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Back to Forms for 'Affidavits'.


20-DAY PRELIMINARY NOTICE

20-DAY PRELIMINARY NOTICE

(For California)

 

(For use on Private Work and Public Works--In accordance with Section 3097, 3098 & 3111, California Civil Code)

 

(To be used by material-men suppliers, subcontractors, architects, engineers and other non-contractors)

 

 

 

PERSON FURNISHING LABOR, SERVICES EQUIPMENT OR MATERIAL:

 

Name: _________________________________________________________

 

Address: _______________________________________________________

 

 

TO OWNER, REPUTED OWNER, OR PUBLIC AGENCY:

 

Name - Owner or Public Agency: ________________________________________

 

Address: ____________________________________________________________

 

Construction Loan Number _____________________________________________

 

 

TO CONSTRUCTION LENDER OR REPUTED CONSTRUCTION LENDER:

 

Name: ____________________________________________________________

Address: ________________________________________________________

 

 

NOTE: This is NOT a lien on your property but a notice required by law to alert you to the possibility of liens being filed in the future if all parties who furnish labor and materials to your job are not paid in full.

 

Dated: ________________________

 

Signature: ______________________

 

Title: __________________________

 

Telephone: _____________________

 

 

DESCRIPTION OF LABOR, SERVICES, EQUIPMENT OR MATERIAL SUPPLIED, OR TO BE SUPPLIED: ________________________________________

 

THE ABOVE FURNISHED TO:

 

Name: __________________________________________________________

 

Address: _________________________________________________________

 

Address of job site: _________________________________________________

 

An estimate of the total price of the labor, services, equipment or materials furnished or to be furnished is _______________________ Dollars ($__________).

 

 

Trust Funds to which Supplemental Fringe Benefits are Payable.

 

Name: __________________________________________________________

 

Address: _________________________________________________________

 

Name: __________________________________________________________

 

Address: _________________________________________________________

 

 

NOTICE TO PROPERTY OWNER

 

 

If bills are not paid in full for the labor, services, equipment, or materials furnished or to be furnished, a mechanic's lien leading to the loss, through court foreclosure proceedings, of all or part of your property being so improved may be placed against the property even though you have paid your contractor in full.  You may wish to protect yourself against this consequence by (1) requiring your contractor to furnish a signed release by the person or firm giving you this notice before making payment to your contractor or (2) any other method or device which is appropriate under the circumstances.

 

 

PROOF OF SERVICE AFFIDAVIT

 

(Section 3097.1 and 3098, California Civil Code)

 

I, ________________________________, declare that I served copies of the above Preliminary Notice (check appropriate box).

 

(a)   [ ] By personal delivery, copies to _______________________________________ (name and title of person served) at _______________________________ (address) on _________________________ (month & day), __________ (year) at ______________ (time).

(b)  [ ] By First Class Certified or Registered Mail service, postage prepaid, addressed to   

      each of the parties at the address shown above on ____________________ (month   

      & day), __________ (year).

 

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

 

Signed at _____________________, California, on _____________________ (month & day), __________ (year).

 

(ATTACH RECEIPTS OF CERTIFIED OR REGISTERED MAIL WHEN RETURNED)

 

 

____________________________________

(Signature of Person Making Service)

 



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