Request for Payment Bond Information

This is not a lien or bond claim, and this notice does not indicate there’s a problem on this project.

Project
Name:

Address:

Requesting Party
Name:

Address:

Services Provided:

Hiring Company:

We were hired to furnish labor and/or materials to this construction project, and we look
forward to working with you! Our services and/or materials were furnished at the request of
the Hiring Company, who hired the Requesting Party.

Please furnish the following information for our records:

(1) the name and last known address of the governmental entity with whom the prime
contractor contracted for the public work;

(2) a copy of the payment and performance bonds for the public work, including bonds
furnished by or to the prime contractor; and

(3) the name of the surety issuing the payment bond and the performance bond, along with
their address and telephone number.

These materials may be sent to the Requesting Party at the address above. If you have any
questions, feel free to give us a call!

Thank you,

(Print)
(Company Name)
(Date)
(Phone)

© 2018 zlien
Get payment under control. L E V E LS E T
Pt;iyment hetp is here.

,•••
Manage Strengthen Your Speed
Risk On All Customer Partnerships Up
Jobs Payments
Quickly resolveissues through
Get alerts about payment direct chat conversations to Exchange and manage payment
problems and risky maintain good relationshipsand paperwork hassle-free and so
contractors keeps cash flowing. payments happen lightning
- like when alien isfiled - fast
soyou
stay ontopof yourjobs.

Danetta cut late payments In halt

IntlMarblehada problem.The r 90+days receivables hadgrown to 70% of
totalAIR As soon as Oanetta started using Levelset, payments started flowing "so fast it
would make your head spin."

Katy saved 3hoursper Job.

Tr plinggrowthledtospreadsheet nightmares for Katy.Shewasoverwhelmed with
paperw0<k. butLevelset madeit easyforher tokeeptrack of everything.What
usedto take Katyadaynow only takes 15minutes.

Dennissecured over $3.7mllllon in 6 months.

With jobs ranging from $2k to over $1 million, Dennis was stressed about securing
his receivables.Levelset makes it easy for Denn s to feelconfident about payments
onover 700 jobsper year.

,'.,"· . · , · Payment help Is here. •· ·c ,·