LIEN WAIVER - CONTRACTOR/SUPPLIER

_______________________________, (Contractor), upon receipt of _____________________________________($_________) from ______ (the Owner) paid in connection with the construction of _____________ (The Project), hereby executes this Lien Waiver and waives and releases any and all lien rights accruing for materials and services furnished through _________, for which the above payment is made. The undersigned represents that all employees, laborers, material men and subcontractors employed by the undersigned in connection with the Project and all bills currently due for labor, materials, supplies and taxes furnished in connection with the Project, have been fully paid their respective portions of previous payments. This Lien Waiver is executed in consideration of the payment of said amount and is effective only to the extent of such payment.

Dated this ____th day of ___________, 200_.

CONTRACTOR

______________________________

Signature

Sworn to and subscribed to me this

day of , 200_.

_____________________

Notary Public

My Commission Expires:___________________________