Fill and Sign the Notice of Labor Performed or Materials Supplied Corporation

Notice of Labor Performed or Materials SuppliedPage 1 of 2NOTICE OF LABOR PERFORMED OR MATERIALS SUPPLIED-Corporation (Colorado Revised Statute Section §38-22-102(4)) TO: ____________________________________[Owner, superintendent of construction, agent, architect, or financial institution]Please take notice that ____________________________________, as President of _____________________________________, a ______________________________ corporation, whose address is _____________________________________, _____________________, Colorado ________________________________, has, or has agreed to and will, furnish labor, materials, or laborers to ________________________________________________________________________ ________________________________________________________________________For: ________________________________________________________(Describe type of work) In connection with improvement of the real property located at ______________________________________________________________________________________________________________________________________________.The estimated value of labor already performed and/or materials already supplied is: $_________.The estimated value of labor to be performed and/or materials to be supplied is: $_________.____________________________________ Signature of Lien Claimant____________________________________Print or Type Name____________________________________Title____________________________________Name of Company________________________________________________________________________Address of Lien Claimant) Notice of Labor Performed or Materials SuppliedPage 2 of 2 Certificate of Delivery I, ____________________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to by: Personal Service Leaving a copy at his residence or place of business with some person in charge located at ____________________________________. By delivering it to his superintendent of construction/agent/architect, ____________________________________, at ____________________________. Leaving a copy at the superintendent of construction/agent/architect’s residence or place of business at ____________________________________ with some person in charge. By delivering it to the financing institution/person disbursing construction funds, ________________________________, at _______________________________. Leaving it either at the place of business of the financing institution or place of business or residence of the person disbursing construction funds at _______________________________________________________________________ with some person in charge. So certified this the ______ day of ___________________, 20____. ______________________________ Signature CO § 38-22-102(4)