Please complete this detailed intake form to submit a formal subcontractor dispute, payment delay claim, change order discrepancy, or backcharge contestation. Providing complete information and attaching required supporting documentation allows our project management, legal, and commercial auditing teams to thoroughly investigate your contract, audit project logs, and resolve payment or performance disputes efficiently.
Subcontractor Company Name
State Contractor License Number
Primary Contact Name & Title
Direct Phone Number
Primary Email Address
General Contractor (GC) Name
Project Name & Job Number
Physical Jobsite Address
City
State / Province
Postal / Zip Code
1. Trade / Scope of Work Performed
Structural (Concrete, Steel, Framing, Masonry)
MEP (Mechanical, Electrical, Plumbing, Fire Protection)
Exterior / Enclosure (Roofing, Glazing, Waterproofing, Facade)
Interior Finishes (Drywall, Painting, Flooring, Millwork)
Civil / Site Work (Earthwork, Utilities, Paving, Landscaping)
Special Systems / Telecommunications
Other:
2. Subcontract Financial Overview
Original Subcontract Value
Total Approved Change Orders to Date
Current Adjusted Subcontract Total
Total Value of Work Completed & Billed to Date
Total Payments Received to Date
Retainage Withheld Amount (if applicable)
3. Disputed Financial Scope
Total Disputed Amount in Contention
Uncontested Balance Outstanding
Current Pay Application / Payment Period Number in Dispute
Primary Reason for Submission (Select all that apply)
Payment Delay / Non-Payment: Unreasonable delay in processing pay applications or failure to disburse funds beyond contractual pay-when-paid / pay-if-paid terms.
Unapproved Change Order / Extra Work: Performed extra work directed by GC field staff without a formal, fully executed written change order.
Unjustified Backcharge / Deduct: GC assessed improper charges for site clean-up, equipment usage, or alleged damages without proper notice.
Schedule Impact / Delay & Acceleration: Forced to accelerate work, work overtime, or suffer project delays caused by preceding trade interference or GC mismanagement.
Disputed Quality / Workmanship Defect: Claims of defective work or punch list items resulting in withheld payment despite corrective action.
Retainage Release Dispute: Failure to release retainage following substantial completion or prime contract closeout.
Other:
Statement of Dispute & Timeline
Please describe the specific project facts, directive dates, communications with the General Contractor, field conditions, or reasons why this payment or backcharge is disputed:
1. Was formal written notice of this delay, extra work, or dispute issued to the GC within the subcontractually required timeframe?
Yes
No
Verbal Notice Only
Pending / N/A
2. Communication & Notice History Log (If applicable, complete the table below)
GC Response Status: 1 = Approved, 2 = Denied, 3 = Response Received / Under Review
Notice / Letter Type | Date Sent / Received | Issued To (Name & Title) | Reference # / RFI # | GC Response Status | |
|---|---|---|---|---|---|
To ensure an expedited commercial audit, please attach all relevant project documentation. Incomplete submissions may delay resolution.
Executed Subcontract Agreement (including all exhibit attachments and general conditions)
Disputed Pay Application(s) & Schedule of Values (SOV) (showing billed percentages and line-item breakdowns)
Original Approved vs. Current Proposed Change Orders (Copies of proposed change requests, field directives, and cost backups)
Written Notices of Dispute / Delay (Formal correspondence sent to the General Contractor pursuant to contract notice provisions)
Daily Construction Reports & Timesheets (Field logs documenting manpower, equipment, and impacted work areas)
Requests for Information (RFIs) & Architect Responses (RFIs demonstrating design delays or clarification requests)
Lien Waivers / Release Documentation (Copies of conditional or unconditional lien waivers associated with past pay apps)
By signing below, the subcontractor representative acknowledges and agrees to the following terms:
Authorized Subcontractor Representative Signature
Phase 1: Subcontract & Notice Compliance Audit
Intake Verification: Received complete form, verified contract execution, and confirmed required documentation attachments.
Timely Notice Check: Cross-referenced formal dispute notice date against contractual notice window clause (e.g., 7-day or 10-day clause).
Pay Application & Lien Waiver Check: Verified past progress payments and matched lien waiver status against accounting records.
Phase 2: Technical, Schedule & Field Audit
Superintendent Daily Log Audit: Cross-referenced claimed manpower and extra work hours against GC superintendent daily field logs.
CPM Schedule & Delay Analysis: Evaluated critical path schedule to verify if delay was caused by subcontractor, GC, preceding trade, or owner.
Architect / Owner Verification: Confirmed whether disputed extra work was approved or paid by the project owner under the prime contract.
Phase 3: Resolution & Commercial Determination
1. Audit Determination
Claim Approved in Full: Change order authorized or delayed progress payment approved for immediate disbursement.
Partial Approval / Compromise Settlement: Partial entitlement verified; negotiated settlement figure agreed upon.
Backcharge Confirmed: GC backcharge verified as contractually compliant; deduction enforced against subcontractor ledger.
Claim Denied: Failure to provide required contractual notice, lack of supporting field logs, or unapproved scope deviation.
2. Financial Adjustment & Action Plan
Change Order Executed (Added to subcontract total)
Payment Released
Formal Dispute Resolution Notice Issued: Written determination letter sent to subcontractor.
Auditor Notes & Summary
Lead AP Auditor Signature
Form Template Insights
Please remove this form template insights section before publishing.
This form functions as a binding, structured intake tool for trade contractors and a rigorous commercial audit roadmap for GC project managers, commercial directors, and legal counsel. Every section is engineered to eliminate ambiguity, preserve legal rights, and enforce contractual compliance.
Why it’s needed: Establishes legal corporate identity, licensing validity, and jobsite jurisdiction.
Why it’s needed: Reconciles the macro contract balance and isolates the exact financial variance in dispute.
Why it’s needed: Categorizes the dispute into an immediate legal and operational workflow.
Why it’s needed: Captures qualitative field facts that financial ledgers cannot convey.
Why it’s needed: Enforces strict contractual "Time-Bar" provisions.
Why it’s needed: Converts subjective claims into verifiable, auditable facts.
Why it’s needed: Protects legal rights and enforces project continuity.
Why it’s needed: Provides an auditable paper trail for project owners, lenders, and surety bond companies.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation section before publishing.
Here are the critical required questions for this template and the exact operational, legal, and commercial reasons why organizations must make them mandatory:
1. Subcontractor & License Details
2. Project & General Contractor Identifiers
3. Scope of Work & Trade Classification
4. Financial Discrepancy Breakdown
5. Dispute Classification & Primary Cause
6. Contractual Notice History
7. Mandatory Document Checklist Attachments
8. Legal Attestation & Authorized Signature