Disclosure Statement Notice To Customers
Download a blank fillable Disclosure Statement Notice To Customers in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Disclosure Statement Notice To Customers with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Disclosure Statement
Department of Labor and Industries
Contractor Registration
Notice to Customers
Business Name:
This contractor is registered with the state of Washington, registration no. _____________________________
has posted with the state a bond or deposit of $____________________ for the purpose of satisfying claims
against the contractor for breach of contract including negligent or improper work in the conduct of the
contractor’s business. The expiration date of this contractor’s registration is ___________________________.
THIS BOND OR DEPOSIT MIGHT NOT BE SUFFICIENT TO COVER A CLAIM THAT MIGHT ARISE FROM
THE WORK DONE UNDER YOUR CONTRACT.
This bond or deposit is not for your exclusive use because it covers all work performed by this contractor. The
bond or deposit is intended to pay valid claims up to $________________________ that you and other
customers, suppliers, subcontractors, or taxing authorities may have.
FOR GREATER PROTECTION YOU MAY WITHHOLD A PERCENTAGE OF YOUR CONTRACT.
You may withhold a contractually defined percentage of your construction contract as retainage for a stated
period of time to provide protection to you and help insure that your project will be completed as required by
your contract.
YOUR PROPERTY MAY BE LIENED.
If a supplier of materials used in your construction project or an employee or subcontractor of your contractor
or subcontractors is not paid, your property may be liened to payment and you could pay twice for the same
work.
FOR ADDITIONAL PROTECTION, YOU MAY REQUEST THE CONTRACTOR TO PROVIDE YOU WITH
ORIGINAL “LIEN RELEASE” DOCUMENTS FROM EACH SUPPLIER OR SUBCONTRACTOR ON YOUR
PROJECT.
The contractor is required to provide you with further information about lien release documents if you request it.
General information is also available from the state Department of Labor and Industries.
I have received a copy of this disclosure statement.
Dated this
day of
of the year
.
Signature of Customer
The contractor must retain a signed copy of this disclosure statement in his or her files for a minimum of three years and
produce a signed or electronic signature copy of the disclosure statement to the department upon request.
For more information, please refer to
RCW
18.27.114.
RESET
F625-030-000 Disclosure Statement Notice to Customer 12-2015
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal