Mechanic's Lien & Bond Services

IMPORTANT! I have reviewed the corporate legal name and information in this section and undstand that by requesting service with this information, I am verifying that it is correct.

Note: You must verify that this information is correct to continue. If there is an error in any of this information, please contact NACM at (410) 740-5560 to have your company records changed.

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

Name

Street

City

State Zip

Phone (e.g. 555-555-1212)

Fax (e.g. 555-555-1212)

DISCLAIMER OF LIABILITY

It is understood and agreed that MLBS will use its best efforts to serve or file the above requested document and that MLBS is providing its services through sources it deems to be reliable and MLBS shall not be responsible or liable for claims for damages for any reason whatsoever, including claims for any special, punitive, incidental, or consequential damages, or claims for lost profit.

AUTHORIZATION

The undersigned hereby authorizes the above service on behalf of the company mentioned above. It is the responsibility of the undersigned to ensure accuracy of information and sufficient time allowance for filing. MLBS is not responsible for any incorrect information furnished or receipt of information after the required time periods. MLBS can only serve or file documents based on the information provided.

I agree and understand the above Authorization and Disclaimer - (** Required**)

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©2007 National Association of Credit Management
National Association of Credit Management
8840 Columbia 100 Parkway
Columbia, Maryland 21045-2158
Phone: 410.740.5560

UserID:	744111
Company:	MLBS
Name:	Gregory Powelson
Phone:	(216) 212-6020
Fax:	(410) 740-5574
Email:	gregp@nacm.org
Contact email for this project:
The contact email address will receive follow-up requests for this project
Address:	8840 Columbia 100 Parkway
	Columbia, MD 21045

Different address?
State of Incorporation:
Registered Agent:

Project Type	*	help
How to determine: is a project Public, Private or Federal? Private: Contract made for construction, alteration or repair of any property owned by a private individual, entity or not-for-profit organization. Public: Contract made by any government authority, i.e., the state, county, city, or a political subdivision, for construction, alteration or repair. Federal: Contract for the construction, alteration or repair of any building or works proejct of the Federal Govt. close help
Service Type	*	help
Which Notice should I use? Use Attorney generated notice when: Receivable is over $10,000. Project information is not reliable. Claim is likely to be disputed. Bankruptcy has been filed. Use MLBS generated notice (using your information with web confirmation) when: Receivable is under $10,000. Project information is reliable. Notice is non-statutory. Notice is being used to leverage payment. Claim is not disputed. Bankruptcy has not been filed. close help
Job Type	*

Do you have a contract?	Yes No Unsure
Contract Number
A purchase order?	Yes No Unsure
Purchase Order Date
A purchase order number?	Yes No Unsure
Purchase Order Number
Proof of delivery?	Yes No Unsure
An itemized statement?	Yes No Unsure
Your A/R Number
Invoices?	Yes No Unsure
Invoice Number(s) (comma separated)
A legal description of the property?	Yes No Unsure
A payment bond copy?	Yes No Unsure
Payment Bond Number
A commencement notice?	Yes No Unsure
A completion notice?	Yes No Unsure
Statutory notices sent by your company?	Yes No Unsure
A joint check agreement?	Yes No Unsure
A personal guaranty?	Yes No Unsure

Material Type		*
Description of Materials and Services*
Rental Equipment?		Yes No Unsure
Claim Amount	*	First Furnishing Date	* Estimate
Total Contract Amt	*	Last Furnishing Date	* Estimate

Your Information

How to determine: is a project Public, Private or Federal?

Which Notice should I use?

Documentation Check List

Material and Labor Information

Project Information

Owner Information

General/Prime Contractor Information

Subcontractor Information

Subsubcontractor Information

Subsubsubcontractor Information

Lender Information

Architect Information

Bonding Company Information

Bonding Company 2 Information

DISCLAIMER OF LIABILITY

AUTHORIZATION