Arizona Final Conditional Lien Waiver

CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT

Project:

Job No.:

Upon receipt by the undersigned of a check from _________________________________________ (Maker of Check) in the sum of $ __________________________________ (Amount of Check) payable to __________________________________ (Payee or Payees of Check), and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanicʼs lien, any state or federal statutory bond right, any private bond right, any claim for payment and any rights under any similar ordinance, rule or statute related to claim or payment rights for persons in the undersignedʼs position, the undersigned has on the job of _________________________________________ (Owner) located at _________________________________________ (Job Description)

This release covers the final payment to the undersigned for all labor, services, equipment or materials furnished to the jobsite or to _______________________________________________ (Person with whom Undersigned Contracted) except for disputed claims in the amount of $ ______________________ (Maker of Check). Before any recipient of this document relies on it, the person should verify evidence of payment to the undersigned.

The undersigned warrants that he either has already paid or will use the monies he receives from this final payment to promptly pay in full his laborers, subcontractors, materialmen and suppliers, equipment or services provided for or to the above referenced project up to the date of this waiver.

Dated:

Company Name:

By: (Signature)

(title)

© 2012 Express Lien, Inc. dba Zlien
Over 680K documents sent by zlien
Click here to let us file this one for you
or
Get this form