21-Doc 00 65 19.16 - CONTRACTORS RELEASE OF LIENS.pdf
PDF 131 KB Posted
- Attached to
- 2026 Bristol Borough CDBG Curb Ramp Program
- Solicitation number
- Not on record
- Issued by
- Bucks County, Brodheadsville CDP, Pennsylvania
About this file
This is a Contractor's Release of Liens document template for Bristol Borough, Pennsylvania, associated with Contract #26-00117 for the 2026 CDBG Design/Build Curb Ramp Project. The document serves as a notarized affidavit wherein a contractor certifies receipt of payment from Bristol Borough in full satisfaction of all monies owed for work performed, including all approved change orders. The release is contingent upon receipt of final payment and requires the contractor to permanently discharge all claims and demands against Bristol Borough arising from the performance of work under the project agreement. The document must be executed before a Notary Public and includes signature blocks for individual contractors, partners, or duly authorized corporate representatives.
This release of liens template is a standard contractual instrument required as part of the project closeout process for the Bristol Borough CDBG-funded curb ramp infrastructure project. The document specifies Bristol Borough's address as 250 Pond Street, Bristol, Pennsylvania 19007, and requires contractors to acknowledge receipt of consideration (stated as one dollar plus other valuable considerations) in exchange for releasing all lien rights. The release protects the Borough from future claims by contractors and their heirs, executors, successors, and assigns, thereby facilitating project completion and final payment processing. The blank spaces indicate this is a template document to be completed at project conclusion with the final payment amount and execution date to be filled in by the contractor and notarizing official.
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Text version
CONTRACTOR'S RELEASE OF LIENS
00 65 19.16-1
DOCUMENT 00 65 19.16
STATE OF______________________________:
COUNTY OF ____________________________:
Before me, the undersigned, a Notary Public in and for said County and State personally appeared
(Individual/Partner/Duly Authorized Representative of Corporate Contractor)
Who being duly sworn according to law deposes and says that
_______________________________________________________________this day has received from (Contractor, Name and Address)
Bristol Borough, 250 Pond Street, Bristol, PA 19007 (Owner, Name and Address) the sum of One Dollar and other valuable considerations in full satisfaction and payment of all sums of money owed and payable to ______________________________________________ arising out of the (Contractor) performance of the Work including all approved change orders under an Agreement dated associated with Contract #26-00117: Bristol Borough 2026 CDBG Design/Build Curb Ramp Project between Bristol Borough (Owner) and .
(Contractor)
THEREFORE,
(Contractor)
(for myself, my heirs, executors and administrators) (for itself, its successors and assigns) release, quit-claim and forever discharge Bristol Borough its successors and assigns, (Owner) of and from all claims and demands arising from or in connection with the aforementioned Agreement.
This Release is contingent upon receipt of the final payment of $___________.
00 65 19.16-2
CONTRACTOR
Company:
(Corp. Seal) Signature:
(Individual, Partner or Duly Authorized Representative of Corporate Contractor)
Name and Title:
Sworn and subscribed before me this
_____day of ________________,20___.
END OF DOCUMENT
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