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PARTIAL WAIVER AND RELEASE OF LIEN
The undersigned, upon receipt of partial payment in the sum of $ , paid by
Richard K. Davis Construction Corporation, do hereby waive, release and quit claim of all liens,
lien rights, claims or demands of every kind whatsoever, which the undersigned now has, or may
hereafter have, against that certain real estate and the improvements.thereon, situated in St. Lucie
County, Florida and legally described as: PB HOLDCO, LLC, 3891 St. Lucie Blvd., Fort Pierce,
Florida, ]Parcel i.D.1432-211-0002-000-2 on account of work and labor performed, and /or
materials furnished in, to, or about the construction of any building thereon, or in improving said
property above described, or any part thereof. It being the understanding of the undersigned that
this is a Partial Waiver and Release of Lien which the undersigned has against the premises
described herein, only to the extent of the payments specified and only for materials furnished or
work done up until (but not releasing or waiving charges for changes,
additions, or extras), the undersigned warrants that no assignment of said liens or claims, nor the
right to perfect a lien against said real estate, by virtue of the accrual of said payment, has or will be
made, and that the undersigned has the right to execute this Partial Waiver and Release, and that all
laborers employed by the undersigned, and all bills for materials and supplies furnished by others to
the undersigned in connection with the construction of improvements upon the aforesaid premises,
to the extent of the payment herein referred to, have been fully paid.
IN WITNESS WHEREOF, I / we have executed this instrument this day of
, 2019.
WITNESSES: Subcontractor / Supplier Name:
Title: