26-Doc 00 65 19.16 - SUBCONTRACTORS RELEASE OF LIENS.pdf
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- Attached to
- 124 Easton Road Demolition 25-01189. 01
- Solicitation number
- Not on record
- Issued by
- Pennsylvania
About this file
This is a Subcontractor's Release of Liens form (Document 00 65 19.16) associated with Contract 2025-01189.01 for the 124 Easton Road Demolition project in Pennsylvania, involving MIRIA (1025 Horsham Road, Horsham, PA 19044) as the owner. The form is designed to be executed before a notary public and documents the release of all lien claims by a subcontractor upon receipt of final payment. The underlying project involves the demolition of an existing apartment building (Shelby Apartments at 111-124 Easton Road), associated concrete patios, and asphalt parking lot, along with environmental remediation within the building and site restoration to match existing grading and stabilization.
The release of liens is contingent upon the subcontractor's receipt of final payment in a specified amount and constitutes full satisfaction for all work performed under the agreement, including any approved change orders. The form requires the subcontractor (individual, partner, or authorized corporate representative) to acknowledge receipt of one dollar and other valuable considerations in exchange for permanently releasing and discharging the owner and its successors and assigns from all claims and demands arising from the performance of work under the dated agreement. The document must be sworn and notarized, with specific blanks for state, county, dates, payment amounts, contractor and subcontractor names and addresses, and the authorized representative's signature.
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Text version
SUBCONTRACTOR'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 Subcontractor)
Who being duly sworn according to law deposes and says that
_______________________________________________________________this day has received from (Subcontractor, Name and Address) (Contractor, 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 (Subcontractor) performance of the Work including all approved change orders under an Agreement dated
_______________________ associated with
Contract 2025-01189.01: 124 Easton Road Demolition between MIRIA, 1025 Horsham Road, Horsham, PA 19044 (Owner) and ________________________________________________________________________________.
(Contractor)
THEREFORE, ________________________________________________________________________ (Subcontractor) (for myself, my heirs, executors and administrators) (for itself, its successors and assigns) release, quit-claim and forever discharge _____________________________________________________________ (Owner) its successors and assigns, 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
SUBCONTRACTOR
Company:
(Corp. Seal) Signature:
(Individual, Partner or Duly Authorized Representative of Corporate Subcontractor)
Name and Title:
Sworn and subscribed before me this
_____day of ________________,20___.
File details come from the government source that posted it. Updated .