CONDITIONAL WAIVER AND RELEASE UPON PROGRESS

CONDITIONAL WAIVER AND RELEASE

UPON PROGRESS PAYMENT

(Pursuant to Nevada Revised Statutes § 108.2457)

Property Name:

Property Location:

Undersigned’s Customer:

Invoice/Payment Application Number:

Payment Amount:

Upon receipt by the undersigned of a check in the above referenced Payment Amount payable to

the undersigned, 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 and the undersigned shall be

deemed to waive any notice of lien, any private bond right, any claim for payment and any rights

under any similar ordinance, rule or statute related to payment rights that the undersigned has on

the above described Property to the following extent:

This release covers a progress payment for the work, materials or equipment furnished by the

undersigned to the Property or to the Undersigned’s Customer which are the subject of the

Invoice or Payment Application, but only to the extent of the Payment Amount or such portion

of the Payment Amount as the undersigned is actually paid, and does not cover any retention

withheld, any items, modifications or changes pending approval, disputed items and claims, or

items furnished that are not paid. Before any recipient of the document relies on it, (s)he should

verify evidence of payment to the undersigned. The undersigned warrants that he either has

already paid or will use the money received from this progress payment promptly to pay in full

all laborers, subcontractors, materialmen and suppliers for all work, materials or equipment that

are the subject of this waiver and release.

DATED on _______________, 20_____ _________________________________________

(Claimant name)

By: ___________________________________

Its: ___________________________________

Address:____________________________

___________________________________

Phone: ____________________________

Fax: _______________________________

UNCONDITIONAL WAIVER AND RELEASE

UPON PROGRESS PAYMENT

(Pursuant to Nevada Revised Statutes § 108.2457)

Property Name:

Property Location:

Undersigned’s Customer:

Invoice/Payment Application Number:

Payment Amount:

The undersigned has been paid and has received a progress payment in the above referenced

Payment Amount for all work, materials and equipment the undersigned furnished to his

Customer for the above described Property and does hereby waive and release any notice of lien,

any private bond right, any claim for payment and any rights under any similar ordinance, rule or

statute related to payment rights that the undersigned has on the above described Property to the

following extent:

This release covers a progress payment for the work, materials or equipment furnished by the

undersigned to the Property or to the Undersigned’s Customer which are the subject of the

Invoice or Payment Application, but only to the extent of the Payment Amount or such portion

of the Payment Amount as the undersigned is actually paid, and does not cover any retention

withheld, any items, modifications or changes pending approval, disputed items and claims, or

items furnished that are not paid. The undersigned warrants that (s)he either has already paid or

will use the money received from this progress payment promptly to pay in full all laborers,

subcontractors, materialmen and suppliers for all work, materials or equipment that are the

subject of this waiver and release.

DATED on _______________, 20_____ _________________________________________

(Claimant name)

By: ___________________________________

Its: ___________________________________

Address:____________________________

___________________________________

Phone: ____________________________

Fax: _______________________________

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 to the

extent of the Payment Amount or the amount received. If you have not been paid, use a

conditional release form.

CONDITIONAL WAIVER AND RELEASE

UPON FINAL PAYMENT

(Pursuant to Nevada Revised Statutes § 108.2457)

Property Name:

Property Location:

Undersigned’s Customer:

Invoice/Payment Application Number:

Payment Amount:

Payment Period:

Amount of Disputed Claims: $

Upon receipt by the undersigned of a check in the above referenced Payment Amount payable to

the undersigned, 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 and the undersigned shall be

deemed to waive any notice of lien, any private bond right, any claim for payment and any rights

under any similar ordinance, rule or statute related to payment rights that the undersigned has on

the above described Property to the following extent:

This release covers the final payment to the undersigned for all work, materials or equipment

furnished by the undersigned to the Property or to the Undersigned’s Customer and does not

cover payment for Disputed Claims, if any. Before any recipient of this document relies on it,

the recipient should verify evidence of payment to the undersigned. The undersigned warrants

that (s)he either has already paid or will use the money received from the final payment promptly

to pay in full all laborers, subcontractors, materialmen and suppliers for all work, materials or

equipment that are the subject of this waiver and release.

DATED on _______________, 20_____ _________________________________________

(Claimant name)

By: ___________________________________

Its: ___________________________________

Address:____________________________

___________________________________

Phone: ____________________________

Fax: _______________________________

UNCONDITIONAL WAIVER AND RELEASE

UPON FINAL PAYMENT

(Pursuant to Nevada Revised Statutes § 108.2457)

Property Name:

Property Location:

Undersigned’s Customer:

Invoice/Payment Application Number:

Payment Amount:

Amount of Disputed Claims: $

The undersigned has been paid in full for all work, materials and equipment furnished to his

Customer for the above described Property and does hereby waive and release any notice of lien,

any private bond right, any claim for payment and any rights under any similar ordinance, rule or

statute related to payment rights that the undersigned has on the above described Property,

except for the payment of Disputed Claims, if any, noted above. The undersigned warrants that

(s)he either has already paid or will use the money he receives from this final payment promptly

to pay in full all laborers, subcontractors, materialmen and suppliers for all work, materials and

equipment that are the subject of this waiver and release.

DATED on _______________, 20_____ _________________________________________

(Claimant name)

By: ___________________________________

Its: ___________________________________

Address:____________________________

___________________________________

Phone: ____________________________

Fax: _______________________________

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 to the

extent of the Payment Amount or the amount received. If you have not been paid, use a

conditional release form.

STATE OF______________ )

COUNTY OF ___________ )

Sworn before me this ______ day of ______________, 20_____.

Notary: ______________________________________________

Commission Expires: ___________________________________