BUILDING MATERIAL DEALERS ASSOCIATION

General Information

* Member Name

* Member Number

* Contact Name

* Phone Number

Your email Address

* Full name and title of authorized signer on construction lien

* BMDA Notice of Right to a Lien Job Number:

Project Specifics:

* Did you use another service for your Notice?

Yes

If so, please fax or email a copy to BMDA

* Customer Name:

person/company by whom you were employed

* Job Site Address:

* Project Type:

Residential

Commercial

* Did you supply labor:

Yes

* Did you supply material:

Yes

* The date you began to perform labor, provide professional services, supply material or equipment:

* The last date on which labor was performed, professional services were furnished, material or equipment supplied:

Project Fees:

* Labor

* Materials

* Rental Equipment:

* Interest Charge Owing:

Through What Date:

Labor, material, rental equipment and interest must add up to the total

* Total

* Payments received:

* Balance owing:

Disclaimer

BMDA will scrivener liens for Oregon and Washington State only. We reserve the right to refuse any lien request and we will not scrivener blanket liens. BMDA is acting only as a scrivener to prepare a lien claim based upon your information.
The completed construction lien can only be signed by an authorized representative of our member requesting the lien.
We are not attorneys; we recommend you seek legal counsel to answer your legal questions including but not limited to evaluating your last substantial day of work.

If you have any questions, please call 503-624-0561 or e-mail.

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