Notice of Back Charge (Fowler Homes) V31314

• Back-charge to:

• Site Address

• Job No.

• Date of Notice

  Date

• Prepared by

Back-charge Number issued from supplier

• Insert Back Charge Number (if applicable)

  Yes

  No

  N/A

Back charge incurred as a result of

• Describe reason for back charge

• Insert any photographs that may be applicable

  Media

Corrective action

• Contractor to rectify?(insert business name and contact)

  Yes

  No

  N/A

• Contractor to supply and fix?

  Yes

  No

  N/A

• Are Materials required as part of this report?

  Yes

  No

  N/A

• Please state materials and cost if known

• Back Charge Amount (if known, if not please state as per agreed rates)

  Yes

  No

  N/A

• Sign off (note you must send this report to contractor to rectify and contractor/supplier that back charge is issued to)

  Sign

• Back Charge amounts are considered a debt due and payable to Fowler Homes Pty Ltd. If you would like to contest this notice you may do so in writing to issuing Manager