Release of Stop Notice Form
RELEASE OF STOP NOTICE & CLAIM ON BOND
(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
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
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