Write the day, month and year of completion of the form.
Print the subcontractor’s name following the word subcontractor.
Print the name and address of the business hiring the subcontractor in the Owner fields.
Print the lender name and address, if applicable in the Lender fields.
Print the name of the contractor in the Prime Contractor blank.
Complete the sum of blank with the monetary amount the contractor will pay the subcontractor for successful completion.
Under Description of Work write a description of the labor or work to be completed. Also describe the materials and equipment furnished.
Under Other Special Provisions write any stipulations or caveats.
Under Schedule of Payments write when payments will be made and the amounts.
Under Time and Scheduling Work write the date work commences and the date work ends. Also, complete the interest rate used for any unpaid or late payments.
In the In Witness Hereof section, print the subcontractor in the Subcontractor Name blank.
Print the subcontractor’s license number in the License No. blank.
Print the name and address of the subcontractor in the Subcontractor fields.
Print the name and address of the contractor in the Contractor fields.
Print the contractor’s license number in the License No. blank.
The subcontractor and contractor sign and date the document.