THIRD PARTY MATERIALMAN
WAIVER OF MECHANICS’ LIEN
TO
ALL WHOM IT MAY CONCERN:
In consideration of payment of all
sums due and owing, receipt of which is hereby acknowledged, the undersigned
does hereby waive, release, and relinquish any and all liens and claims for
liens for labor or work performed and/or material or equipment provided to
___________________________ for the construction project commonly known as
______________________________________located at
_________________________________________, and owned by
____________________________________________________________________.
The
undersigned hereby states that they have paid in full for any and 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. 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