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| ARIZONA CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT |
| PROJECT: |
_________________________________________________________ |
| JOB NO: |
_________________________________________________________ |
| On receipt by the undersigned of a check from
____________(maker of check) _____ in
the amount of $______(amount)
__________ 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
mechanic's 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
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 undersigned's 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 job site or to ____________(person with whom undersigned contracted)
_____, except for disputed claims in the amount of $________________. 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 received from this final payment to promptly pay in full all of
his laborers, subcontractors, materialmen and suppliers for all work, materials, equipment
or services provided for or to the above referenced project up to the date of this waiver.
Date: _________________
_________(Company Name) ___________________
By _________(Signature) ________________________
__________(Title)_____________________
© 1999, Folk &
Associates, P.C. |
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