HomeMy Public PortalAboutAgreement for Services 04 25 2012 Geothermal revised.docxFINAL CONTRACTOR WAIVER OF LIEN AND RELEASE
TO: Georgia Environmental Finance Authority
233 Peachtree Street
Harris Tower, Suite 900
Atlanta, Georgia 30303
RE: Subrecipient: Contract:
Contractor(s):
Project Location(s):
1. The undersigned Contractor hereby certifies that it performed all of its work at the above specified Project Location(s) in accordance with the terms of the above specified Energy
Efficiency and Conservation Block Grant Contract (EECBG), including the Contract Scope of Work attached as Exhibit A thereto; and all applicable laws, ordinances, policies and codes
of the Federal, State and local governments.
2. The Contractor further certifies that all of the work, equipment, supplies, materials, labor and services furnished by the Contractor and its suppliers, materialmen, Contractors,
and laborers at the above specified Project Location(s), in accordance with above specified EECBG Contract, have been fully paid for and the Contractor and its suppliers, materialmen,
Contractors, and laborers have been paid and satisfied in full, and that there are no outstanding claims of any character (including disputed claims or any claims to which the Contractor
has or will assert any defense) arising out of the performance of the contract which have not been paid and satisfied in full except as listed hereinbelow:
[Instructions- ENTER THE WORD “NONE” OR LIST THE NAMES OF CLAIMANTS AND THE AMOUNT CLAIMED BY EACH]
3. The Contractor further certifies that the above specified Project Location(s) cannot be made subject to any valid lien or claim (including disputed claims or any claims to which
the Contractor has asserted or will assert any defense) by anyone who furnished work, equipment, supplies, material, labor or services to the Contractor at the Project Location(s) and/or
in accordance with the terms of the above specified EECBG Contract.
4. The Contractor hereby releases GEFA, the Energy Efficiency and Conservation Block Grant program, and the owner(s) of the above specified Project Location(s) from all liability in
connection with the work, equipment, supplies, materials, labor and services furnished by the Contractor and its suppliers, materialmen, Contractors, and laborers at the Project Location(s)
and/or in accordance with the above specified EECBG Contract.
5. The Contractor has received final payment in full satisfaction and settlement of all claims against the Energy Efficiency and Conservation Block Grant program and GEFA arising by
virtue of its work at the above specified Project Location(s) and/or in accordance with the terms of the above specified EECBG Contract, and acceptance of such payment is acknowledged
as a release of EECBG and GEFA from any and all claims arising under or by virtue of the subcontract.
6. Payments pursuant to this certificate shall in no way diminish, change, alter or affect the rights of EECBG or GEFA
under the contract documents.
Notary Affidavit:
Sworn to and authorized before me
CONTRACTOR
This day of 20 . By:
Notary Public
Date:
NOTICE: A COPY OF THIS WAIVER AND RELEASE SHALL BE GIVEN TO GEFA, THE EECBG, AND THE OWNER(S) OF THE PROJECT LOCATION(S).
New Form – April 12, 2011