Adjudication Application Form

Important

Please make sure you have served the Notice of Adjudication on the other party/parties before completing this application form.

Unless the parties have agreed to the Building Disputes Tribunal making the appointment of an adjudicator, you must make this application for appointment within two to five working days of service of the Notice of Adjudication.

This is a statutory requirement. If the parties have agreed to the Building Disputes Tribunal making the appointment of an adjudicator, you may proceed to complete this application at any time.
What remedy are you seeking?
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Claimed amount:
Enter claimed amount (excluding interest)
Claimed amount is required
Claimed amount is required
How many issues are in dispute?
"Issue in dispute" refers to each of the matters or items upon which there is a disagreement and for which you intend to submit supporting evidence. An issue in dispute could be an unpaid invoice or a specific defect in a building project, among others.
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Field is required!
Would you like to proceed under the fixed fee scheme?
You are eligible to apply for our fixed fee scheme for Low Value Claims (LVC). This scheme is suitable for claims of low complexity with no onsite inspection or conference of the parties. The volume of supporting evidence is limited according to the corresponding LVC bracket.

Excluding the notice of adjudication, the construction contract, and the Claim, you are entitled to submit up to

- 15 single sided A4 pages for LVC5
- 15 single sided A4 pages for LVC10
- 20 single sided A4 pages for LVC20
- 30 single sided A4 pages for LVC30
- 40 single sided A4 pages for LVC40
- 50 single sided A4 pages for LVC50

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Field is required!
Security payable (fixed fee scheme) LVC5:
$0.00
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Field is required!
Security payable (fixed fee scheme) LVC10:
$0.00
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Field is required!
Security payable (fixed fee scheme) LVC20:
$0.00
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Field is required!
Security payable (fixed fee scheme) LVC30:
$0.00
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Field is required!
Security payable (fixed fee scheme) LVC40:
$0.00
Field is required!
Field is required!
Security payable (fixed fee scheme) LVC50:
$0.00
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Field is required!
Security payable (general claim scheme):
$0.00
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Field is required!
Security payable (general claim scheme):
$0.00
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Field is required!
Security payable (general claim scheme):
$0.00
Field is required!
Field is required!
Security payable (general claim scheme):
$0.00
Field is required!
Field is required!
Security payable (general claim scheme):
$0.00
Field is required!
Field is required!
Security payable (general claim scheme):
$0.00
Field is required!
Field is required!
Security payable (general claim scheme):
$0.00
Field is required!
Field is required!

Key Dates

When was the construction contract entered into?
Please enter date "day - month - year".
day - month - year
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Field is required!
Have you served a notice of adjudication on the other party or parties to the construction contract (and where appropriate for the purpose of the adjudication, on the owner of the construction site)?
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Field is required!
IMPORTANT: You must serve a notice of adjudication on all other parties to the construction contract (and the owner where appropriate) before proceeding to apply for the appointment of an adjudicator. We cannot process your application until this has been completed. Please see link on this page to download a template notice of adjudication.

You may then proceed to make your application two to five working days after service of the notice of adjudication.*

*for disputes arising under construction contracts entered into before 1 December 2015, you may make your application immediately (but within five working days).
When was the notice of adjudication served?
Please note if your contract was entered after 1 December 2015, this application for the appointment of an adjudicator must be made between the second and fifth working day after service of the Notice of Adjudication.
Select a date
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Notice of Adjudication
Please upload a copy of your notice of adjudication.
Upload your notice of adjudication...
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Claimant

Who is the claimant?
Please choose from the below options.
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Field is required!
Claimant's full legal name
Insert Full Legal Name of Claimant
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Field is required!
Is the Claimant represented?
For the purpose of serving and receiving notices during the adjudication process, please indicate if the claimant is self represented. If not, we will require you to provide the contact details of the person who is representing the claimant for the purpose of this adjudication.

