New York Lien Waiver Form

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Lien Waiver and Release of Lien

Date: {{date}}

Project Name: {{project_name}}

Project Location: {{project_address}}

Owner: {{owner_name}}

Contractor: {{contractor_name}}

Waiver Information

In consideration of the payment of {{amount}} US Dollars ($US {{amount}}) by {{payer_name}} (the "Payer") to {{payee_name}} (the "Payee"), the Payee hereby acknowledges receipt of said payment and does unconditionally waive and release any and all liens, claims, or rights to assert claims for liens that the Payee has, or may have, for labor, services, equipment, or materials furnished to the Project through the date of {{through_date}}.

Scope of Waiver

This waiver applies to all work performed and materials supplied to the Project up to the specified "through date," regardless of whether all payments for such work and materials have been fully received prior to the execution of this waiver. The Payee further agrees that this waiver covers all claims against the Project and the property owner arising from or related to the work performed and materials supplied up to the aforementioned date.

Representations and Warranties

The Payee represents and warrants that it has the full right and authority to execute this Lien Waiver and Release of Lien, and that it has not assigned or transferred any lien rights or claims to any third party. The Payee further warrants that all subcontractors, laborers, and material suppliers engaged by the Payee have been paid in full for their work and materials provided up to the date of this waiver, or that provisions have been made for the payment of same.

Indemnification

The Payee agrees to indemnify and hold harmless the Owner and Contractor from any and all claims, demands, losses, damages, costs, and expenses (including attorney's fees) arising out of or related to any liens, claims, or demands asserted by any subcontractor, laborer, or material supplier claiming through the Payee for work performed or materials supplied prior to the date of this waiver.

Governing Law

This Lien Waiver and Release of Lien shall be governed by and construed in accordance with the laws of the State of New York.

Signature

___________________________

{{payee_name}} (Print Name)

___________________________

Title: {{payee_title}}

___________________________

Date

Notarization (Optional)

STATE OF NEW YORK )

) ss.

COUNTY OF {{county_name}} )

On this {{day}} day of {{month}}, {{year}}, before me, the undersigned, a Notary Public in and for said State, personally appeared {{payee_name}}, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument and acknowledged that he/she executed the same for the purposes therein contained.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal.

___________________________

Notary Public

My Commission Expires: {{commission_expiry_date}}