Release Form

• Document No.

• Client Company Name

• Site Contact Name

• Site Contact Phone

• Site

• Conducted On

  Date

• Prepared By

• Location
  Address

RELEASE FORM

• I acknowledge that the conditions are not compatible with the optimum performance from the linemarking paint due to the presence of any of the below conditions.
  
  On behalf of the company I direct Linemarkers South East Queensland to paint as directed, despite these conditions, thereby cancelling any warranties or guarantees (both implied and statutory). I understand that full payment must be made to Linemarkers South East Queensland despite any failures of the paint.

• Moisture (obviously wet or greater than 4% moisture)

• Insufficient curing time (slab less than 28 days old)

• Debris, dust, dirt or other foreign matter

• Chemical coatings on the surface

• Other

• Specify the conditions

• Insert photographs of the effected area

  Media

• On behalf of the client

  Sign

• For Linemarkers SEQ

  Sign