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Conditional Waiver and Release of Mechanic's Lien Template

Conditional lien waivers are provided by contractors or suppliers before they’ve been paid. This means they are owed the money and will waive their lien rights once payment has been received. These waivers are often used as a form to show agreement on the amount owed for a certain time period.

CONDITIONAL WAIVER AND RELEASE OF MECHANIC’S LIEN

[DATE]

[NAME OF OTHER PARTY]

[OTHER PARTY’S ADDRESS]

Re: Waiver of Mechanic’s Lien on [ADDRESS] Upon Payment 

Dear [NAME],

This correspondence is to confirm that upon making the payment reflected hereunder, the undersigned will waive and release any mechanic’s lien right (the “Mechanic’s Lien”) arising from a payment bond pursuant to any state or federal statute, ordinance, common law right, or regulation pertaining to the rights of parties in the position of the undersigned. 

The Mechanic’s Lien subject to this correspondence pertains to the following services, which were completed at the property located at [ADDRESS]: [DESCRIPTION OF SERVICES PERFORMED]. 

The undersigned agrees and acknowledges that it will waive and release its right to the Mechanic’s lien, as reflected in the opening paragraph, upon payment of [AMOUNT], which must be made on or before [DATE].

To the extent that any additional payment is owed to such third parties, the undersigned agrees and acknowledges that it will utilize the funds received to pay such amounts to its laborers, contractors, materialmen, and suppliers for any and all services and/or goods received pursuant to the above-referenced services. Only upon remitting full payment to such third parties shall the undersigned personally retain any such funds. 

Please reach out to me directly should there be any questions or concerns with regard to the above. 

Sincerely,

_______________________________ _________

Signature Date

_____________________________________________

Name

NOTARY FORM

STATE OF ______ )

COUNTY OF ______ )

I, ____________________________________. a Notary Public, do hereby certify that on this ______ day of ___________________, 202___, personally appeared before me ___________, known to me to be the person whose name is subscribed to the foregoing instrument, and swore and acknowledged to me that he executed the same for the purpose and in the capacity therein expressed, and that the statements contained therein are true and correct.

_______________________________________________

Notary Public, State of ________

Name, Typed or Printed:__________________________________________

My Commission Expires:___________________________

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Our templates are intended for reference use. Concord holds no responsibility for any reliance placed on these templates. These templates do not constitute legal counsel and should not be treated as such. By using any of these templates, you acknowledge and consent to these conditions.

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Our templates are intended for reference use. Concord holds no responsibility for any reliance placed on these templates. These templates do not constitute legal counsel and should not be treated as such. By using any of these templates, you acknowledge and consent to these conditions.

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Our templates are intended for reference use. Concord holds no responsibility for any reliance placed on these templates. These templates do not constitute legal counsel and should not be treated as such. By using any of these templates, you acknowledge and consent to these conditions.

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