Letter of Proposal to Supply Materials and Labour

DEMAND OF SUPPLIER OF MATERIALS, MACHINERY, TOOLS,
LABORERS, OR SERVICES FOR INFORMATION REGARDING OWNER,
DISBURSER AND PRINCIPAL CONTRACTOR – CORPORATION or LLC
(Colorado Revised Statute §38-22-126(3))

COMES NOW, the undersigned from

whom has ordered or contracted for labor,

services, machinery, tools, equipment, laborers, or materials to be used in the improvement of property and demands a statement of the following information from

who has ordered or contracted with the undersigned as described above:

1. The name, address, and telephone number of the owner or reputed owner of the land to be improved;

Name:

Address:

Phone:

2. The name, address and telephone number of the principal contractor, if any;

Name:

Address:

Phone:

3. The name, address and telephone number of the disburser, if any; and

Name:

Address:

Phone:

4. A legal description or the address, if any, of the land to be improved.

This the day of , 20

STATE OF COLORADO

COUNTY OF

In on the day of , 20 before me, a

Notary Public in and for the above state and county, personally appeared

known to me or proved to be the person named in and who executed the foregoing instrument, and being first duly sworn, such person acknowledged that he or she executed said instrument for the purposes therein contained as his or her free and voluntary act and deed.

Type of ID Produced:

Affiant is personally known to me

CO § 38-22-126(3)