Adjudication Application

Adjudication Application
Please complete all details of this application where applicable
Application scheme Fixed fee Non-fixed fee
Please refer to the relevant terms and conditions for each application scheme prior to making an application. The full
details for each scheme are included as an appendix to this adjudication application and are available from our website
(www.abcdrs.com.au)
Please complete all applicable details below and take care particularly in regard to the business details of the respondent
and the contract. All details must be correctly completed.
Claimant details
Name of business
(and trading name if applicable)
DIRT DIGGLER PTY LTD
Business address
(number, street, suburb,
state and postcode)
CANBERA CITY
Postal address 50 Marcus Clarke St
Phone number
Fax number
Email address
Contact person
Claimant type
(please select one)
Pty Ltd company Limited company Partnership
Sole trader Trust Incorporated
association
Claimant business type
(please select one)
Trade contractor/
subcontractor
General/main/
head contractor Project manager
Consultant Supplier Surveyor
Designer Developer/client
Other [describe]
Claimant trade (i.e. building,
tiling, development etc) tiling
ABN / ACN
(provide both if applicable) 10 987 654 321 ACN:

Respondent details
Name of business
(and trading name if applicable) Crook Constructions Pty Ltd
Business address
(number, street, suburb,
state and postcode)
NSW
Postal address 100 Iron Knob Street
Phone number
Fax number
Email address
Contact person
Respondent type
(please select one)
Pty Ltd company Limited company Partnership
Sole trader Trust Incorporated
association
Respondent business type
(please select one)
Trade contractor/
subcontractor
General/main/
head contractor Project manager
Consultant Supplier Surveyor
Designer Developer/client Other [describe]
Respondent trade
(i.e. building, tiling,
development etc)
ABN / ACN
(provide both if applicable) 12 345 678 910 ACN: