Lien Waiver Template (Word)

What it's for

This lien waiver template puts four blank forms in one Word file: a conditional and an unconditional waiver for a progress payment, and a conditional and an unconditional waiver for a final payment. Each form has its own page under your letterhead, with fields for the parties, the project and the payment.

The label on every page reads Not a statutory form. Some states prescribe their own lien waiver wording, and this form does not follow any state's. Its note links to the statutory lien waiver forms by state hub, which links a page reproducing the forms word for word for each state with a statutory form on this site. The wording in this file is our own. It copies no state's form.

States with a statutory form on this site: Arizona, California, Florida, Massachusetts, Michigan, Missouri, Nevada, Texas, Utah, and Wyoming.

A waiver names a payment amount, and this file only records the figure you type. To work the amount out, the pay application template does the progress-billing arithmetic, and the contractor invoice template totals a bill.

What's inside

Four Letter-size pages, one form to a page, with our logo, a credit link and the page number in each footer. The pale yellow boxes are yours to fill in. Nothing calculates. Every page has the same parts, in this order:

• Letterhead: YOUR LOGO, Your Company Name and LIEN WAIVER, with Waiver no. and Date on the right.
• The form's name, in a band: CONDITIONAL WAIVER, PROGRESS PAYMENT; UNCONDITIONAL WAIVER, PROGRESS PAYMENT; CONDITIONAL WAIVER, FINAL PAYMENT; or UNCONDITIONAL WAIVER, FINAL PAYMENT. Under it sits the label note.
• PARTIES AND PAYMENT: CLAIMANT, CUSTOMER, PROPERTY OWNER, PROJECT and PROPERTY ADDRESS, then THROUGH DATE on the two progress forms only, PAYMENT AMOUNT, and PAID BY on the two conditional forms only.
• A bold notice on the two unconditional forms: Notice: This waiver is unconditional. It takes effect when signed, whether or not the payment amount has been received.
• WAIVER AND RELEASE: one paragraph of waiver wording, different on each form.
• EXCEPTIONS: on the progress forms, RETAINAGE NOT YET PAID, UNPAID EXTRAS AND CHANGES, EARLIER PAYMENTS NOT RECEIVED and OTHER EXCEPTIONS. On the final forms, DISPUTED AMOUNTS and OTHER EXCEPTIONS.
• OPTIONAL CLAUSE: a note on Colorado's statute, then the clause itself.
• SIGNATURE: CLAIMANT, with lines for signature, printed name and title, and date.

The waiver wording differs by form. On the conditional forms it says the waiver takes effect only when the claimant has received the payment amount and that payment has cleared. The unconditional progress form says the claimant has received the payment amount. The unconditional final form says the claimant has received final payment in full. The progress forms release rights for work furnished through the through date, to the extent of the payment amount. The final forms release all lien rights and payment bond rights. Each one excepts what is listed under EXCEPTIONS.

The optional clause is Colorado's statement. Its note names C.R.S. § 38-22-119(2), which says an agreement to waive lien rights must contain a statement, by the person waiving them, providing in substance that the signer's debts to third parties for the goods or services covered are paid or will be timely paid. The clause is one sentence stating that those debts have been paid or will be timely paid, and the note says to strike it where it is not used. It is Colorado's statement only, and this page describes no other state's.

How to fill it in

1. Replace YOUR LOGO and Your Company Name with your own, fill in the address and Phone · Email · License no., then enter Waiver no. and Date.
2. Under PARTIES AND PAYMENT, type the CLAIMANT, the CUSTOMER, the PROPERTY OWNER, the PROJECT and the PROPERTY ADDRESS. The release wording refers to the claimant, the customer and the project above.
3. On a progress form, enter THROUGH DATE. The release wording runs through that date.
4. Type the PAYMENT AMOUNT. It is a plain box, so the file does not check it against a pay application or an invoice. On a conditional form, fill in PAID BY.
5. Under EXCEPTIONS, type what the release leaves out, one entry to a line. The wording points to the exceptions listed there, so an empty line lists nothing.
6. Read the OPTIONAL CLAUSE note. To drop the clause, delete the note and the clause together. To keep it, leave both.
7. The CLAIMANT signs, prints a name and title, and dates the form on the lines under SIGNATURE.
8. Print the page you need, or delete the other pages. Forms 2 to 4 each start on a new page, so removing a page leaves the rest whole.

Using the forms on the job

Each form has a Waiver no. and a Date in its letterhead, so a form can carry its own number and its own date. The PAYMENT AMOUNT box is a plain box, and the file holds no figure from a pay application or an invoice.

Each page has one signature block, for the claimant, with lines for signature, printed name and title, and date. Pages can be printed one at a time.

The file does not say which form a payment calls for. That question belongs to the contract and an attorney, not to this page.

Frequently asked questions