Subcontractor Lien Release Form

The undersigned represents and warrants that it has been paid and has received (or that it will be paid and will receive via proceeds from this pay application) $   1 as full and final settlement under the contract/agreement dated   Date (the Contract) between the undersigned and    First Name   Last Name(Contractor/Vendor) for the   2 Agreement owned by   First Name   Last Name   (Owner). In consideration for this final payment, and other good and valuable consideration, receipt of which is acknowledged, the undersigned makes the following representations and warranties: 

1. The undersigned and Owner have fully agreed on all terms and conditions of the Contract (including any amendments or modifications thereto), as well as any other written or oral commitments, agreements, and/or understandings.
2. The undersigned has been paid in full (or it will be paid in full via proceeds from this pay application) for the labor, services, and materials related to the Contract, including all work performed or any materials provided by its subcontractors, vendors, suppliers, laborers, or other persons or entities.  
3. The undersigned has paid in full (or it will pay in full via proceeds from this pay application) all its subcontractors, vendors, suppliers, laborers, and other person or entity providing services, labor, or materials; there are no outstanding claims, demands, or rights to liens against the undersigned, the Agreement, or the Owner in connection with the Contract on the part of any person or entity; and no claims, demands, or liens have been filed against the undersigned, the Agreement, or the Owner relating to the Contract. 
4. The undersigned releases and discharges Contractor/Vendor and Owner from all claims, demands, or causes of action (including all lien claims and rights) that the undersigned has, or might have, under any present or future law, against either of them in connection with the Contract. The undersigned hereby specifically waives and releases all lien or claim or right to lien related to the Contract against Contractor/Vendor, Owner, Owner’s property, and the Agreement, and also specifically waives, to the extent allowed by law, all liens, claims, or rights of lien in connection with the Contract by the undersigned’s subcontractors, laborers, and all other persons or entities furnishing services, labor, or materials in connection with the Contract. 
5. The undersigned shall indemnify, defend, and hold harmless Contractor/Vendor and Owner from any action, proceeding, arbitration, claim, demand, lien, or right to lien relating to the Contract, and shall pay any costs, expenses, and/or attorneys’ fees incurred by Contractor/Vendor and/or Owner in connection therewith.

Agreement Date   Date   

State of   3   

Country of   4   

Subcontractor Name and Title   First Name   Last Name   ,   5   

I,   First Name   Last Name   , agree that   First Name   Last Name   came before me this day and informed me that s/he is   title   of   company name   , and that s/he, as   title   , being authorized to do so, executed the foregoing on the behalf of   company name  .

Signature