___________________________________________

___________________________________________

___________________________________________
(Name/Address)

THE ORIGINAL CONTRACTOR OR REPUTED ORIGINAL CONTRACTOR:

___________________________________________

___________________________________________

___________________________________________
(Name/Address)

THE CONSTRUCTION LENDER, IF ANY, OR REPUTED CONSTRUCTION LENDER, IF ANY:

___________________________________________

___________________________________________

___________________________________________
(Name/Address)

1. The name and address of the person/entity furnishing the labor, services, equipment or materials (use name of entity holding license):

___________________________________________

___________________________________________

___________________________________________

2. The general description of the labor, services, equipment or materials furnished or to be furnished by the undersigned:

___________________________________________

___________________________________________

___________________________________________

3. Date Claimant first provided said labor, services, equipment or materials:

___________________________________________

___________________________________________

___________________________________________

4. Estimated total price: $ _____________________

5. The name of the person/entity who contracted for purchase of the labor, services, equipment or materials:

___________________________________________

___________________________________________

___________________________________________

6. Description of the jobsite sufficient for identification:

___________________________________________

___________________________________________

___________________________________________

7. The identity and address of the trust fund(s) (if required pursuant to a collective bargaining agreement to pay supplemental fringe benefits into an express trust fund described in Civil Code §3111):

___________________________________________

___________________________________________

___________________________________________

___________________________________________

Dated: ____________________

________________________________________
(Name of Claimant)

By:_____________________________________
(Signature)

________________________________________
(Print or Type Name and Title)

PROOF OF SERVICE AFFIDAVIT
I,__________________________, declare that I served the above Preliminary Notice by (check appropriate box below):

[ ] Personally delivering a copy to :

__________________________________________
(Name and title or capacity of person served)

at_________________________________________,

__________________________________________
(Address)

on _________________,__________, at ____ __ m.
(Date) (Year) (Time)

[ ] By First Class Certified or Registered Mail service, postage prepaid, return receipt requested, addressed to the party at the address shown below:

___________________________________________

___________________________________________

___________________________________________
(Name/Address)

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Signed at ___________________________,_______
(Location)

on _____________________
(Date)

Signature of person making service:

___________________________________________

[Use the Postal Service's Return Receipt Requested service. Under Civil Code §3097.1, service by mail is proved with the signed Proof of Service Affidavit (above) accompanied by either: 1.) the return receipt for certified or registered mail delivery; or 2.) by a photocopy of the record of delivery and receipt maintained by the Postal Service showing the date of delivery and to whom delivered; or 3.) by the returned envelope itself in the event of nondelivery.]

[Prepare one Proof of Service for each person served.]

TO:

THE PUBLIC AGENCY:

___________________________________________

___________________________________________

____________________________________________
(Name/Address)

THE ORIGINAL CONTRACTOR OR REPUTED ORIGINAL CONTRACTOR:

___________________________________________

___________________________________________

____________________________________________
(Name/Address)

1. The name and address of the person/entity furnishing the labor, services, equipment or materials (use name of entity holding license):

___________________________________________

___________________________________________

___________________________________________

2. The general description of the labor, services, equipment, or materials furnished or to be furnished by the undersigned:

___________________________________________

___________________________________________

___________________________________________

3. Date Claimant first provided said labor, services, equipment or materials:

___________________________________________

___________________________________________

4. Estimated total price: $_______________________

5. The name of the person/entity who contracted for purchase of the labor, services, equipment or materials:

___________________________________________

___________________________________________

___________________________________________

6. Description of the jobsite sufficient for identification:

___________________________________________

___________________________________________

___________________________________________

Dated: ____________________

____________________________________________
(Claimant's Name)

By:_________________________________________
(Signature)

____________________________________________
(Print or Type Name/Title)

PROOF OF SERVICE AFFIDAVIT

I,__________________________, declare that I served the above Preliminary Notice by (check appropriate box below):

[ ] Personally delivering a copy to :

____________________________________________
(Name and title or capacity of person served)

at___________________________________________,

____________________________________________
(Address)

on _________________,__________, at ___ __ m.
(Date) (Year) (Time)

[ ] By First Class Certified or Registered Mail service, postage prepaid, return receipt requested, addressed to the party at the address shown below:

___________________________________________

___________________________________________

___________________________________________
(Name/Address)

I declare under penalty of perjury under the laws of the state of California that the foregoing is true and correct.

