*What type of construction project?
New
Remodeling
Repair Work
Addition & Renovation
Other - please specify:
*Was a building permit obtained for the construction project?
Yes
No
If yes, who obtained the building permit?
*Were you given a Certificate of Occupancy?
Yes
No
*Were you given a written warranty for the work performed?
Yes
No
*What was the total contract amount of the construction project? $
*Has the contract amount been paid in full?
Yes
No
If no, how much is owed on the contract? $
*Are any amounts in dispute (billings, payments, change orders, etc.)?
Yes
No
If yes, give a complete explanation of amounts in dispute:
*What date was the construction project contract signed?
*What date was the construction project started?
*What date was the construction project completed (date of closing)?
*What date was the construction project occupied for intended use?
*Are you willing to work with one of our inspectors and the contractor to resolve the construction problems on your project?
Yes
No -- If no, explain unwillingness to work with our inspectors and the contractor:
*NOTE: If you are unwilling to allow the contractor back on your construction project or property, there may be very
little that the Board for Licensing Contractors can do to assist you, other than to place the complaint on record.
*What is the name of the foreman/supervisor in charge of the construction project?
*Is this the individual you dealt with the most?
Yes
No
If no, please list the name of the individual.
ARCHITECT/ENGINEER INFORMATION
*Was and Architect/Engineer retained for this project?
Yes
No
If yes, please list below.
Name of Architect/Engineer
Name of Firm
Street Address
Street Address
City
State
Zip
Telephone Number
ATTORNEY/LEGAL INFORMATION
*Have you retained an attorney in reference to your complaint?
Yes
No
If yes, please list below.
Name of Attorney
Name of Firm
Street Address
Street Address
City
State
Zip
Telephone Number
*Has litigation been filed by you or the contractor in reference to this complaint?
Yes
No
If yes, has a court date been set?
Yes
No
If yes, what is/was the court date:
*Is litigation concluded?
Yes
No
If yes, you will be asked to provide a copy of this judgment.
DESIRED REMEDY AND CONSTRUCTION PROJECT LOCATION
Below you will be able to completely list your total complaint. But in short, what do you want this Board to have the contractor do or what will remedy your complaint?
*Please provide the location of the construction project:
*Street Address
*Street Address,
*City,
*State,
*Zip
*County
*In the space below, give directions to assist our inspectors in locating the project if an inspection becomes necessary.
**BASIS FOR YOUR COMPLAINT**
The Board for Licensing Contractors is primarily concerned with problems which have not been resolved at the time of the filing of this complaint. To assist this office in processing your complaint more efficiently, we request that you list below only the existing problems. If other problems arise during the processing of your complaint, you may provide this information to the Board assigned inspector. You will be asked to provide copies of the proposal, contract, purchase orders, change orders, punch lists and permits for this project. DO NOT SEND ORIGINAL DOCUMENTS.
**THE BELOW SECTION IS REQUIRED**