Conditional Waiver & Release upon Progress Payment

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This form is to be used as a conditional waiver & release based on a progress payment only to the extent of the progress payment.

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This form is generally used in the construction industry, however it has many other applications. It requires a claimant to some right or sum of money to execute a waiver and release in exchange for a progress payment, but only to the extent of the progress payment. This form ensures that the release is not effective until the bank upon which the funds are drawn actually pays the money owed. This form also limits the waiver and release to certain conditions covered by the progress payment.

Among others this packet includes the following provisions:
  • Names of parties: Identifies the parties to the transaction
  • Sum paid: Clarifies the money paid for the waiver and release
  • Job description: Indicates the job for which the release applies
  • Extent of release of claim: Describes the extent to which the waiver applies
This attorney-prepared packet includes:
  1. Conditional Waiver & Release upon Progress Payment Information
  2. Conditional Waiver & Release upon Progress Payment form
State Law Compliance: Designed for use in all states
Number of Pages2
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#29284
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
Conditional Waiver and Release
Upon Progress Payment


Upon receipt by the undersigned of a check from ________________________________
__________________ [Maker of the Check] in the sum of $___________ [Sum of Check]
Payable to ___________________________________________ [Person Receiving Check] 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 mechanics lien, stop notice, or bond right the undersigned has on the job of ____________________
_______________________ [Owner] located at _________________________________
_______________________ [Job Description] to the following extent.
This release covers a progress payment for labor, services, equipment, or material furnished to _________________________________________ [Your Customer] through ____________ [Date] 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 mechanics lien, stop notice, or bond 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 furnished labor, services, equipment, or material covered by this release if that furnished labor, services, equipment or material 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: ________________
By: ______________________________________
      [Name of Person Granting Release]
         [Company Name]
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