Upon receipt by Contractor of final payment in the amount of , for labor, services, equipment
or or material furnished to the New Jersey Schools Development Authority (SDA), Contractor does hereby release
any and all actions, causes of action, liens, bond rights, debts, dues, accounts, covenants, agreements, judgments,
claims and demands of whatsoever nature or character that Contractor now has or ever has had against SDA, their
successors and assigns, that shall have arisen or may arise out of or be incidental to work undertaken or done under
or in connection with the Contract and related extra work or change orders thereto.
FINAL WAIVER AND RELEASE
NJSDA 821
Date
Contract No.:
PMF/CM:
Package Name:
PMF/CM PM:
Contractor warrants that all its equipment lessors, suppliers, subcontractors, labor and taxes applicable to
the Contract work have been paid in full through the date set forth above and agrees to indemnify and
hold NJSDA and its sureties harmless against any claim or loss arising from the nonpayment thereof.
Contractor has executed this receipt, release, and waiver of lien this day of , 20 .
Contractor:
By:
(Name of Firm)
(Signature of Authorized Agent)
(Printed Name)
File:
/o, y-2
Rev. 04/03/12
Form NJSDA 821
Page 1 of 1
