Exhibit_G_-_City_of_Doral_Partial_Waiver_and_Release_of_Lien_Form_(Subs-Suppliers).PDF

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Attached to
Government Center 3rd Floor Renovation – Recondition of the Existing City Manager’s and Finance Department Office Areas
Solicitation number
2026-16
Issued by
Miami-Dade County, Florida

About this file

This is a Partial Waiver and Release of Lien form document issued by the City of Doral Capital Improvements Division for use by subcontractors and suppliers on municipal projects. The form serves as a legal instrument through which subcontractors and suppliers acknowledge receipt of progress payments and relinquish all lien rights, claims, and demands against the prime contractor, the City of Doral as project owner, and any associated sureties. The document requires completion with specific project identification information including project number, location, and county/state designation, along with the payment amount received and the date through which the lien waiver extends.

The form necessitates signature by the lienor (subcontractor or supplier) with printed name and title, followed by notarization to authenticate the acknowledgment. The notarization section accommodates both physical presence and online notarization methods and requires the notary public to confirm the statements' truthfulness and document identification procedures. This standardized form ensures compliance with Florida lien law requirements and protects the City of Doral and prime contractors by establishing documented evidence that subcontractors and suppliers have been paid and have surrendered all claims to project funds or assets. The form is applicable to the Government Center 3rd Floor Renovation project at 8401 NW 53rd Terrace, Doral, Florida 33166, involving recondition of existing City Manager and Finance Department office areas.

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Text version

"For all the right reasons! SM

CITY OF DORAL

CAPITAL IMPROVEMENTS DIVISION

PARTIAL WAIVER AND RELEASE OF LIEN

(Sub-Contractor/Supplier)

LET THE FOLLOWING BE KNOWN:

That the undersigned lienor in consideration of the progress payment in the amount of

, has been paid in full all amounts due and owed to it by (Prime Contractor) and does hereby waive, release and relinquish any and all rights, liens, lien rights, claims or demands of any kind whatsoever, through , (date) against (Prime Contractor) and City of Doral the owner, its successors and/or assigns and its surety if one exists, arising out of or in connection with the following project:

Project No.:

Location:

County/State:

IN WITNESS WHERE OF, I have hereunto set my hand seal this day of ; 20

Lienor's Name:

By: (sign):

Print Name:

Title:

STATE OF:

COUNTY OF:

I hereby acknowledge that the statements contained in the foregoing Release of Lien are true and correct to the best of my knowledge and belief.

The foregoing instrument was acknowledged before me, by means of ☐ physical presence or ☐ online notarization, this day of , (year), by on behalf of (lienor) [ ] who is personally known to me or [ ] who produced as identification and who [ ] did [ ] did not take an oath.

Notary Signature:

Notary Name:

My commission expires:

File details come from the government source that posted it. Updated .