Fill and Sign the Delaware Waiver Form

This Instrument Prepared By: Name __________________________ Address __________________________________________________ CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT (25 Del. Code § 2706) The undersigned, __________________________________ , has been paid and has received a progress payment in the sum of $ _________________ for labor or services performed or equipment or materials supplied to ________________________ (Your __________________________________ (sub-contractor, agent) on the job of __________________________________ (Contractor or General Contractor) located at the (Customer’s) (Owner’s) property located at _____________________________________________________________________________ , in the City of _________________ , County of _________________ , State of Delaware, and does hereby waive and release any right to a mechanic’s lien, stop notice, or any right against a labor and material bond on the job to the following extent. This release covers a progress payment for labor or services performed or equipment or materials supplied to _____________________________ , your customer, through the _____ day of __________________ , 20 _____ only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; extras or items furnished after the release date. Rights based upon work performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by the claimant in this release. This release of any mechanic’s lien, stop notice, or any right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for performed labor or services or supplied equipment or materials covered by this release if that performed labor or services or supplied equipment or materials was not compensated by the progress payment. Before any recipient of this document relies on it, said party should verify evidence of payment to the undersigned. Dated this the _____ day of ________________ , _____ . ____________________________________________ (Company Name) By _________________________________________ Print/Type Name _____ _________________________ Title _____ ___________________________________ Conditional Waiver and Release Upon Progress Payment Page 1 of 2 Conditional Waiver and Release Upon Progress Payment Page 2 of 2