Fill and Sign the Release of Lien Upon Final Paymentconstruction Lawthe Form

Conditional Waiver and Release of Lien Upon Final Payment Page 1 of 2 Conditional Waiver and Release of Lien Upon Final Payment- Corporation On this _____ day of ________________, 20______, the undersigned, as representative of ___________________________________ a ___________________________________ corporate lienor, in consideration of the final payment in the amount of $ _______________, hereby waives and releases its lien and right to claim a lien for labor, services or materials furnished through _________________________________, 20 _____, to ___________________________ (customer) on the job of ____________________________ (owner of property) to the following described property: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________________. This Conditional Waiver and Release of Lien Upon Final Payment is condit ioned upon the undersigned receiving collected funds in the amount of $ ___________________ for the work described herein. Should these funds not be received within _____ days of the date hereof, this Conditional Waiver and Release of Lie n is void. This waiver and release covers the final payment to the undersigned for all labor, services, equipment, or material furnished on the job. Before any recipient of this document relies on it, the party should verify evidence of payment to the undersigned. __________________________________ Signature __________________________________ Type or Print Name Title Corporation Conditional Waiver and Release of Lien Upon Final Payment Page 2 of 2 STATE OF MAINE COUNTY OF __________________ The foregoing instrument was acknowledged before me this _____________________ (date) by _________________________________________ (name of officer or agent, title of officer or agent) of _____________________________ (name of corporation acknowledging) a _____________________________________ (state or place of incorporation) corporation, on behalf of the corporation. ___________________________________ Signature of Notary Public ___________________________________ Name of Notary Public Notary Public, State of Maine My commission expires: ____________________