If the Claimant is a company, please select "Represented by a person authorised to act on the claimant's behalf).
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Field is required!
Claimant's first name
First Name
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Field is required!
Claimant's Surname
Surname
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Field is required!
Claimant's phone number
Enter phone number
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Field is required!
Claimant's address for service
Enter the address for service of notices (CCA, s28(2)(g) and s80).
Enter Claimant's address for service
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Field is required!
Claimant's email address
Please note: If all the parties have agreed to communicate by email in relation to your construction contract or this dispute, notices will be issued by email only. Please note that consent may be inferred from a person's conduct (see CCA, Regulations 9 and 10).
Claimant's Email Address
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Field is required!
Claimant's representative - First name:
First Name
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Field is required!
Surname of Claimant's representative
Surname
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Field is required!
Phone number of Claimant's representative
Enter phone number
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Field is required!
Address for service of Claimant's representative
Enter the address for service of notices (CCA, s28(2)(g) and s80).
Enter Claimant's address for service
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Field is required!
Email address of Claimant's representative
Please note: If all the parties have agreed to communicate by email in relation to your construction contract or this dispute, notices will be issued by email only. Please note that consent may be inferred from a person's conduct (see CCA, Regulations 9 and 10).
Claimant's Email Address
Field is required!
Field is required!
If someone else needs to receive communications on behalf of the claimant, please enter email address/es here
Enter Email Address
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Respondent

Who is the Respondent?
Please choose from the below options.
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Respondent's Full Legal Name
XYZ Limited
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Field is required!
Respondent's Legal Name
Mary Jane Doe & John Doe
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Respondent's Legal Name
John Doe, Mary Smith, Mary Doe as trustees of The XYZ Family Trust
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Field is required!
Is the respondent represented?
For the purpose of serving notices during the adjudication process, please indicate if the respondent is self represented. If not, we will require you to provide the contact details of the person who is representing the respondent. If not sure, please enter the respondent's details.

If the Respondent is a company, please select "Represented by a person authorised to act on the respondent's behalf).
Field is required!
Field is required!
Respondent's first name
First Name
Field is required!
Field is required!
Respondent's surname
Surname
Field is required!
Field is required!
Respondent's phone number
Phone Number
Field is required!
Field is required!
Respondent's address for service
Enter the address for service of notices (CCA, s28(2)(g) and s80).
Enter Respondent's address for service
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Field is required!
Respondent's email address
Please note: If all the parties have agreed to communicate by email in relation to your construction contract or this dispute, notices will be issued by email only. Please enter the respondent's email address below if you can confirm that the respondent has consented to receiving and sending information concerning your construction contract by email. Please note that consent may be inferred from a person's conduct (see CCA, Regulations 9 and 10).
Respondent's Email Address
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Field is required!
First name of Respondent's representative
First Name
Field is required!
Field is required!
Surname of Respondent's representative
Surname
Field is required!
Field is required!
Phone number of Respondent's representative
Phone Number
Field is required!
Field is required!
Address for service of Respondent's representative
Enter the address for service of notices (CCA, s28(2)(g) and s80).
Enter address for service
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Field is required!
Email address of the Respondent's representative
Please note: If all the parties have agreed to communicate by email in relation to your construction contract or this dispute, notices will be issued by email only. Please enter the respondent's email address below if you can confirm that the respondent has consented to receiving and sending information concerning your construction contract by email. Please note that consent may be inferred from a person's conduct (see CCA, Regulations 9 and 10).
Email Address
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Field is required!
If someone else needs to receive communications on behalf of the Respondent, please enter email address/es here
Other Email Address for Respondent
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Field is required!
Other details for Respondent:
Use this field if there is any information related to the Respondent's details that you could not enter above.
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Field is required!
If you need to add another Respondent, please click on the Plus sign on the right-hand corner below.

