MILLER ACT NOTICE  REQUEST FORM

Telephone: 619-460-9020 -  Fax 619-460-9025

*   Indicates Required Fields

Please check your fax machine for confirmation the morning following the process of your MILLER ACT NOTICE.  If you do not receive a confirmation, please contact MASTER LIENS immediately.

Company Name:   *

Your Name: *

Company Telephone No.:  *

Total Contract Value  (including change orders)  of Labor, Materials and/or Services  furnished by you to the Project:       $   *

Outstanding Balance Owed to your Company:    *

Your Customer Or The Party That You Contracted With:  *

Customer or Party’s Address:   *

City   *

State  *   Zip *

GENERAL CONTRACTORS

Contractor Name:      *

Contractor Address:   *

 City   *

State  *   Zip *

Contract No.:    *

Project Address:  *

Project Name (If Known): *

Description of Materials, Labor and/or Services provided:

*

THE BONDING COMPANY  (IF KNOWN)

Bonding Company Name:  

Bonding Company Address: 

The Payment Bond Number (If Known).:   

Do you want Rush Service? (Only check this field if you want rush service). **

Note!!!!  Once your Miller Act Notice has been served you have a statutory timeframe in which you must file a lawsuit if you intend to enforce your Miller Act rights.

IMMEDIATELY contact an attorney for advice regarding the enforcement of your Payment Bond claim.