HomeMy WebLinkAboutAgreement for the Installation of Elimination SystemHomdeam
THIS AGREEMENT PROVIDES FOR
RETREATMENY OF A STRUCTURE
r e a T 0110911111.
AND THE REPAIR OF DAMAGES
SAINT LUC1E COUNTY USE ONLY CAUSED BY WOOD DESTROYING
ORGANISMS WITHIN THE LIMITS
Aceoma Na:
STATED IN THIS AGREEMENT.
AGREEMENT FOR THE INSTALLATION AND MONITORING
OF THE SENTRICONG COLONY ELIMINATION SYSTEM FOR NEW CONSTRUCTION
Secdon L GENERAL INFORMATION.
Name: R.K Able X-P C W' 1C i1 .
Service address: Ct !o l y
City: Fort Pierce
State: FL Zip Code: 3 y1s I
Lmutiom 01"En stmoulStickerr Panel
Lima rocup ofstrocu*ee 210
Billing Address:.T-90 A10 M 6-zg aj)-
City:
State: Zip Code:,-3V-7&0
Home Phone:
Work Phone:_"i7Z 9•,4 — /';P/ 1
TwounsesTypm O Comaivo is Ptoraaive
Seedoa IL SERVICE COMMITMENT
HomoTate Pea Defense, Ina, (the 'Compe cyl wa in compliance whit applicable fodeml, veto and load laws, eclat cad regulations:
A. In" the Swlriwo tamio ball suldons (the 'SiWam7 e s U the perimeter of tho ttnxturgs) (no attach d graph) locoed at the Service Address
above(tiro'Soueaaa(sy�for the funaimteafee ofS er
B. Maaito► e i aSttlFoa fo amordonoo with the tabd diaodims fora period ortwelvo (1:) monUn Immodistsiy following knalbelon oriho stotiona far an reread
faoti
C. Total anrat the fmymrofiaadhuionand Moahof SZefO
D. m"ApermlFee dwthe rust Yale
f30n.A0
R Dodos the monbminspadod, add and remove Raab t® tamito bdt from the Stations a appropriate;
F. Delius the mmritariagpulled, maimainall Stations inserviceable conditiox
SeedoD ILL CUSTOMER UNDERSTANDING OF PERFORMANCE OF SENTRiCON SYSTEM.
Cuaoma oadasonda that:
A. The SaMam System iavdva instolklica cad mmdtaing, colony elimination with Rtauit wanho balL end subsequent moahodng for eondriumu proteaiom
from new tatmito edodos;
B. IderwhofflareBfaww olatomornthanoyearshmddbeexportedbetweenn:
L fastallatims rat secedaonsweiamendsallideattamiroaairitytoallowthodd'atonofRamittamitobait;end
ii. Addido ofitscmlttenailobdt.
C. Dating the Futevd(s) bdw= Installation of lire Stations end compteo elimination of osiaiag tangle eolonio . lamnlo foodtes within tiro Suuctara, possibly
iovolviag additional structural damnA may occur. Additional services such as spot oppliadow of conventional tomtitieides are available to cotebst termite
activity as o localized. dtort tam basis If desired, but sro not needed fmsad will not contribute to tangle owy dicdnatian.
D. The active
) hngra llen is the Semdeon System la an insect SmaA regtdamr (Reauit) thot prevan s wwka termites from moltins. (Molting is aided to colony
E totem tltm it conducted ea R=rW% Dow ASmSeiatcos I.I.C. giro maxothowd of Reaoi%observed av* 1 , of vety low levels of memmlian tmdeity only te
Very high tombofeapesom
P. Trumann is provided spina the amock of abtamnom tamlta (Rdiauliiamas spp„ Hdactor mes spp. end Copw mm *p• (pormoaan). This Agreement
does not provide for the trecunate of any Atha putt, plant. suited or Wganlam other then nth tangles. no Compaq has not impacted or tratcd the
suaetme(s)for boahhedseed mddaorfimSL By law, the Company 6adquafiSA authorized orGamdto Inspect fahecllh ralatd molds or flmsL
0. The CompanymanwrepresenationvegardinsthecouslocmimormmnbaermyClimestanglecolonies.
Seetton W. DOW AGROSCIENCES LLC OWNERSHIP OF SENTRICON SYSTEM COMPONENTS.
