Fillable Clb-consumer-complaint - Consumer Complaint Cover Sheet

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Clb-consumer-complaint - Consumer Complaint Cover Sheet

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Bowling Green – Warren County Contractors Licensing Board
1141 State St, Ste 200 – PO Box 1268 – Bowling Green, KY 42102
Phone: 270-781-3530 Fax: 270-781-3481 www.bgky.org
CONSUMER COMPLAINT INFORMATION
General Information
The Bowling Green-Warren County Contractors Licensing Board was established by the
City of Bowling Green and Warren County Fiscal Court in order to help protect the
property owner’s health, safety, and welfare by regulating construction activity. The
Board regulates construction activity according to current ordinances, and furnishes
contractors licenses to individuals, partnerships, and corporations. The Contractors
Licensing Board also provides a method for administration and enforcement of these
provisions.
The Contractors Licensing Board does not have the authority to award monetary
damages or force the contractor to make repairs. However, they may revoke or
suspend the contractor’s license through a Formal Hearing. If a hearing is warranted,
you may be asked to present testimony in conjunction with your filed complaint.
Consumer Complaint Procedures
Should your case fall into the jurisdiction of the Contractors Licensing Board, the
complaint process is as follows:
• Obtain and complete a Consumer Complaint Form.
• Return completed form to the Contractors Licensing Board located at 1141 State
Street, Suite 200, Bowling Green, Kentucky.
• Copy of the complaint will be forwarded to Contractor and he/she will be directed
to respond in writing.
• Letter of receipt will be sent to Complainant as verification that complaint is
being processed.
• The Executive Director and/or Contractors Licensing Board staff will review this
complaint. If they determine investigation is warranted, the staff will begin its
investigation within 15 days.
Complaint # _____________________
Bowling Green – Warren County Contractors Licensing Board
1141 State St, Ste 200 – PO Box 1268 – Bowling Green, KY 42102
Phone: 270-781-3530 Fax: 270-781-3481 www.bgky.org
Consumer Complaint Form
Property Owner Name:___________________________________________________
Mailing Address:_________________________________________________________
Street Address:___________________________________________________________
City, State, Zip:__________________________________________________________
Daytime Telephone Number:________________________________________________
Cellular Telephone Number:________________________________________________
Fax Number:_____________________________________________________________
Email Address:___________________________________________________________
Contractor Name:________________________________________________________
Mailing Address:__________________________________________________________
Street Address:___________________________________________________________
City, State, Zip:___________________________________________________________
Daytime Telephone Number:________________________________________________
Cellular Telephone Number:_________________________________________________
Fax Number:_____________________________________________________________
Email Address:___________________________________________________________
Location of Construction Project: __________________________________________
________________________________________________
List the individuals dealt with on Project: ____________________________________
________________________________________________
________________________________________________
For Office Use Only:
Unlicensed ______ License # ________ Date Received ___________
Complaint # _____________________
Have you contacted the contractor in reference to the complaint? Yes No
(If yes, please attach a copy of the letter that you sent to the contractor.)
What type is the construction project? New Remodeling Repair Work
Addition & Renovation Other - Please specify ______________________
Was there a written contract with the contractor on this project? Yes No
(If yes, please attach a copy of the contract)
Was there an estimated completion date on the contract? Yes No
(If yes, what was the date ____________________________________)
Was a building permit obtained for the construction project? Yes No
(If yes, who obtained the building permit? ______________________________)
Were you given a Certificate of Occupancy? Yes No
Were you given a written warranty for the work performed? Yes No
What was the total contract amount of the construction project? __________________
Did you pay any money up front? Yes No
(If yes, how much? $_______________________)
Has the contract amount been paid in full? Yes No
(If no, how much is owed on the contract? $____________)
Are any amounts in dispute (billings, payments, change orders, etc.)? Yes No
(If yes, give a complete explanation) ________________________________________
______________________________________________________________________
______________________________________________________________________
What date was the construction project contract signed? _____________________
What date was the construction project started? ____________________________
What date was the construction project completed? _________________________
Name any sub-contractors on site ________________________________________
________________________________________
Did Contractor have employees on site? Yes No
(If yes, please list names if possible) ________________________________________
________________________________________
________________________________________
________________________________________
Complaint # _____________________
Have you retained an attorney in reference to your complaint? Yes No
(If yes, please list name, address, and telephone # below)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Has Litigation been filed by you or the contractor in reference to this complaint?
Yes No If yes, has a court date been set? Yes No
If yes, what is / was the court date: ___________________
Is Litigation concluded? Yes No
(If yes, please attach a copy of the final judgment.)
Will you testify at a Hearing and/or Trial should this be necessary? Yes No
Please Describe the Nature of Your Complaint: ________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Give a complete statement of the facts. You may add additional pages in necessary. Please attach
copies of any pertinent information, documents or contracts. Do not send originals.
SIGNATURE: Under penalty of perjury, I/we certify that the information I/we am/are providing in this complaint is correct and
complete to the best of my/our knowledge. I/we am/are aware that should investigation show falsification, the complaint may be
considered invalid and be immediately dismissed.
___________________________________ ___________________
Signature of Complainant Date
___________________________________ ____________________
Signature of Second Complainant Date
The Executive Director and/or Contractors Licensing Board staff will review this complaint.
If they determine investigation is warranted, the staff will begin its investigation within 15
days.
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Clb-consumer-complaint - Consumer Complaint Cover Sheet

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Completed 1 November 2019

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