Fill and Sign the Utah Waiver Form

Waiver and Release Upon Final Payment Page 1 of 2Prepared by, recording requested by and return to:Name: _____________________Company: _____________________Address:_______________________ City: ____________________State: _____Zip: _________Phone: _________________Fax: _________________Nature of Document: Waiver and Release Upon Final Payment----------------------Above this Line for Official Use Only--------------------- WAIVER AND RELEASE UPON FINAL PAYMENT- CORPORATION (Utah Code Ann. §38-1-39(4)(c)) COMES NOW, __________________________________, as a representative of _________________________________ a _________________________________ corporate lien claimant who is required to execute a waiver and release in exchange for or to induce the payment of a final billing, and would state the following: Property Name: ________________________________________________________________________Property Location and Description: ________________________________________________________________________Undersigned's Customer: __________________________________Invoice/Payment Application Number: __________________________________Payment Amount: ________________ To the extent provided below, this document becomes effective to release and the undersigned is considered to waive any notice of lien or right under Utah Code Ann., Title 38, Chapter 1, Mechanics' Liens, or any bond right under Utah Code Ann., Title 14, Contractors' Bonds, or Section 63G-6-505 related to payment rights the undersigned has on the above described property once the undersigned endorses a check in the above referenced payment amount payable to the undersigned, and the check is paid by the depository institution on which it is drawn.This waiver and release applies to the final payment for the work, materials, equipment, or combination of work, materials, and equipment furnished by the undersigned to the property or to the undersigned's customer. Waiver and Release Upon Final Payment Page 2 of 2 The undersigned warrants that the undersigned either has already paid or will use the money the undersigned receives from the final payment promptly to pay in full all the undersigned's laborers, subcontractors, materialmen, and suppliers for all work, materials, equipment, or combination of work, materials, and equipment that are the subject of this waiver and release. This the _____ day of _______________ , 20______. ______________________________ Company Name ______________________________ By______________________________Its ______________________________ Type or Print NameAttest: Secretary Acknowledgment of Corporation State of UtahCounty of __________________On the ______ day of __________________ , 20______, personally appeared before me ______________________________,who being duly sworn, did say that he/she is the ________________________ of ______________________________ , a corporation, and that said instrument was signed on behalf of said corporation by authority of a resolution of its Board of Directors, and said ______________________________ acknowledged to me that said corporation executed the same.(Seal)Notary PublicMy commission expires: Type or Print NameResiding at: