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fi. ,. MODEL DISCLOSURE STATEMENT <br /> NOTICE TO CUSTOMER <br /> This contractor is registered with the state of Washington, registration no. 247FLFF850MN, and <br /> has posted with the state a bond or deposit of$12,000.00 for the purpose of satisfying <br /> claims against the contractor for breach of contract including negligent or improper work in the conduct <br /> of the contractor's business. The contractor's registration is ongoing. <br /> THIS BOND OR DEPOSIT MIGHT NOT BE SUFFICIENT TO COVER A CLAIM THAT MIGHT <br /> ARISE FROM THE WORK DONE UNDER YOUR CONTRACT. <br /> This bond or deposit is not for your exclusive use because it covers all work performed by this contractor. <br /> The bond or deposit is intended to pay valid claims up to $12,000.00 that you and other customers, <br /> suppliers, subcontractors, or taxing authorities may have. <br /> FOR GREATER PROTECTION YOU MAY WITHHOLD A PERCENTAGE OF YOUR <br /> CONTRACT. <br /> You may withhold a contractually defined percentage of your construction contract as retainage for a <br /> stated period of time to provide protection to you and help insure that your project will be completed as <br /> required by your contract. <br /> YOUR PROPERTY MAY BE LIENED. <br /> If a supplier of materials used in your construction project or an employee or subcontractor of your <br /> contractor or subcontractors is not paid, your property may be liened to force payment and you could pay <br /> twice for the same work. <br /> FOR ADDITIONAL PROTECTION YOU MAY REQUEST THE CONTRACTOR TO PROVIDE <br /> YOU WITH ORIGINAL "LIEN RELEASE" DOCUMENTS FROM EACH SUPPLIER OR <br /> SUBCONTRACTOR AT YOUR PROJECT. <br /> The contractor is required to provide you with further information about lien release documents if you <br /> request it. General information is also available from the state Department of Labor and Industries. <br /> I have received a copy of this disclosure statement. <br /> Dated this day of of the year <br /> For signature &date see work authorization on the other side of this page <br /> Client signature <br /> The contractor must retain a signed copy of the disclosure statement in his or her files for a minimum of <br /> three years, and produce a signed or electronic signature copy of the disclosure statement to the <br /> department upon request. <br /> ,o3 <br />