Breach of Contract Complaint Form
for Primary Contractors
(Residential & Small Commercial)
Before filling out a complaint, you may want to read “Resolving Disputes With Your Contractor.”
https://www.oregon.gov/CCB/Documents/pdf/resolvingdisputeswithyourcontractor.pdf
You may also want to view the license of the contractor you are filing against and verify that they hold an
endorsement. You can do this at www.oregon.gov/CCB
If you are filing against a residential contractor, you must first send the contractor written notice (pre-
complaint) by certified mail that you plan to file a complaint. We cannot accept your complaint until 30 days
after you have mailed this notice. The law requires only that the notice be mailed, not that the contractor
receive it. You can use the CCB notice at: https://www.ccb.state.or.us/PreClaim/preclaim_notice.htm
The pre-complaint notice you send to the contractor must have all of the following information in it.
1. Date
2. Contractor’s Name
3. Contractor’s Address - This must be the address shown in the CCB licensing record. You can get this from our
website at www.oregon.gov/CCB
or by calling us at 503-378-4621.
4. Your letter must state that you intend or plan to file a complaint with the CCB.
5. Your name must be on the letter.
You will need certain required documents for your complaint.
• A Completed Breach of Contract Complaint form.
• A copy of the pre-complaint notice sent to the contractor.
• A copy of the post office receipt showing that you sent the notice by certified mail.
• All documentation showing a contractual relationship. (example: copy of the contract, invoices,
estimates, front & back copy of checks, etc.)
We can process your complaint more quickly if you:
• Use only 8 ½ by 11 size paper. Small items should be taped to blank paper. No staples.
• Send legible copies, not originals and if handwritten, use a black ink pen (not pencil).
• Use white or light paper – other colors do not copy well and do not highlight portions of documents.
• Do not submit documents in binders, notebooks, flash drives, or compact discs.
• Do not submit photographs.
• Your complaint must be received by the CCB on work involving a new structure:
o Within 14 months from the date the structure was first occupied or two years after
substantial completion of the structure, whichever is earlier.
• Your complaint must be received by the CCB on work involving an existing structure:
o Within 14 months from the date the contractor substantially completed the work.
Submit your complaint by e-mail at disputes@ccb.oregon.gov or by regular mail to CCB, Attn: Dispute
Resolution, PO Box 14140, Salem, OR 97309-5052. If sending by regular mail, please send the
complaint at least two weeks before the deadline to ensure timely receipt.
If you need any assistance, either e-mail us at disputes@ccb.oregon.gov or call us at 503-934-2247.
RETURN ALL PAGES TO CONSTRUCTION CONTRACTORS BOARD
DO NOT SEND PROCESSING FEE WITH THIS FORM
THIS SECTION FOR OFFICE USE ONLY
File Number
License Dates:
90 Day Period License Type Complaint Type
2. Complaint Against
Name:
Company: CCB #:
Mailing Address:
State: Zip Code: County: City: State: Zip Code:
Work Phone: Home Phone: Cell Phone: Phone Numbers with Area Codes:
Email Address:
Are you a licensed contractor? If Yes: CCB License #:
5. Nature of Complaint
State: Zip Code: County:
6. Other Filings
(Check only the boxes that apply)
Another CCB complaint has been filed regarding this property.
CCB File No.(s):
Oral (Submit checks & invoices to verify contractual relationship)
This issue has been submitted to a court or arbitration for
Written (Complete copy of contract must be attached)
determination or resolution, and the details are attached.
7. If you are an Owner: Did the contractor give you the
following Notices?
Info Notice About Const.Liens?
Yes No
Consumer P
rotection Notice?
Notice of Pro
cedure?
Yes No
Yes No
8. Employees
Were there employees of the contractor on the job during
construction?
Yes No
9. Corrections
Yes No
Yes No
Residential
Small Commercial
You MUST include a copy of the notice and proof of certified mailing. Date Mailed:
OFFICE DATE STAMP
Business Name(if Applicable):
Salem, OR 97309-5052
1. Person Making Complaint
BREACH OF CONTRACT COMPLAINT
Primary Contractor
Construction Contractors Board
PO Box 14140
Name:
Has the work been corrected at this time?
Have you hired another contractor to correct
the work?
Email Address:
Street:
$
City:
$
Date Work Started:
Date Contractor Ceased Work:
11. Pre-Complaint Notice
Date of Actual Occupancy:
Date Structure Completed:
What work was to be performed under the contract?
(Example: build
house; install a roof)
10. Structure Type
For New Home Construction Only
Complaint by Owner Construction Lien Filed
Complaint by Primary Contractor against Subcontractor
NOTE: DO NOT USE THIS FORM if you are a subcontractor,
material/equipment supplier or an employee.
Mailing Address:
City:
Yes No
4. Contract
3. Job Site Address
Contract Date:
Total Contract Amount:
Total Paid to Contractor:
RETURN ALL PAGES TO CONSTRUCTION CONTRACTORS BOARD
DO NOT SEND PROCESSING FEE WITH THIS FORM
BREACH OF CONTRACT COMPLAINT
Owner or Primary Contractor Page 2
No. Estimated Cost
1 $50.00
2 $200.00
Date: Signature:
File Number:
12. Complaint Items
13. Certification:
I certify that this complaint form with all attachments are true, complete, and correct to the best of my knowledge and belief.
Note: Please attach pages if you need additional space to list your complaint items.
Briefly List by number, items of improper or negligent work or breaches of contract
Example:
Bubbling Paint
Roof Leaking
NOTE: You MUST sign this document in order for your complaint to be processed.