808-004-0340 Form of Claims (1) A claim must be submitted on a Statement of Claim form provided by the agency. The agency may require the use of the most recent revision of the Statement of Claim form. (2) The claimant must provide the following information with the Statement of claim, if applicable: (a) The name, address, and telephone number of the claimant; (b) The name, address, telephone number and license number of the landscaping business; (c) The amount, if known at the time the Statement of Claim is filed, that the claimant alleges is due from the landscaping business after crediting payments, offsets, and counterclaims in favor of the landscaping business to which the claimant agrees; (d) Identification of the type of claim as defined in OAR 808-002-0220; (e) The date on which the contract was entered into; (f) If the contract was in writing, a copy of the contract with attached material invoices, time sheets, or other relevant attached documents; (g) Job site address with driving directions to the job site; (h) The beginning and ending date of the work or invoices; (i) Payments, offsets, and counterclaims of the landscaping business, if known, to which the claimant does not agree; (j) A certification by the claimant that the Statement of Claim is true; (k) A copy of any court judgment or arbitration award, including the original complaint and any answers or counter-suits related to the work that is the subject of the claim; and (l) Additional information required under sections (3) through (8) of this rule. (3) A claim by a subcontractor shall include a copy of each original invoice relating to the claim. (4) An employee claim shall include copies of time cards or other evidence of the amount of compensation claimed. (5) A material supplier or equipment claim shall include a copy of each original invoice relating to the claim and a recapitulation of the indebtedness showing the job site address, the date of each invoice, each invoice number, and each invoice amount. Claimant shall include documentation that claim is a minimum of 60 days old and two attempts to collect have been made. (6) A claim involving negligent or improper work shall include a list of the alleged negligent or improper work. (7) A claim involving a breach of contract shall describe the nature of the breach of contract. (8) A construction lien claim must include evidence that the claimant paid the landscape contracting business as required in OAR 808-004-0530(1)(a), a copy of the notice of right to lien, a copy of the lien bearing the county recorder’s stamp and signature, a copy of each invoice or billing constituting the basis of the lien, a copy of the ledger sheet or other accounting of invoices from the lienor, if applicable and any foreclosure documents. (9) The Statement of Claim form must be signed by the claimant or an agent of the claimant. (10) A Statement of Claim that does not comply with the requirements of this rule is subject to OAR 808-004-0350. Statutory/Other Authority: ORS 183, 670.310 & 671.670 Statutes/Other Implemented: ORS 671.703 History: LCB 6-2007, f. 12-24-07, cert. ef. 1-1-08 LCB 4-2007, f. 12-19-07, cert. ef. 1-1-08 LCB 3-2006, f. & cert. ef. 8-2-06 LCB 5-2003, f. & cert. ef. 8-1-03 LCB 4-2002, f. & cert. ef. 12-4-02 LCB 1-2000, f. & cert. ef. 2-1-00, Renumbered from 808-004-0010 LSCB 2-1997, f. & cert. ef. 11-3-97 Renumbered from 808-010-0040, LCB 1-1988, f. 1-26-88, cert. ef. 2-1-88 LC 1-1984, f. & ef. 7-17-84 LC 1-1981, f. & ef. 10-8-81 LC 3, f. & ef. 2-7-77