Attachment_Q_Release_of_Lien_Forms.pdf
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- Solicitation number
- DCAM-26-CS-RFP-0011
- Issued by
- District of Columbia
About this file
This file contains Release of Lien forms templates issued by the Government of the District of Columbia Department of General Services for the Hendley Elementary School Modernization design-build project. The document provides two standardized forms: a Release of Liens form for use during partial payments and a Final Release of Liens and Claims form for final payment processing. Both forms require the contractor or consultant to acknowledge receipt of specified payment amounts, warrant that all work has been properly performed in accordance with contract documents, confirm that all subcontractors and material suppliers have been paid in full for labor (including fringe benefits and workers compensation), materials, equipment, services, taxes, insurance premiums, and bonds, and release all claims and lien rights against the District of Columbia and the project premises. The forms must be signed by authorized representatives of the contractor and notarized by a District of Columbia Notary Public, including specification of the notary's commission expiration date and official seal.
These lien release forms serve as standard contractual documentation required during the payment process for the modernization of Hendley Elementary School, which involves design-build services for renovation and new construction to expand the approximately 79,575 square-foot facility. The forms facilitate the District's ability to make partial and final disbursements while ensuring that all subcontractors, laborers, and material suppliers have been compensated, thereby protecting the District from potential mechanics' lien claims and stop work notices that could encumber the project or delay completion.
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Text version
GOVERNMENT OF THE DISTRICT OF COLUMBIA
DEPARTMENT OF GENERAL SERVICES
2000 14TH STREET, NW, 5TH FLOOR, WASHINGTON, D.C. 20009
FAX: (202) 671-0648
RELEASE OF LIEN
Project Name:
Contract No.:
Task Order No.:
Work Performed:
Contract Date:
Contract Amount:
Date:
Release of Liens:
The undersigned (insert Consultant/Contractor), has been paid partial payments totaling the sum of (insert net amounts), which is _____% of the current contract value, in accordance with the contract terms for the above referenced project, and hereby indemnifies, waives, releases and holds the District of Columbia harmless for the above referenced project, including all claims, right to liens, and stop work notices upon said premises or the improvements thereon under the statutes of the jurisdiction in which the project is located.
In consideration of this payment due in the net amount of insert net amount due, in accordance with contract terms for the above referenced project. Hereby indemnifies, waives, and releases the District of Columbia for the above referenced project. All claims, right to liens, stop work notices upon said premises or the improvements thereon under the statues of the jurisdiction in which the project is located.
The undersigned further represents and warrants, as of this date, that he/she is duly authorized to sign and execute this Release of Liens on behalf of (insert Consultant/Contractor); that (insert Consultant/ Contractor) has properly performed all work in accordance with the Contract Documents and that all consultants, subcontractors or material men have been paid for all labor, including fringe benefits, workers compensation, materials, equipment, services, taxes, insurance premiums, and bonds (if required), and that any materials supplied to or incorporated in this project were taken from fully paid or open stock with any exceptions noted below.
This letter must be signed and notarized below by authorized individuals.
Insert Consultants /Contractors name: _______________
By:___________________
Print Name: ___________________
Title: ________________ Date: _______________
DISTRICT OF COLUMBIA ) ss
I, a Notary Public in and for the District of Columbia, hereby certify that, on this ___ day of , 20 , personally appeared before me , known to me (or satisfactorily proven) to be the person who executed the foregoing Final Release of Liens and Claims, as of (insert Consultant/Contactor name) who acknowledged having done so for the purposes therein contained.
IN WITNESS WHEREOF, I have set my hand and official seal.
Notary Public, D.C.
My commission expires: _______________________________
[NOTARIAL SEAL]
GOVERNMENT OF THE DISTRICT OF COLUMBIA
DEPARTMENT OF GENERAL SERVICES
2000 14TH STREET, NW, 5TH FLOOR, WASHINGTON, D.C. 20009
FAX: (202) 671-0648
FINAL RELEASE OF LIENS AND CLAIMS
Project Name:
Contract No.:
Task Order No.:
Work Performed:
Contract Date:
Contract Amount:
Date:
Final Release of Liens and Claims:
The undersigned (insert Consultant/Contactor name), in consideration of payments received and upon receipt of the amount of a final payment of $ __________________ hereby indemnifies, waives, releases, and holds the District of Columbia harmless for the above referenced project, including all claims, right to liens, terminations, and stop notices upon said premises or the improvements thereon under the statutes of the jurisdiction in which the project is located.
The undersigned further represents and warrants, as of this date, that he/she is duly authorized to sign and execute this Release of Final Liens and Claims on behalf of (insert Consultant /Contractor; that (insert Consultant /Contractor) has properly performed all work and furnished all materials of the specified quality in accordance with all contract documents in an acceptable workmanlike manner to the Department of General Services/Construction Division, District of Columbia and that (insert Consultant /Contractor) has paid for all labor, including fringe benefits and workers compensation, all materials, equipment, services, taxes, insurance premiums, and bonds (if required) and that any materials supplied to or incorporated in this project have been paid.
(Insert Consultant/Contactor) is executing this Final Release of Liens and Claims for the express purpose of inducing the District to make final disbursement and payment to (insert Consultant/Contactor name) of
This letter must be signed and notarized below by authorized individuals.
Insert Consultants /Contractors name: _______________
By:___________________
Print Name: ___________________
Title: ________________ Date: _______________
DISTRICT OF COLUMBIA ) ss
I, a Notary Public in and for the District of Columbia, hereby certify that, on this ___ day of , 20 , personally appeared before me , known to me (or satisfactorily proven) to be the person who executed the foregoing Final Release of Liens and Claims, as of (insert Consultant/Contactor name) who acknowledged having done so for the purposes therein contained.
IN WITNESS WHEREOF, I have set my hand and official seal.
Notary Public, D.C.
My commission expires: _______________________________
[NOTARIAL SEAL]
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