Fill and Sign the Private Work Kegler Brown Hill Ampampamp Ritter Form

Notice of Contract – Professional Sub -consultant Page 1 of 2 NOTICE OF CONTRACT – PROFESSIONAL SUBCONSULTANT - CORPORATION (La.Rev.Stats § 9:4801(5)) COMES NOW, __________________________________ , as a representative of _________________________________ a ________________________________ corporate Professional Sub consultant whose address is ________________________________________________________________________ to provide notice to __________________________________ as Owner of a contra ct, within thirty (30) days after the date that the Su bconsultant enters into a written contract of employment and would provide the following: (1) The n ame and address of the Employer (Prime Professional) is: ___________________________________________________ _____________________ . (2) The d ate of employment/ contract is: ________________________________________________________________________ . (3) A g eneral description of the work undertaken : ________________________________________________________________________ . (4) A description of the property where the construction is to be performed is: ________________________________________________________________________ . (5) The price of the work to be performed or method by which the price will be calculated is: ___________________ _____________________________________________________ . (6) Payment for the work is to be made on: __________________ (date). Dated: __________________ ________________________________ Signature _____ __ _________________________ Type or Print Name _____ ___________________________ Title _____ ___________________________ Name of Corporate Contractor Attest: Secretary Notice of Contract – Professional Sub -consultant Page 2 of 2 Certificate of Delivery I, , hereby certify that I have delivered this day a true and correct copy of the foregoing to Notice of Lease 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