Fill and Sign the Conditional Waiver and Release on Final Payment California Form

Unconditional Waiver and Release Page 1 of 1 Prepared by, recording requested by and return to: ---------------------- Above this Line for Official Use Only --------------------- Name: ______________________ Company: ____________________ Address: _____________________ City: _____________________ State: _____ Zip: __________ Phone: ______________________ Fax: ______________________ CONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT (Title 14, California Civil Code) Upon receipt by the undersigned of a check from _____________________ ______________ in the sum of $ __________________ payable to ____________________________________ and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, this document shall become effective to release any mechanic’s lien, stop notice, or bond right the undersigned has on the job of __________________ located at ________________________ . (Owner) This release covers the final payment to the undersigned for all labor, services, equipment, or mat erial furnished on the job, except for disputed claims for additional work in the amount of $_______________ . Before any recipient of this document relies on it, the party should verify evidence of payment to the undersigned. Dated: _______________ _____________________________________ (Company Name) By _____________________________________ _____________________________________ (Title)