TranSystems Corporation - LGM Construction

FINAL WAIVER OF LIEN: MATERIAL AND LABOR
Project: Date:
Project No.
STATE OF
COUNTY OF
TO WHOM IT MAY CONCERN:
1. The undersigned, , has
(Contractor/Subcontractor)
been employed by to furnish labor
(Owner/Contractor)
or materials for
(Description of the work)
for the Building and Premises known as
in
(Address) City, County, State
2. The undersigned, subject only to the receipt of the sum of $ , which is
acknowledged to be the full amount payable to the undersigned for the work described, hereby
waives and releases all liens, or any claims of right to liens on the described Building and
Premises, on account of labor or materials furnished, or which may be furnished, by the
undersigned to or for said Building or Premises.
______________________ Subscribed and sworn to before me on
, 20 .
By:
Title: NOTARY PUBLIC
Date:
(Seal, if Corporation) (Seal of Notary Public)