Transcript
CONDITIONAL PARTIAL WAIVER OF LIEN
STATE OF COLORADO COUNTY OF ________________ TO WHOM IT MAY CONCERN: WHEREAS, the Undersigned XXX , has been employed by Alliance Construction Solutions, LLC, hereinafter referred to as the “Contractor”, or their agents, or both, to furnish labor and/or material in connection with improvements to the _________________________________________ / 2012-00xM project located at _________________________________________. NOW THEREFORE, the Undersigned, having full authority to execute this document for and upon receipt of PARTIAL PAYMENT in the amount of $___________ through the _______ day of ___________, 2012, does hereby: 1. Waive and release any and all lien and claim or right to lien on said above described building and premises or any portions thereof under the Statutes of the State of Colorado, relating to the Mechanic’s Lien, on account of labor or materials, or both, furnished by the undersigned to date in connection with said improvements, reserving however, all lien rights for labor and/or materials furnished after said date. 2. Represents to the Contractor that the Undersigned has paid, or immediately upon the receipt hereof will pay, all of its subcontractors, material suppliers or laborers who have furnished materials, services, or labor who have or may have a lien against said property or a portion thereof. 3. Agree that in the event the procedures set forth in Paragraph 2 above are not followed, the Undersigned will hold the Contractor harmless from any and all claims or liabilities, to include necessary attorney fees. Dated this ___________ day of _________________, 2012 PLEASE SIGN AND RETURN TO: Subcontractor Name Alliance Construction Solutions, LLC Email:
[email protected] or Fax: 303.228.7434
___________________________________ By: (Authorized Signature)
Original (12/01) J.\std-form\4-60.doc