Signed at ____________________________________
(Location)

on _____________________
(Date)

Signature of person making service:

___________________________________________

[Use the Postal Service's Return Receipt Requested service. Keep the signed Proof of Service Affidavit (above) and the return receipt for certified or registered mail delivery. Civil Code §3098 provides that for "any public works constructed by the Department of Public Works or the Department of General Services of the state," the 20-day notice, if served by mail, must be "addressed to the office of the disbursing officer of the department constructing the work" or must be personally served upon that officer.]

[Prepare one Proof of Service for each person served.]

	Information about Commercial General Liability Insurance
	Did your contractor tell you whether he or she carries Commercial General Liability Insurance? Home improvement contractors are required by law to tell you whether or not they carry Commercial General Liability Insurance. This written statement must accompany the bid, if there is one, and the contract.
	What does this insurance cover? Commercial General Liability Insurance can protect against third-party bodily injury and accidental property damage. It is not intended to cover the work the contractor performs.
	Is this insurance required? No. But the Contractors State License Board strongly recommends that all contractors carry it. The Board cautions you to evaluate the risk to your family and property when you hire a contractor who is not insured. Ask yourself, if something went wrong, would this contractor be able to cover losses ordinarily covered by insurance?
	How can you make sure the contractor is insured? If he or she is insured, the contractor is required by law to provide you with the name and telephone number of the insurance company. Check with the insurance company to verify that the contractor's insurance coverage will cover your project.
	What about a contractor who is self-insured? A self-insured contractor has made a business decision to be personally responsible for losses that would ordinarily be covered by insurance. Before contracting with a self-insured contractor, ask yourself, if something went wrong, would this contractor be able to cover losses that should be covered by insurance?

For more information about Commercial General Liability Insurance, contact the Contractors State License Board at www.cslb.ca.gov or call 800-321-CSLB (2752).

[Formatting: The regulation provides: "The heading shall be printed in at least 14-point type, the questions in at least 12-point type, and the comments in italics of at least 11-point type. The text should be bold where indicated."]

ATTACHMENT FOR CONSTRUCTION OF SINGLE-FAMILY RESIDENCES
(16 California Code of Regulations §872)

	Information about Commercial General Liability Insurance
	Did your contractor tell you whether he or she carries Commercial General Liability Insurance? Contractors building single-family residences for owners who intend to occupy the home for at least a year are required by law to tell you whether or not they carry Commercial General Liability Insurance. This written statement must accompany the contract.
	What does this insurance cover? Commercial General Liability Insurance can protect against third-party bodily injury and accidental property damage. It is not intended to cover the work the contractor performs.
	Is this insurance required? No. But the Contractors State License Board strongly recommends that all contractors carry it. The Board cautions you to evaluate the risk to your family and property when you hire a contractor who is not insured. Ask yourself, if something went wrong, would this contractor be able to cover losses ordinarily covered by insurance?
	How can you make sure the contractor is insured? If he or she is insured, the contractor is required by law to provide you with the name and telephone number of the insurance company. Check with the insurance company to verify that the contractor's insurance coverage will cover your project.
	What about a contractor who is self-insured? A self-insured contractor has made a business decision to be personally responsible for losses that would ordinarily be covered by insurance. Before contracting with a self-insured contractor, ask yourself, if something went wrong, would this contractor be able to cover losses that should be covered by insurance?

For more information about Commercial General Liability Insurance, contact the Contractors State License Board at www.cslb.ca.gov or call 800-321-CSLB (2752).

[Formatting: The regulation provides: "The heading shall be printed in at least 14-point type, the questions in at least 12-point type, and the comments in italics of at least 11-point type. The text should be bold where indicated."]

CHECKLIST FOR HOME IMPROVEMENT CONTRACTS WITHOUT SWIMMING POOLS
(16 California Code of Regulations §872.1)

	Check Out Your Contractor
	Did you contact the Contractors State License Board (CSLB) to check the status of the contractor's license? Contact the CSLB at 1-800-321-CSLB (2752) or visit our web site: www.cslb.ca.gov.
	Did you get at least 3 local references from the contractors you are considering? Did you call them?
	Building Permits - will the contractor get a permit before the work starts?
	Check Out the Contract
	Did you read and do you understand your contract?
	Does the 3-day right to cancel a contract apply to you? Contact the CSLB if you don't know.
	Does the contract tell you when work will start and end?
	Does the contract include a detailed description of the work to be done, the material to be used, and equipment to be installed? This description should include brand names, model numbers, quantities and colors. Specific descriptions now will prevent disputes later.
	Are you required to pay a down payment? If you are, the down payment should never be more than 10% of the contract price or $1,000, whichever is less.
	Is there a schedule of payments? If there is a schedule of payments, you should pay only as work is completed and not before. There are some exceptions - contact the CSLB to find out what they are.
	Did your contractor give you a "Notice to Owner," a warning notice describing liens and ways to prevent them? Even if you pay your contractor, a lien can be placed on your home by unpaid laborers, subcontractors or material suppliers. A lien can result in you paying twice or, in some cases, losing your home in a foreclosure. Check the "Notice to Owner" for ways to protect yourself.
	Did you know changes or additions to your contract must be in writing? Putting changes in writing reduces the possibility of a later dispute.

