Application

Dispute Resolver Nomination Application

Name of Claimant
Contact person
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Tel Number
Fax Number
Email *

Name of Respondent
Contact person
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Tel Number
Fax Number
Email

Name of Respondent
Contact person
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Tel Number
Fax Number
Email
Third Party type

Project Name
Project Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Project Type
Form of Contract

Date notice was served
Has there been any other adjudications between the parties on this project?
YesNo
If yes, provide details

If Adjudication
Does the claimant seek the adjudicator's approval under section 29 of the Act for the issue of a charging order in respect of a construction site owned by the respondent?YesNo
Does the claimant seek a determination under section 30(a) of the Act of the owner's liability to make payment to the claimant and approval under section 30(b) of the Act for the issue of a charging order in respect of the construction site owned by that owner?YesNo

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Phone:
+64 (0)21 0845 1837
Email:
resolution@constructiondrb.com
Address:
Auckland 1010
New Zealand

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