7/1/12
UNCONDITIONAL
WAIVER
AND
RELEASE
ON
PROGRESS
PAYMENT
NOTICE TO CLAIMANT: THIS DOCUMENT WAIVES AND RELEASES LIEN, STOP
PAYMENT NOTICE, AND PAYMENT BOND 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 BEEN PAID, USE A CONDITIONAL
WAIVER AND RELEASE FORM.
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) a right based on rescission, abandonment, or breach of
contract, and (B) the right to recover compensation for work not compensated by the payment.
Signature
