| STATE OF GEORGIA COUNTY OF _________________ UNCONDITIONAL WAIVER AND RELEASE CONTRACTOR: _____________________________________ OWNER:_____________________________________________ TENANTS:___________________________________________ PROJECT:___________________________________ located at_______________________________________ PROPERTY: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ (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.) 1. CONTRACTOR has submitted its Final Request for Payment Number ____ dated ___________ in the amount of $ _________________ for labor and services performed and materials supplied to the PROJECT pursuant to the CONTRACT. 2. The Undersigned CONTRACTOR has been employed by the OWNER to furnish ____________________________________________________________________________________ (describe materials and/or labor) for the construction of improvements for the PROJECT described above, which is located in the City of ____________________, County of _______________, State of __________________, and is owned by the OWNER and more particularly described above as the PROPERTY. CONTRACTOR waives and releases any and all liens or claims of liens or any right against any labor and/or material bond it has upon the foregoing described PROPERTY. 3. CONTRACTOR releases the OWNER and TENANTS from any claim, liability or debt by reason of labor, services, equipment, materials and rentals which have been or will be performed or furnished by CONTRACTOR, including, without limitation, all "claims", "changes", "extras" and other charges of any description. 4. CONTRACTOR further represents and certifies that no lien has been filed against the PROPERTY by CONTRACTOR or any laborer, sub-subcontractor, or materialman who has directly or indirectly furnished labor, services, equipment, rentals or materials to or for the PROJECT under the CONTRACT, and that CONTRACTOR has paid all bills and charges at the agreed prices for all of said labor, services, equipment, rentals and materials which have been or are to be furnished to or for the PROJECT under the CONTRACT. 5. CONTRACTOR authorizes OWNER to complete any blank spaces in this document. IN WITNESS WHEREOF, CONTRACTOR has either individually or by its duly authorized representative set his hand and seal hereto this _______ day of ____________________, 20_____. Sworn to and subscribed before the undersigned this ______ day of _________________________________ (SEAL) ____________________, 20 ___. Name of CONTRACTOR By: ____________________________________ (Owner, Partner, Officer) ___________________________________ (Please Designate) Notary Public My Commission Expires:_____________ Witness _______________________________________ Date__________ NOTICE: THIS DOCUMENT WAIVES RIGHTS 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 YET BEEN PAID, US A CONDITIONAL RELEASE FORM. |
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| Harps Home Improvements |