WAIVER AND RELEASE ON PROGRESS PAYMENT
NOTICE TO CLAIMANT: THIS DOCUMENT MAY WAIVE AND RELEASE THE LIEN,
STOP PAYMENT NOTICE, AND ANY PAYMENT BOND RIGHTS CONDITIONALLY
OR UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GIVING
UP THOSE RIGHTS. THIS DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU
SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID. IF YOU HAVE NOT BEEN PAID,
CHECK THE CONDITIONAL WAIVER AND RELEASE CLAUSE.
PLEASE CHECK ONE (1)
☐ 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:
☐ Unconditional 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. The claimant has received
the following progress payment.
$___________________________________
Exceptions
This document does not affect any of the following:
(1) Retentions.
(2) Extras for which the claimant has not received payment.
(3) Contract rights, including (A)