Casomsr also andastmuls that:
A The Scredcon system end all of the components of the Seattcoa System ('Corapoccoul) have been dedp al by Dow ASrostitaw LLC. The Cmaponws
aromad will formalho propely ofDowAsmSdmtea I.I.C. Cislomerhasao dshrawith mWel to any arthe components,otherthan the tight to theirwoa
instdld by tiro Compmy on do Cast@ melt premiss ada this AgroemmL
B. On expiration at termination of this Agromom, the Company sad Dow AgroSetmoes LLC or their respective repraadotives we amberired by Customer to
radmoo Rom oil"mds premises the SW= and other Components rat app wflste disposition. to addition, Witte Company, fa whatever man. ceases to
nyraeat ato ba amhmiead to repraanl tho Senrlcon Systan,
I. TheCompanywatz.
e. So notify CUSIMAer,
b. OfferLlraomathe dtemaWesefeitherantes adilfacatform oreamdteprotection ortamimsttegibis Asrama d;
a CtedittheQmwnst&rsenicapddfor but noyet received, ifsppropriaw;
d Rcr=d to the Custotea Bra omama equal to the fen paid for savica rot ya rcWvd if Customer elects to diseominuo the relationship, or if the
Company emtnot offer an effective alternative fors of tamito protadon; and
L Retriom or &iow DowASmSeiaas LLC of its reprasmotives rasontble atom to do pmndsw fa the retrieval of tho Components ord
S. LlmemawiU:
L GrIml do Company end Dow ASt4dencrs LLC or their rapc6vo npre aelatives reasonable minas to the preaiaes fa the rculmosl of tho
and
b. ShhaegreowiththeCompanyontheusedondtanotiveformoftandleommrolalandasothisAgreement.
PAYMBNrMBTHOD. OCash OChcck OCreatcad
tfpoyi%by «wise cold or soaralus dew from you beak Become, plume complete the socehd Amholin ins far hkaAaanged payments.
This Agmemertcoatdols arialsIimUadcos, condition and esdalonson the Company'sobllgalboe.Ftessorod theendreAgreementbermstptlog.
In coaddemtion fa tho.Company perfomdag the writes spocilied dew and subject to the term and conditions of this Agreaaan6 Customer agrees to make the
paymems Moved above. Customer admowledgm tatxdpt of a shgoed copy or this Agrmeatt. This Agreement b tat binding on the Company umii aw" by an
attthaired amaga a auwdva offaar of the Camtpmy.
CUSTOMER: HOMETEAM PEST DEFENSE, INC.
SiSaamaa• �y,�0 Sigmtole:
NmdNsmo � Jr �,sr p�N— VOID/ FOR PRESLA13 APPROVAL ONLY
o mer. com Eff d oa,a, NONEFFECTIVE
RIGHTTOGMCi:'L:Y01/,rHSCV.VTOMBAIIAYCAAMY1ILrTAANS CriOHATANYTIMEPR10RTOM10N1GHrOFTHETH1R0BUSINESS
1NYAPMTHEDArSOFTNOTMVSALTIOM SEETHBAfrACHONUT10EOFCANLTLL4T10NFORANEVLoWArIGNOFTHISNGHT.
THE REMOVAL OF THE BAIT OR BAmNG SYSTEM MAY RESULT iN A LACK OF TERMITE PROTECTION
S eSamRmpozzle& to,lao.lslt3eredtadeawAsofDowApaSrlmaaLLC (UMSYR)NIS
SmOon V. CUSTOMER COMMITMENT AS TO CONDITIONS CONDUCIVE TO INFESTATION& The Comma agrees to he solely respma'bio for
maintaining the Treated Premises free from any condition coududvo to temtitc htreststion ('Conditions CondudW am below for explanation). The Customer IBM"
BM"
to be solely responsible for Idettilybg and cqm d erg Conditions Condudv& The Mgwibility raw aelusiwlr with the Cuaoma, ad with the Compsoy. Fannie of
the COMM o dart Cmloma to nay of the above conditions does at alter Customer's rmpomtib7ity under this Section. in eddifim% the mdsteame of my ("bons
Coad! ive thol was um timelY cwmted. Ineladittg mty Conditions Condudw existing; bus am vistblo to as time of the occasion of tbu Agreement, will Wo
ComPOY, At its sale dberetbs1. to terminate tbo Agreement or to requite Customer toparchm• any addltieml accuroat requited as a result of the Conditions
Conducive. Customer luaus- to fay onopersto with the Comptmy daring the tam of this Agranenk. and ogees to mahualn the ara(e) baited free from such
Coaditiom CwAWM COW specift items may be noted bdowin *Additional Cbrameas• (Section XV).
CONDITIONS CONDUCIVE! CaW'utian Conducive lacludo, but tam not iimited to, work" improper watnation, featly phambing, and water baba or immodest in
at arcs ed the Mtct we bhuct stractanl Problems, Including, but eat limited to, wood to ground canines, masonry failurok' amd sattlamem of the foundation, been
insmldfm% stump ocastructiab expended polystyrene or Wrabaam molded feundwlm system, ddiag (Including vbtyl, wood teal mad) if within 6 inches of the
ge=ul; match or other pratectivo ground covering; end firewood, twit, lumber. wood, muhh, sludbt, vines, and other protective 1putml covaitlq Uwitida 6Inches of
MwMM.,,e1hNnwWe.�
Seaton VL ADDITIONS. ALTERATIONS, AND OTHER CHANCES. This Agroaant covers tie Shuctme(s) Identified In Seadon I as of the date of the initial
f nagaie.CustomerwinimmadimelyMI&theCompanyinwddng(1)FfWto-theStrudan(s)beingstructurallymotined,altmodofodnowsochanged,(Z)Ptiao
any tandtiddo being applied on or duo to the tomion ofmty Station, (3) if son b removed or added +rood the foundation of the Sarctuga) a (4) oy tsmpatng of
baiting egalpme m or supplies Gmurs, Failure to notify the Compmy in Withfg of d1W oven listed above mr void the AgrmmanL Additional service rognited by Sty
eddhion, dlaabnaalurs udtovmt may be Provided by the Company atCartama'sospm a6andmay more anadjutmumt in thoremnwl fan.
Seetim VIL DAMAGE RELATED TO SERVICES The Company wall mrardte duo Caro while peffbrming &rube hereunder to attempt to avoid damaging my pan
Of Qmoauefe proFwY. F11110 or animals. Under no draaestmea Wig the Company be —%Is for Amens Caused I- the C a tit ti rho ark I
vpar(oronod, cxoepr than damages w
Bee so VIGIL REPAIR AND RRFTR
song from gross oegllgmao of the Company. Cumma is °mpSar o ono vw s
-- - _ responsible. ro Custoanu'a solo oxpeuso, for relintbishing Cttaranera
infesstion ofsubtarSemt tataba ooeros b No trsoted 16,
dmrg& la addition, subject to the goomal Item and eondtiant of
The Compmy's toad liability will not exceed in say ono calendar )
S1,000.000 in tho aggregate era the tam of the Asmarm a, ladudiq
1. Ctrmma apaady viva arty dsdm for _:_ campanrato
Wants or rtmesat taraatt. Amnonfor buxamw ens, loss of use, busiau intarw
damage. The Customer selmawledges the the
daaugo to Ono anent ceased by the Company In the paformon
drumnnnas shell Comuary be hold liable for any mount greater th
1Ike to subta►aows Wmlt* babtty termite activity may coath
responsible for repairs ofsubterrmaae terealto damap• that acm
2. The Coamparyrs obBgdlmt to repair taantadmwge tm6 b000aro ei
Addresser (G) the Bra mmiva smy of tho lactallaft Grills Stati=
fading an Roavit termite bait in one or more tanute bait whom 1
commutivo service visits to the Service Address, any live tamita In
pwenoa of Iive termites, occurs while the Compm)h obligation to rc
der Cempary, the Compmy sgoa to reimburse Costs= fa the to
tar la[ttab Subject to thage tad tamAgreement. ran
the tam of thisAgraomma, tho Company will tetrnss the Cues of infestation stno oddidmd
;meta, the Company will ir, asits eau, new Jambe damage to the waled an cturgs).
