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TEMPLATE - Suppliers - Quitclaim and Waiver

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Republic of the Philippines )

_________________________ )S.S.

WAIVER RELEASE & QUITCLAIM

I, [Full name], Filipino, of legal age, with postal address at [Full Address], after having been
sworn to in accordance with law, do hereby depose and state that:

1. I am the duly authorized representative of [Name of Supplier/Subcontractor]


with principal office address at [Office Address], and warrant that I have full
authority to execute this instrument;

2. [Name of Supplier/Subcontractor] has a bill/claim/charge against


____________________ CORPORATION for [give the details on the
bill/claim/charge];

3. I hereby acknowledge receipt the sum of [amount in words]


(P_____________________), Pesos, Philippine Currency constituting full and
complete payment in consideration of the above-mentioned bill/claim/
charge, the sufficiency of which is hereby acknowledged;

4. [Name of Supplier/Subcontractor] hereby quitclaim, release, discharge and


waive any and all actions of whatever nature, expected, real or apparent,
against ____________________ CORPORATION, its directors, officers, employees,
agents and clients by reason of or arising from the aforementioned
bill/claim/charge;

5. [Name of Supplier/Subcontractor] will institute no action, whether civil, criminal,


labor or administrative against _______________________ CORPORATION, its
directors, officers, employees, agents and clients. Any and all actions which
may have been commenced either solely in the name of [Name of
Supplier/Subcontractor] or jointly with others before any office, board, bureau,
court, or tribunal against _______________________ CORPORATION, its directors,
officers, employees, agents and clients are hereby deemed and considered
voluntarily withdrawn;

6. I, the undersigned has personal knowledge of the facts sworn to in this Waiver
and Release upon Payment and such facts are true and correct;

7. I, the undersigned, declare that I have read this document and have fully
understood its contents. I further declare that I voluntarily and willingly
executed this Release, Waiver, and Quitclaim for and on behalf of [Name of
Supplier/Subcontractor] with full authority for all intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of __________________ at
______________, Philippines.

_____________________
Affiant
SUBSCRIBED AND SWORN to before me this ____ day of _________________ in _________,
Philippines, affiant exhibiting to me as competent proof of identification
_______________________________________.

Doc. No. _____,


Page No. _____,
Book No. _____,
Series of _____,

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