HomeMy WebLinkAboutWork Authorization FormAUTHORIZATION FOR REPAIRS AND PAYMENT
Property Owner J~ \J.QJ--d ~
Property Address r l..<, ' (' l u ~~
City Ctl1du1oQQ_ V Stated Zip 93211)5
Phone(H)(%BJJ155-D7DLQ (C) 19:Cf3) jtJ/...o ~ {)q'>-5]
Email Address: ~ d~1j.1f1Wei ,aG.9 • ma.i..J.,.. ~
Insurance Company ______________ Deductible ________ _
Adjuster ________________ Phone ____________ _
Policy # Claim # _________ _
The undersigned ~ V -t..vtX.,.--l.-\t . , hereinafter referred to as
Owner, authorizes ServiceMaster Clean Fire & Water Cleanup by: CPR, hereinafter referred
to as ServiceMaster, to proceed with reconsirucuon sentn's required to restore the above
listed property from damage caused by~--~. \i? w"'---on _____ _
VJ"'\<-,.~
Owner understands that the totaJ cost of repairs shall be payable upon completion of work and
hereby authorizes and instructs that direct payment be made to ServiceMaster. Owner
understands that he/she is liable for payment of any deductible and for any and all charges not
covered by Owner's insurance company. ()•.-.. 11.::-1,n,kr~Li::.J,. itJn ,-,tirnatt .~ hui!r and 0 ,111ci
Owner further understands that emergency services are necessary steps taken to prevent
additional damage to the building and/or contents and that restoration services may include
cleaning, drying, repair, resurfacing, refinishing and/or replacement of building materials and
contents. Servicel\!Iaster agrees to perform emergency services and restoration services in a
workmanlike manner using reasonable care to restore the property and contents as nearly as
possible to their pre-loss condition_ With respect to items that need to be restored at a remote
location, ServiceMaster is hereby authorized to move those items. ServiceMaster will prepare
an inventory of items removed from the property and Owner will be given an opportunity to
accept the inventory count and description before items are transferred.
Owner agrees that if any invoice for services shall not be paid when due, the balance due shali
bear interest of 18% per annum. The makers, endorsers, guarantors or sureties hereby jointly
.,,. a,nd severally agree to pay all costs of collection including reasonable attorney's fees. Unless
otherwise prohibited by state law, if any unpaid balance is referred to an attorney for collection,
Owner authorizes any attorney of record to confess judgment to be entered by any Court that
may have jurisdiction, at any time after default in payment shall occur and hereby waives all
exceptions to the extent permitted by law.
Date /J. /; {Jj &.'-I I I Time of Crew Arrival /D; / q Ill k".L-
Property Owner_,.,_,,__,_,,,_....____,,_,.""-4._.....,.._'-Sl'""'!'--~----,,-::::\----++--------------
ServiceMaster Representative ---,,<¼-"-.....c.;=t--,¥'----"---==:::;__------------
Form 1
GENERAL CONTRACTOR RESIDENTIAL PROPERTY DISCLOSURE
'?,-4-vw,. V'A."'-5>:W-V \?<, &h,v«-b"1 Y'.~ ("General Contractor") provides to
<lN.k-v~,:;,(i.vy... ("Property O\vner(s) or Purchaser(s)") this disclosure
slalement as required under Idaho Code § 45-525.
In connection with a contract to construct, alter or repair improvements on residential
property or a contract to sell newly constructed residential property, general contractors are
required to advise homeowners or residentiai property purchasers of their rights under Tdaho
Code § 45-525:
1. The right, at the reasonable expense of the homeowner or
residential real property purchaser, to require that the
gctu:ral t:ontractur obtain lien waivers from any
subcontractors providing services or materia1s lo the
gem:ral conlraclor;
2. The right to receive from the general contractor proof that
the general contractor has a general liability insurance
policy including completed operations in effect and proof
that the general contractor has worker's compensation
insurance for his employees as required by Idaho law;
3. The right and opportunity to purchase an extended policy
of title insurance from a title insurance company which
would provide insurance coverage covering certain liens
which may be untiled or unrecorded; and
4. The right to require at the homeowner or residential real
property purchaser's expense, a surety bond in an amount
up to the value of the construction project.
Acknowledgement
~~ \J~cl-u,,,...c_ the homeowner(s) or residential real property purchaser(s), hereby
acknowledgc(s) receipt of a copy of this General Contractor Residential Property Disclosure.
DATED this~ day of
Signed
GE~ERAL CONTRACTOR RESIDl::NTIAL PROPERl'V DISCLOSURE -I