G PO BOX 1722 DARWIN NT 0801 FACSIMILE 08

5 POINTS OF DARWIN’S NATURAL SELECTION READ THE FOLLOWING
ABIOTSKI IN BIOTSKI DEJAVNIKI S CHARLESOM DARWINOM V KNJIŽNICI
“CORRIGENDUM” OF THE “ADENDUM” TRÉMAUX VERSUS DARWIN (AND GOULD)

CHARLES DARWIN EL ORIGEN DE LAS ESPECIES PRÓLOGO
DARWIN ANIMAL DOCTORS GALAPAGOS ISLANDS AINOA NIETO CLAUDIN DVM
DARWIN CHARLES ROBERT (SHREWSBURY REINO UNIDO 1809DOWN ID 1882)

Application adjudication of payment dispute

GG PO BOX 1722 DARWIN NT 0801 FACSIMILE 08 PO Box 1722 Darwin NT 0801

Facsimile: 08 8999 6226

Email: [email protected]

Website: www.cjc.nt.gov.au

Application for Adjudication

For adjudication of construction contracts payment disputes under $10,000 pursuant to the Construction Contracts (Security of Payments) Act 2004 and in accordance with Part 4 of the Community Justice Centre Act 2005.


Applicant details: Respondent details:

Company name




Company name


Street address




Street address


Postal address




Postal address


Contact name




Contact name


Phone



Phone


Email



Email


Mobile



Mobile


Fax



Fax



Enter amount of claim and give brief details of the dispute:


This application is made in respect of a payment dispute in the amount of $...................

Details:

………………………………………………………………………………………………………………………………


………………………………………………………………………………………………………………………………


………………………………………………………………………………………………………………………………


………………………………………………………………………………………………………………………………

Lodgement requirements:


A lodgement fee of $500 is payable with this completed application form.

Lodge with any relevant documentation at:

Community Justice Centre, Level 1 Nichols Place Darwin Magistrates Court.


Please make cheques payable to Community Justice Centre Trust Account.


Office use only

Date received

Amount paid

Receipt no.

Contract price verified

Documentation received

Adjudicator

File number

Brief sent












G PO BOX 1722 DARWIN NT 0801 FACSIMILE 08


Department of Justice


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