CHECKLIST FOR HOME IMPROVEMENT CONTRACTS WITH SWIMMING POOLS
(18 California Code of Regulations §872.1)

	Check Out Your Contractor
	Did you contact the Contractors State License Board (CSLB) to check the status of the contractor's license? Contact the CSLB at 1-800-321-CSLB (2752) or visit our web site: www.cslb.ca.gov.
	Did you get at least 3 local references from the contractors you are considering? Did you call them?
	Building permits - will the contractor get a permit before the work starts?
	Check Out the Contract
	Did you read and do you understand your contract?
	Does the 3-day right to cancel a contract apply to you? Contact the CSLB if you don't know.
	Does the contract tell you when work will start and end?
	Does the contract include a complete description of the work to be done, the material that will be used and equipment to be installed? This description should include a plan and scale drawing showing the shape, size, dimensions and specifications. It should include brand names, model numbers, quantities and colors. Specific descriptions now will prevent disputes later.
	Are you required to pay a down payment? The down payment for swimming pools should never be more than 2% of the contract price or $200, whichever is less.
	Is there a schedule of payments? If there is a schedule of payments, you should pay only as work is completed and not before. There are some exceptions - contact the CSLB to find out what they are.
	Did your contractor give you a "Notice to Owner," a warning notice describing liens and ways to prevent them? Even if you pay your contractor, a lien can be placed on your home by unpaid laborers, subcontractors, or material suppliers. A lien can result in you paying twice or, in some cases, losing your home in a foreclosure. Check the "Notice to Owner" for ways to protect yourself.
	Did you know changes or additions to your contract must all be in writing? Putting changes in writing reduces the possibility of a later dispute.

NOTICE OF NON-RESPONSIBILITY
(California Civil Code §3094)

NOTICE IS HEREBY GIVEN THAT:

1. I, the undersigned, am the ___________________ (office/position) of _______________ (notice giver's name) and have the necessary authority to verify this document for ____________________ (notice giver's name).

2. ________________________ (notice giver's name) is the _____________ (nature of property interest, such as owner in fee simple) of that certain property located at: _______________________________ (address, city, state), which is further described as: _______________________________________ (legal description and parcel number) in the property records of ________ County, California.

3. The name of the purchaser under contract and/or the lessee is ______________.

4. Within the last ten (10) days, _______________________ (notice giver's name) has obtained knowledge that improvements, namely ________ (describe the work), are being made on the property described above.

5. _____________________ (notice giver's name) has not caused this work to be performed and will not be responsible for its performance or for any claims that arise out its performance. Furthermore, _______________________ (notice giver's name) will not be responsible for the payment of any labor, services or materials used or to be used therein or in connection therewith.

6. _________________ (notice giver's name) will post this notice at the property described above and cause this notice to be recorded within ten (10) days of first obtaining knowledge of the work described herein.

_____________________________________
(Notice giver's name)

By: _________________________________
(Authorized person signing)

_____________________________________
(Position of person signing)

VERIFICATION

I, the undersigned, say I am the __________________ (position of person signing) of _____________________ (notice giver's name). I have read the above Notice of Non-Responsibility, know the contents of it and it is true of my own knowledge. This is a true and correct copy of the Notice of Non-Responsibility to be posted at the property described above.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ____________, ____ (date this document was signed) at _______________________, California (name of city where signed).

____________________________________________
(Personal signature of person providing the verification)

CERTIFICATE OF ACKNOWLEDGEMENT

On _____________ (date) before me, the undersigned, a Notary Public in and for the State of __________ (name of state), personally appeared _________________ (person signing), personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.

WITNESS my hand and official seal.

