Cash Flow Managament - Customer Setup

Use this form to register your company to use the CFM Lien Services.

Please fill out the form completely to begin using our web-based lien services. By filling out this form, you will be registered with Cash Flow Management to submit requests for preliens and mechanics liens on an as-needed basis. Registration indicates agreement with the pricing shown below.

Please email or call if you have any questions 651-430-9999 or 888-651-2802. Our Customer Service Agreement, Prelien Order Sheet, and Mechanical Lien Order Sheet are also available in a PDF file.

PROGRAM PRICING

Description	Per Unit Fee
Preliminary Notices and Notices of Intent (Minnesota and Wisconsin)	$24.00
Additional Notices on the same Project (Minnesota and Wisconsin)	$14.00
Mechanic’s Liens (Minnesota)	$140.00
Satisfaction of Mechanic’s Liens (Minnesota and Wisconsin)	$20.00

Preliminary Notices and Notices of Intent (All Other States*)	$27.00
Additional Notices on the same Project (All Other States*)	$17.00
Mechanic’s Liens (All Other States*)	$140.00
Satisfaction of Mechanic’s Liens (All Other States*)	$20.00

* Subject to change prior to beginning service.

PLEASE FILL OUT THIS FORM COMPLETELY

Setup Information (Fields with an asterisk * are required)
First, & Last Name*	(person Authorized to sign lien waivers)
Title*
Company*
Street Address*

City*
State/Province*
ZIP/Postal Code*
Phone*	Fax
Cell Phone
E-mail *
Is Your Company:	a Corporation a Partnership a Sole Proprietership a Limited Liability Company
Your Company is Organized under: *
Type of work your company provides:

* I accept the following CFM Lien Service and Collection Terms and Conditions Terms and Conditions I (hereinafter "Customer") am entering into this Service Agreement with Cash Flow Management, Inc., a Minnesota Corporation (hereinafter "CFM") upon the following terms and conditions. The customer hereby appoints CFM as its attorney-in-fact and agent for the limited purposes of executing pre-lien notices, 30 day intent to lien notices, mechanic liens, claims for liens, or related lien claims and to complete the requested declarations of service for and on behalf of the customer. CFM will promptly provide a copy of each pre-lien and/or other related lien notices to the customer. The services of CFM are designed to provide accurate and timely preparation and service of pre-lien notices and preparation, service and filing related notice of lien claims. With information obtained to complete the service is deemed reliable it is gathered from public records. The accuracy of which cannot be independently confirmed by CFM. Accordingly, customer acknowledges that CFM makes no representations as to the ultimate accuracy of any information contained in the pre-lien notices or related notices of lien claims. CFM and the customer agree to hold each other, their respective officers, agents and employees harmless from any and all claims, loss, damage or injury, including special or consequential damages and attorney's fees, by, resulting from or related to information contained in the service request or the preparation, service and/or recording of pre-lien notices and/or other related notices of lien claims except to the extent such loss or damage is caused by the other's bad faith or willful misconduct. Customer acknowledges that CFM is not rendering legal, accounting or other professional advice. This agreement and the legal relations between the parties will in all respects be governed by and construed solely in accordance with the laws of the State of Minnesota. It is acknowledged and understood that the payments terms between parties is net 10 days, unless otherwise written. Commission Rates – All Accounts are Placed on a Contingent Fee Basis Only Placements Over $2,000 or with Judgments --- 25% Placements Under $2,000 --- 30% NSF checks: If Cash Flow Management Inc. is able to collect maximum civil penalties, that will be accepted as payment of commission, otherwise the above commission schedule will apply. Placements forwarded to an attorney on your behalf will be at 30%. Cash Flow Management Inc. will front all legal costs on collection accounts forwarded to an attorney. Costs to be reimbursed upon collection. CONTRACT: All accounts placed with Cash Flow Management Inc. will be justly due and accepted at the above rates. The agreed upon rate will be applied to all payments made to Cash Flow Management Inc. and payments made directly to Client. Client will furnish all proper documents to assist in the collection. Cash Flow Management Inc. is authorized to receive payments and endorse checks, money orders or notes and deposit in a trust account on Client’s behalf. Cash Flow Management Inc. is also authorized to act as attorney in fact for the Business, to commence, prosecute, defend, satisfy or settle any claim or cause of action brought by or against said Business in Conciliation Court in the States of Minnesota or Wisconsin, and to execute on behalf of the Business any and all documents and pleadings necessary to accomplish said purpose. Customer acknowledges that CFM is not rendering legal, accounting or other professional advice. This agreement and the legal relations between the parties will in all respects be governed by and construed solely in accordance with the laws of the State of Minnesota. Cash Flow Management, Inc. P.O. Box 576 Stillwater, MN 55082 PHONE 651-430-9999 FAX 651-430-1494 CFM terms and conditions.doc 8/19/2002
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