Fi Form - Unconditional Waiver And Release Upon Final Payment printable pdf download

Fl FORM

Subcontractor

UNCONDITIONAL WAIVER AND RELEASE

UPON FINAL PAYMENT

STATE OF FLORIDA

COUNTY OF ______________

The undersigned mechanic and/or materialman has been employed by Benning Construction

Company to furnish _____________________________________________________ for the construction of

(describe materials and/or labor)

improvements known as _______________________________________________________ which is located

(title of the project or building)

in the City of __________________________, County of ____________________________, and is owned by

_________________________________________ and more particularly described as follows:

(Name of Owner)

_____________________________________________________________________________________________

(DESCRIBE THE PROPERTY UPON WHICH THE IMPROVEMENTS WERE MADE BY USING

EITHER A METES AND BOUNDS DESCRIPTION, THE LAND LOT DISTRICT, BLOCK AND LOT

NUMBER, OR STREET ADDRESS OF THE PROJECT.)

Upon receipt of the sum of $___________________, the undersigned hereby certifies and warrants

that it has provided all work required by the Subcontract as a condition of final payment and the

undersigned waives and releases any and all liens or claims of liens or any right against any labor and/or

material payment bond it has upon the foregoing described property, including any claims for changes to the

Work which were not detailed by Subcontractor in a change order request as of the date of this document

and which were based on improvements actually provided by the undersigned through the date of this

document.

Given under hand and seal this ____ day of _______________________, _______.

*Company Name:_______________________

By: ITS AUTHORIZED REPRESENTATIVE

_____________________________(Seal)

Name:_______________________________

________________________

Title:________________________________

(Witness)

*Benning

may

rely

the

statement

authorization in taking action based on this

document.

________________________

(Address)

Fi Form - Unconditional Waiver And Release Upon Final Payment