Sub-Total Change Order Work Change. Order No. 1 Change Order No. 2 Change Order No. 3 Change Order No. 4 Change Order No. 5 Total To Date Total of all prior Change Orders Change Orders approved this month Total Additive/Deductive Changes to Date Continuation Sheet of Name of Claimant: Name of Customer: Job Location: Owner: Through Date: This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, under a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant, are waived and released by this document, unless listed as an Exception below. This document is effective only on the claimant’s receipt of payment from the financial institution on which the following check is drawn: Maker of Check: Amount of Check: $ Check Payable to: This document does not affect any of the following:
Appears in 1 contract
Sources: Construction Services Agreement
Sub-Total Change Order Work Change. Order No▇▇. 1 Change Order No▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇. 2 ▇ Change Order No. 3 Change Order No. 4 Change Order No. 5 Total To Date Total of all prior Change Orders Change Orders approved this month Total Additive/Deductive Changes to Date Continuation Sheet of Name of Claimant: Name of Customer: Job Location: Owner: Through Date: This document waives and releases lien, stop payment notice, and payment bond rights the claimant has for labor and service provided, and equipment and material delivered, to the customer on this job through the Through Date of this document. Rights based upon labor or service provided, or equipment or material delivered, under pursuant to a written change order that has been fully executed by the parties prior to the date that this document is signed by the claimant, are waived and released by this document, unless listed as an Exception below. This document is effective only on the claimant’s receipt of payment from the financial institution on which the following check is drawn: Maker of Check: Amount of Check: $ Check Payable to: This document does not affect any of the following:
Appears in 1 contract
Sources: Construction Services Agreement