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 Change Order Summary Additions Deductions Net Change to Date Total of all prior Change Orders Change Orders approved this month Total Additive/Deductive Changes to Date Continuation Sheet of CONDITIONAL WAIVER AND RELEASE (PROGRESS PAYMENT) (Civil Code Section 8132) NOTICE: THIS DOCUMENT WAIVES THE CLAIMANT’S LIEN, STOP PAYMENT NOTICE, AND PAYMENT BOND RIGHTS EFFECTIVE ON RECEIPT OF PAYMENT. A PERSON SHOULD NOT RELY ON THIS DOCUMENT UNLESS SATISFIED THAT THE CLAIMANT HAS RECEIVED PAYMENT. IDENTIFYING INFORMATION Name of Claimant: Name of Customer: Job Location: Owner: Through Date: CONDITIONAL WAIVER AND RELEASE 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: EXCEPTIONS This document does not affect any of the following:
