Fill and Sign the Notice Contract Form

NOTICE TO OWNER OF CONTRACT – PRIME CONSULTANT/PROFESSIONAL SUBCONSULTANT- CORPORATION La.Rev.Stats § 9:4802(A)(5)(b) COMES NOW, __________________________________, as a representative of _________________________________ a ________________________________ corporate Prime Consultant/Professional Subconsultant whose address is ________________________________________________________________________ and who has a claim against __________________________________ as Owner and __________________________________ as Contractor to secure payment for obligations arising out of the performance of work under a contract, to provide notice to Owner of this contract, within thirty (30) days after the date that the Prime Consultant/Professional Subconsultant is employed and would provide the following: (1) The name and address of the Subconsultant is: ________________________________________________________________________. (2) The name and address of the Employer (Prime Professional) is: ________________________________________________________________________. (3) The date of employment/contract is: ________________________________________________________________________. (4) A general description of the work undertaken: ________________________________________________________________________. (5) A description of the property where the construction is to be performed is: ________________________________________________________________________. Dated: __________________ ________________________________ Signature ________________________________ Type or Print Name ________________________________ Title ________________________________ Name of Corporation Notice to Owner of Contract Page 1 of 2 Certificate of Delivery I, , hereby certify that I have delivered this day a true and correct copy of the foregoing to Notice to Owner of Contract- Prime Consultant/Professional Subconsultant by: Personal Service Mailing a true and correct copy of the same by Certified or Registered U.S. Mail, postage prepaid, return receipt requested to , who is the Owner located at ___________________________________________. Certified or Registered Mail Number: . So certified this the ______ day of __________________, 20______. Signature Notice to Owner of Contract Page 2 of 2