Signature : __________________________ (Seal)

NOTICE OF CESSATION
(California Civil Code §3092)

1. The full name of the owner is:

_______________________________________

2. The address of the owner is:

_______________________________________

_______________________________________

3. The nature of the property interest or estate of the owner is:

_______________________________________

_______________________________________

4. A description of the site sufficient for identification is:

_______________________________________

_______________________________________

_______________________________________
(Include the street address if any and city, county and state)

5. The name of the original contractor is:

_______________________________________

6. The kind of work done or materials furnished pursuant to the contract is:

_______________________________________

_______________________________________

7. The names and addresses of all persons, if any, who hold an interest or estate with the owner as joint tenants or as tenants in common are:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

8. The full names and full addresses of the predecessors in interest of the owner if the property was transferred after the work or improvement referred to in this notice began:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

9. The work of improvement, described in Paragraph 6, on the property ceased on ______________ (date), and the cessation has continued to the giving of this notice.

Dated: _______________

_______________________________________
(Owner's Name)

By_____________________________________
(Signature)

VERIFICATION

I, the undersigned, say:

I am the ________________________________
(Owner, officer of owning entity, agent of owner, etc.)

of the interest or estate, described in Paragraph 3, of the property, described in Paragraph 4;

I have read the foregoing notice and know and understand the contents of it, and the facts stated in it are true and correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on _____________________, ______, (date)

at _____________________________________
(Place where signed)

_______________________________________
(Personal signature)

CERTIFICATE OF ACKNOWLEDGEMENT

On _____________ (date) before me, the undersigned, a Notary Public in and for the State of __________ (name of state), personally appeared _________________ (person signing), personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.

WITNESS my hand and official seal.

Signature : __________________________ (Seal)

NOTICE OF COMPLETION
(California Civil Code §3093)

1. The full name of the owner is:

__________________________________________

2. The address of the owner is:

__________________________________________

__________________________________________

3. The nature of the property interest or estate of the owner is:

__________________________________________

__________________________________________

4. A description of the site sufficient for identification is:

__________________________________________

__________________________________________

__________________________________________
(Include the street address if any and city, county and state)

5. The name of the original contractor is:

__________________________________________

6. The kind of work done or materials furnished pursuant to the contract is:

__________________________________________

__________________________________________

7. The names and addresses of all persons, if any, who hold an interest or estate with the owner as joint tenants or as tenants in common are:

__________________________________________

__________________________________________

__________________________________________
(Name/Address)

__________________________________________

__________________________________________

__________________________________________
(Name/Address)

__________________________________________

__________________________________________

__________________________________________
(Name/Address)

8. The full names and full addresses of the predecessors in interest of the owner if the property was transferred after the work or improvement referred to in this notice began:

__________________________________________

__________________________________________

__________________________________________
(Name/Address)

__________________________________________

__________________________________________

__________________________________________
(Name/Address)

__________________________________________

__________________________________________

__________________________________________
(Name/Address)

9. The work of improvement, described in Paragraph 6, on the property was completed on ______________ (date).

Dated: __________________

__________________________________________
(Owner's Name)

By________________________________________
(Signature)

VERIFICATION

I, the undersigned, say:

I am the ____________________________________________
(Owner, officer of owning entity, agent of owner, etc.)

of the interest or estate, described in Paragraph 3, of the property, described in Paragraph 4;

I have read the foregoing notice and know and understand the contents of it, and the facts stated in it are true and correct.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ____________________________, ______, (date)

at ____________________________________________
(Place where signed)

____________________________________________
(Personal signature)

CERTIFICATE OF ACKNOWLEDGEMENT

On _____________ (date) before me, the undersigned, a Notary Public in and for the State of __________ (name of state), personally appeared _________________ (person signing), personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.

WITNESS my hand and official seal.

Signature : __________________________ (Seal)

DESIGN PROFESSIONAL'S LIEN
NOTICE OF LIEN
(California Civil Code §3081.3)

1. By this notice, a lien is created in favor of

_________________________________________
(Name of design professional)

in the amount of

_________________________________________
(Amount of claim of lien)

2. The current owner of record of the real property is:

_________________________________________

3. A legal description of the real property to which the lien attaches is:

_________________________________________

_________________________________________

_________________________________________

4. The building permit or other governmental approval for the work of improvement designed to be constructed on the above property is:

_________________________________________

_________________________________________

_________________________________________

5. Not less than ten days before the recording of this notice of lien, the undersigned design professional mailed by registered or certified mail, postage prepaid, to the landowner, a written demand for payment specifying that a default occurred pursuant to the terms of a written contract for design professional services and the amount of the default.

Dated_______________________

_________________________________________
(Name of design professional)

_________________________________________
(Signature)

VERIFICATION

I, the undersigned, say: I am the

_________________________________________
(Title)

of the claimant of the design professional's lien; I have read said claim of design professional's lien and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct.

Executed on __________________, ________, (date this document was signed)

at ____________________________________, California
(Name of city where signed).

_________________________________________
(Personal signature of person providing the verification)

CERTIFICATE OF ACKNOWLEDGEMENT

On _____________ (date) before me, the undersigned, a Notary Public in and for the State of __________ (name of state), personally appeared _________________ (person signing), personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.

WITNESS my hand and official seal.

Signature : __________________________ (Seal)

MECHANIC'S LIEN
(California Civil Code §3084)

Claimant,

_______________________________________
(Name - use name of entity holding license)

_______________________________________
(Address)

_______________________________________

hereby claims a mechanic's lien as follows:

1. Claimant's demand, after deducting all just credits and offsets, is $________,

plus interest at the rate of ____% per annum

from __________________________________
(Date balance became due)

2. The name of the owner or reputed owner, if known, is:

_______________________________________

3. Claimant furnished the following kinds of labor, services, equipment or materials:

_______________________________________

_______________________________________

4. Said labor, services, equipment or materials were performed or furnished at:

_______________________________________

_______________________________________

_______________________________________
(Description of location sufficient for identification)

5. The name of the person by whom the Claimant was employed or to whom the Claimant furnished the labor, services, equipment or materials is:

_______________________________________

Dated: ______________

_______________________________________
(Claimant)

By: ____________________________________
(Signature)

_______________________________________
(Print or Type Name/Title)

VERIFICATION

I, the undersigned, say: I am the

_______________________________________
(Title)

of the claimant of the foregoing mechanic's lien; I have read said claim of mechanic's lien and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct.

Executed on _____________________, ____, (date this document was signed)

at __________________________________, California
(Name of city where signed).

____________________________________
(Personal signature of person providing the verification)

CERTIFICATE OF ACKNOWLEDGEMENT

On _____________ (date) before me, the undersigned, a Notary Public in and for the State of __________ (name of state), personally appeared _________________ (person signing), personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument.

WITNESS my hand and official seal.

Signature : __________________________ (Seal)

TO:

_______________________________________

_______________________________________

_______________________________________
(Name/address of owner or construction lender if a private project or public
entity if a public project)

Holder of Funds.

PLEASE TAKE NOTICE that:

_______________________________________
(Name of Claimant - use name of entity holding license)

_______________________________________
(Address)

_______________________________________

has furnished or has agreed to furnish the following kind of labor, services, equipment or materials:

_______________________________________

The name of the person to or for whom the same was done or furnished is:

_______________________________________

which was performed in connection with the project located at:

_______________________________________

_______________________________________

The value of all labor, services, equipment and materials already done or

furnished by Claimant is $________________.

The value of all labor, services, equipment and materials agreed to be done

or furnished by Claimant is $________________

Claimant has been paid the sum of $_______________,

and there remains due and unpaid the sum of $___________________

plus interest thereon at the rate of _____% per annum

from ______________________.
(Date unpaid balance became due)

WHEREFORE, YOU SHALL WITHHOLD SUFFICIENT FUNDS TO SATISFY THIS CLAIM.

Dated: ________________________

_______________________________________
(Claimant)

By:_____________________________________
(Signature)

_______________________________________
(Print or Type Name/Title)

[NOTE: A bond may be needed to make a stop notice fully effective. Consult an attorney if you are unsure.]

VERIFICATION

I, the undersigned, say: I am the

_______________________________________
(Title)

of the claimant of the foregoing stop notice; I have read said claim of stop notice and know the contents thereof; the same is true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct.

Executed on _____________________, ____, (date this document was signed)

at ___________________________________, California
(name of city where signed).

_______________________________________
(Personal signature of person providing the verification)

PROOF OF SERVICE AFFIDAVIT

I,__________________________, declare that I served the above Stop Notice by (check appropriate box below):

[ ] Personally delivering a copy to :

_______________________________________
(Name and title of person served)

at_____________________________________,

_______________________________________
(Address)

on ______________________, at ______ __ m.
(Date) (Year) (Time)

[ ] By First Class Certified or Registered Mail service, postage prepaid, addressed to the party at the address shown below:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

I declare under penalty of perjury that the foregoing is true and correct.

Signed at __________________________________
(Location)

on ______________________
(Date)

Signature of person making service:

_______________________________________

[It is advisable to use the Postal Service's Return Receipt Requested service.]

[Prepare one Proof of Service for each person served.]

NOTICE OF CLAIM ON BOND (PUBLIC PROJECT)
(California Civil Code §3227)

TO:

BOND PRINCIPAL:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

SURETY:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

PUBLIC AUTHORITY:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

FROM:

CLAIMANT:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

PLEASE TAKE NOTICE that Claimant is looking to Bond Principal and Surety for payment:

1. The following kind of labor, services, equipment or materials were furnished or agreed to be furnished by Claimant:

_______________________________________

_______________________________________
in connection with the public work of improvement known as:

_______________________________________

and located at:

_______________________________________

_______________________________________

2. The name of the person to or for whom the labor, services, equipment or material were furnished is:

_______________________________________

_______________________________________

3. The amount in value, as near as may be determined, of any labor, services, equipment, or materials already furnished or to be furnished is:

$_________________________________

Dated: ____________________________

_______________________________________
(Claimant)

By:____________________________________
(Signature)

_______________________________________
(Print or Type Name/Title)

PROOF OF SERVICE AFFIDAVIT

I,__________________________, declare that I served the above Notice or Claim on Bond by (check appropriate box below):

[ ] Personally delivering a copy to :

_______________________________________
(Name and title of person served)

at ____________________________________,

_______________________________________
(Address)

on _________________,__________, at ______ __ m.
(Date) (Year) (Time)

[ ] By First Class Certified or Registered Mail service, postage prepaid, addressed to the party at the address shown below:

_______________________________________

_______________________________________

_______________________________________
(Name/Address)

I declare under penalty of perjury that the foregoing is true and correct.

Signed at _____________________________,_______
(Location)

on _____________________
(Date)

Signature of person making service:

_______________________________________

[It is advisable to use the Postal Service's Return Receipt Requested service.]

[Prepare one Proof of Service for each person served.]

The progress payment releases are used during the job. Contractors (as well as subcontractors and suppliers) often are required to submit a signed conditional release with their pay applications. As the release states, it takes effect only when the contractor gets a check in the amount of its bill and the check clears the bank. Thus, contractors may safely provide conditional releases with pay applications. Although a conditional release and proof of actual payment effectively constitute an unconditional release, many owners nevertheless seek unconditional releases. For one thing, this means owners do not have to match up conditional releases with proof of payment to have an effective release. Proper procedure is for the unconditional release to be submitted with the next pay request after the conditional release -- and only if payment has been made. Thus, the April pay request for $1,000 would be accompanied by a conditional release in that amount. The May pay request for $1,100 would be accompanied by a conditional release in that amount plus an unconditional release for April's payment of $1,000 -- if the payment check had cleared the bank.

Care must be taken in filling out the effective or "through" date of the release. The release should cover only the same period as the accompanying billing. Thus, if the owner is being billed for work through March 31, that date should be used is the effective date for the release -- even if the release is being signed on April 30. If April 30 were entered on the release, then the contractor might be deemed to have waived its rights to payment for work and materials provided in April -- even though the contractor had not yet billed for them.

Also, the contractor must be aware of what the releases say is and is not being released. While the release excludes numerous items from its reach, it specially includes the cost of work and material provided pursuant to a fully executed change order unless specifically reserved in the release itself.

Owners need to be concerned with whether subcontractors, sub-subcontractors and suppliers are being paid by the general contractor or subcontractor to whom they are providing goods or services. Non-payment could render releases ineffective.

In terms of conditional v. unconditional, the releases for final payments operate in the same manner as progress payment releases.

But, both final payment releases provide a location in which a contractor can exclude claims for disputed work from the release. Thus, if the contractor and owner have a dispute about extra work, the contractor can be paid for the undisputed amount owed, and the contractor can provide the owner with a release for the entire price of the project except the specific issues in dispute. If there are such disputes, the releases must be filled out with care.

Any participant in the construction process – owner, contractor, subcontractor, supplier, design professional – should consult counsel if it is uncertain about lien releases or other payment issues.

Dated: ___________________


_________________________
(Company Name)

By_______________________


Title______________________

Dated: ___________________


_________________________
(Company Name)

By_______________________


Title______________________


NOTICE:  THIS DOCUMENT WAIVES RIGHTS UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS.  THIS DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF YOU HAVE NOT BEEN PAID.  IF YOU HAVE NOT BEEN PAID, USE A CONDITIONAL RELEASE FORM.