Lien Against Excess Medical Payments

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Customer agrees that the liability of Dar-Liens, Inc., its agents and employees, in connection with services hereunder to the Customer and to all persons having contractual relationships with them, resulting from any acts, errors and/ or omissions, whether negligent or otherwise, of Dar-Liens, Inc., its agents and/or employees is limited to the total fees actually paid by the Customer to Dar-Liens, Inc., for those services.

Lien Against Excess Medical Payment Details

To the best of Claimant's knowledge, the names and addresses of all persons, firms or corporations and their insurance carriers, that the insured or their legal representative alleges to be liable for damages arising from the accident.

PRELIMINARY NOTICES & MECHANIC LIENS

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