The Owner

Are you including the owner of the construction site in your claim under section 30 of the CCA?
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Field is required!
Owner's full legal name:
Provide the name and address of the Owner of the construction site if, under section 30 of the Act, a determination that the Owner is jointly and severally liable with the respondent to pay the claimed amount and approval for the issue of a charging order in respect of the construction site is sought under section 50 of the Act.
Insert Full Legal Name of Owner
Field is required!
Field is required!
Is the owner represented?
For the purpose of serving notices during the adjudication process, please indicate if the owner is self represented. If not, we will require you to provide the contact details of the person who is representing the owner. If not sure, please enter the owner's details.
Field is required!
Field is required!
Owner's first name
First Name
Field is required!
Field is required!
Owner's surname
Surname
Field is required!
Field is required!
Owner's address for service
Enter the address for service of notices (CCA, s28(2)(g) and s80).
Enter Owner's address for service
Field is required!
Field is required!
Owner's phone number
Enter Owner's phone number
Field is required!
Field is required!
Owner's email address
Please note: If all the parties have agreed to communicate by email in relation to your construction contract or this dispute, notices will be issued by email only. Please enter the owner's email address below if you can confirm that the owner has consented to receiving and sending information concerning your construction contract by email. Please note that consent may be inferred from a person's conduct (see CCA Regulation 9 and 10).
Owner's Email Address
Field is required!
Field is required!
First name of Owner's representative
First Name
Field is required!
Field is required!
Surname of Owner's representative
Surname
Field is required!
Field is required!
Address for service of Owner's representative
Enter the address for service of notices (CCA, s28(2)(g) and s80).
Enter address for service
Field is required!
Field is required!
Email address of Owner's representative
Please note: If all the parties have agreed to communicate by email in relation to your construction contract or this dispute, notices will be issued by email only. Please enter the owner's email address below if you can confirm that the owner has consented to receiving and sending information concerning your construction contract by email. Please note that consent may be inferred from a person's conduct (see CCA Regulation 9 and 10).
Email Address
Field is required!
Field is required!
If someone else needs to receive communications on behalf of the Owner, please enter email address/es here
Owner's Email Address
Field is required!
Field is required!
Note about contact details for Owner:
Use this field if there is any information you could not enter above.
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Field is required!

Nature of Claim

On what basis are you bringing your claim?
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Brief description of the dispute:
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Charging order (over land owned by respondent)
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?
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Field is required!
Charging order (over land owned by an associate of the respondent)
Does the claimant seek the adjudicator's approval under section 30(b) of the Act for the issue of a charging order in respect of the construction site owned by an associate of the respondent (the Owner)?
Field is required!
Field is required!
Please note that you will be required to provide a current copy of the Certificate of Title/Search Copy of the Computer Freehold Register Under Land Transfer Act 1952 for the construction site over which approval for the issue of a charging order is sought.


Is a site inspection likely to be requested?
Please advise whether the claimant is likely to request the Adjudicator to carry out an inspection of any construction work or any other thing to which the dispute relates (Please note that any inspection will be carried out at the sole discretion of the Adjudicator)
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Field is required!
Please note
Site inspections are extremely rare for adjudication proceedings, please explain why, in your view, this case might require an inspection.
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Field is required!
If your claim is proceeding under our fixed fee low value claim scheme there will be an additional fee of $750.00 for any site visit.

Site location
Please include address and city
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The Adjudicator

Do you have any preference as to the area of expertise of the adjudicator to be appointed?
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Adjudicator's expertise required
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Have the parties reached an agreement on the adjudicator to be appointed?
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Name of adjudicator agreed by parties
Adjudicator's name
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Upload the agreement here
You can include a signed document or the email exchange containing express agreement on the adjudicator to be appointed.
Upload your documents...
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I confirm that the information I have supplied is true and correct to the best of my knowledge and that I have read and accepted the terms and conditions of the Building Disputes Tribunal.
To submit this application you are required to confirm that the information you have supplied is true and correct to the best of your knowledge and that you have read and accepted the terms and conditions of the Building Disputes Tribunal.
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When you click "Submit", you will access the payment instructions for the payable security fee.
Total Security Fee Required: $0.00
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Submit