date. Before any recipient of this document

relies on it, that person should verify evidence of payment to the undersigned.

The undersigned warrants that it either has already paid or will use the monies it receives from

this progress payment to promptly pay in full all of its laborers, subcontractors, materialmen and suppliers

for all work, materials, equipment or services provided for or to the above referenced project up to the

date of this waiver.

(Type of Work, Materials and/or Equipment Furnished)

The following invoices and pay applications are included in the above referenced amount:

Date Signed:

(Company Name)

By:

(Signature)

(Title)

(Claimant’s Phone Number)

 Western States Lien Company.

AZ Conditional – Progress Release

602-677-2960

AZ-Lien-Release-1 (18-Dec-2011)

Conditional Waiver And Release On Progress Payment - Arizona

Related Articles

Related forms

Related Categories