Fillable Conditional Waiver And Release On Progress Payment Form printable pdf download

Conditional Waiver And Release On Progress Payment Form

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CONDITIONAL WAIVER AND RELEASE ON

PROGRESS PAYMENT

(CA CIVIL CODE §8132)

NOTICE: THIS DOCUMENT WAIVES THE CLAIMANT’S LIEN, STOP PAYMENT NOTICE, AND PAYMENT BOND

RIGHTS EFFECTIVE ON RECEIPT OF PAYMENT. A PERSON SHOULD NOT RELY ON THIS DOCUMENT UNLESS

SATISFIED THAT THE CLAIMANT HAS RECEIVED PAYMENT.

Identifying Information:

Name of Claimant: _____________________________________________________________________________________

Name of Customer: ____________________________________________________________________________________

Job Location: _________________________________________________________________________________________

Owner: ______________________________________________________________________________________________

Through Date: ________________________________________________________________________________________

Conditional Waiver and Release

This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the

customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, pursuant to a written change order that

has been fully executed by the parties prior to the date that this document is signed by the claimant, are waived and released by this document, unless listed as an Exception below. This

document is effective only on the claimant’s receipt of payment from the financial institution on which the following check is drawn:

Maker of Check: ______________________________________________________________________________________

Amount of Check: $ ___________________________________________________________________________________

Check Payable to: _____________________________________________________________________________________

Exceptions

This document does not affect any of the following:

(1)

Retentions.

(2)

Extras for which the claimant has not received payment.

(3)

The following progress payments for which the claimant has previously given a conditional waiver and release but has not received