Release of Stop Notice Form

RELEASE OF STOP NOTICE & CLAIM ON BOND

Claimant

(Givename & address)

 

 

 

 

Owner

(Givename & address)

 

 

 

 

Prime Contractor

(Givename & address)

 

 

 

 

Surety

(Givename & address)

 

 

 

 

Project

(Identify Project)

 

 

 

 

Amount

(Amount of Stop Notice)

$

FOR GOOD AND VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, the undersigned and above - identified Claimant, d oes hereby release from the effect of that certain Stop Notice served on the construction fund holder(s) and against the above - named Owner, Prime Contractor and Surety, as above - indicated, on the construction job identified and described above as the Proje ct.

The amount of the Stop Notice, and the amount so released, is above - identified as the Amount.

agent of Claimant

Signed by

Acknowledgement

State of _____________________________ County of _______________________________

On the _____ day of _______________________, 20_____, before me, undersigned Notary Pu blic, personally came and appeared _________________________________________, of _______________________ , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the written instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/ their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under the PENALTY OF PERJURY under the laws of the State and County above - identified that the foregoing paragra ph is true and correct.

WITNESS my hand and official seal.

(This area for official Notary Seal)

 

 

 

 

 

 

 

PROOF OF SERVICE AFFIDAVIT

I, __________________________, declare that on the _____ day of _____________, 20____, I served c opies of the attached Release of Stop Notice to the following parties identified on the Notice:

[_____]    Public Entity

 

 

 

[_____]    Prime Contractor

 

 

 

[_____]    Surety

 

 

 

[_____]   Other

 

 

 

I served the attached Stop Notice:

[_____]   By personally delivering the notice to the identified parties;

[_____]   By First Class Certified Mail service, return receipt requested and postage prepaid, addressed to the party at the address shown on the Release of Stop Notice document.

I declare under penalty of perjury that the foregoing is true and correct.

Dated: _____ day of _____________, 20____.

Agent for CLAIMANT

Signed by

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