The undersigned is a general contractor or subcontractor, material man or other person furnishing services of labor or material in the construction or repair of improvements upon real estate owned by ____________________________ ______________________________ and described as follows:
In consideration of the sum of $1.00 to the undersigned in hand paid, receipt whereof is hereby acknowledged, and other benefits accruing, the undersigned does hereby waive, release and quitclaim in favor of the owner or owners of said real estate and in favor of each and every party making a loan on said real estate, as improved and his/her or its successors and assigns, all rights that the undersigned may have to a lien upon the land and improvements above described.
IT IS UNDERSTOOD AND AGREED THAT THIS WAIVER AND RELEASE IS FOR ALL SERVICES RENDERED, WORK DONE AND MATERIAL FURNISHED, PRIOR TO THE DATE HEREOF and is for all such services rendered, work done and material furnished and not only for the particular item indicated below.
Witness the following signature and seal this the ___________ day of ____________________, _____
FIRM: ______________________________________________
BY:__________________________________________________
(Title)
_____________________________________________________
Services, labor or material furnished (subcontractor or supplier)
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