MATERIALMAN
WAIVER OF MECHANICS’ LIEN
Invoice(s): ___________
Check Number: __________
TO
ALL WHOM IT MAY CONCERN:
The undersigned, in consideration of the sum of
__________________________and __/100 Dollars ($_______), does hereby waive,
release, and relinquish any and all liens and claims for liens for labor or
work performed and/or material or equipment furnished through the _____day of
_____, 2005 to the construction project commonly known as
__________________________________________________________, located at
________________________________________, and owned by
_______________________________________________________________. This waiver is given to induce payment of the
consideration herein for the above items and becomes effective only at the time
such total payment is received by the undersigned for those items.
The
undersigned, in further consideration of the above-referenced sum, hereby
agrees to apply the funds herein referenced only to pay in full all obligations
of the undersigned for materials and equipment supplied to or work, labor, and
services performed for the undersigned on the above-described premises and
hereby indemnifies and agrees to hold CHARLES CONSTRUCTION SERVICES INC. and
OWNER harmless for all claims, losses, damages, and expenses, including,
without limitation, attorneys' fees on account of the failure or alleged
failure of the undersigned to satisfy in full any such obligation.
THE INDIVIDUAL SIGNING THIS LIEN WAIVER ON BEHALF OF
THE UNDERSIGNED WARRANTS THAT HE/SHE HAS FULL AUTHORITY TO EXECUTE THIS LIEN
WAIVER.
Dated
this day of ,
2005.
________________________________
Company
_____________________
Signature
Name and Title
COUNTY
OF ) ss:
Sworn to before me and subscribed in
my presence as being the free and voluntary act and deed of for the use and purposes therein mentioned on the day of ,
2005.
Notary
Public