Date Company Address City State Zip ATTN: Contact ... - RR Simmons
Date Company Address City State Zip ATTN: Contact ... - RR Simmons
Date Company Address City State Zip ATTN: Contact ... - RR Simmons
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WAIVER AND RELEASE OF LIEN<br />
UPON PROGRESS PAYMENT<br />
The undersigned lienor, in consideration of the sum of $<br />
, hereby waives and releases its lien<br />
and right to claim a lien for labor, services, or materials furnished through , 20 , to<br />
on the job of to the following described property:<br />
Legal Description:<br />
TBD<br />
This waiver and release does not cover any retention of labor, services, or materials furnished after the date<br />
specified.<br />
DATED on _________________________<br />
______________________________<br />
(Lienor)<br />
By:<br />
(Signature)<br />
________________________________<br />
(Printed Name)
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