r Faa or(7 SUMM or i) the rain males vdwaf tha uwcd +Wesutgs), user cwccd
or mmeyueww &mws mtmiog to lho adatmm or Subtaraaneu termites err subtemmm
4 dim'mmim of vahe, or any %smo• damage dap to the prescuae of Subaarmeon land ta or
quay is performing a serviu and a 1 far tomint dto damage mpeirs set faabove and my
of its savcoa, Customer wolf as mry alaim for property "a. and aaroa the mule to
the amount paid by lla Casten to Cempey for the lamito tame* to be padormed.
to be prarmt to a structure for ■ Parlhd of Um• fallowlog to atmenL The Company Is not
ofarsthe tapir portion Ofthe warsmaybeeoroes•114CUM
five tpmthecadkrof(i) climimtim ofd m colony oreatmia loaned on or about do Service
loay diminntim shall bo deaaad to oaur wdaoA following ttve ooaseeroive roomthf of tatmhes
ted st tit* Service Address, the Company's tmhaldm is usable to team for o period of three
r of the temuo bob motions located a$ the Service Address. lfmow damage, a evidenced by the
t onnho damage is h► rev% following tmitte wifiatim from Cumma and an inspection by
nablo sou of Ott repass, bin a* to the wcat that alto lord resssable cost of sell mpoin is
4. Su*xl to the randidog pmvisiont of this Staion V111.4. Comma will be quilled to select the contractor who will perform the aaedrd reports to the treated
doe aes oar imooeosmactwitheeoauaetoyCuuamcrogremmpmvWodmComP&WGC yofthopmpoudeonumerwhtobid.ifthoCompcny
second bid for bite work in eases be , Co Aaor � green o do tre scd neaesare(a) o a eamoetor desitpuaed by the Company far the purpose of obmaining a
second the o The �° repair Work Comma admowiedgm that the Company reserves the right to soled the contromor to
ft
J. The Company is not nesponswo fa tho repair of either visible damage (noted an the attached inspection graph) or hidden domage existing as of the data of"
Agreement. The Company dam not guarmnee that the damage disclosed on the aucehed Inspection graph rcpreseta ail of the existing damage a of the doe of this
Agra m aL The Company WM not be responsible for (1) any damop caused by Merolla to the treated straaurs(s) or the Comeau the►mf orWat; prior to or
following the tam of tble Agreement or (1) any eats or aspirates locoweed by Casomw a a rods of any such damage. Customer wolves all claims for
damap to the Pro" a people the may rent$ directly or todiree0y from urvias prodded by she Company, with the sole exception ofdalms fwdmsga
due to the pouae esoftheCom andforIts amployea.
Sedloo IX, PAVMBNT. TM Compmlrs otlonto pafamr aWa Out AgmcmaM b omMlwted a = Cumma%ppaayymet in Bun of the price set Penh in Seetim 11
abet Cnoomea'a fanaro to pay Sub price in full will ewes* Out Agreement to automatically tied iasmedimly, terminate to its atiaety and the Company will be
disebtrped of all lisbili$y. All amumas paid. if any. will bocamo the property of Cho Compwy as 64ul*W damages hereunder. The i—nation fee is duo and pryable
at tho time of the Initial service. The renewal fee is duo and payable upon receipt of introdes Invokes the are ad paid within thirty (30) days of tho dinroim d+o will
acres idaest on the u+p+dd balansa ate rate equal o tho barer of I.S7L per aumaln (ISSi Per yw) as the owbunn ono allowed by low. In the event the legal action Is
aoowmy 90440901 MY sooud due the Company, the Company, will bo ambled to reeve from Comma all sow atsoncwm% Indading "==able worosye foes,
In edditim o all aartwndlag eaSattsduo the Compmy.
Section X. TERM. Unless otherwise apcditWty FrAded herein. tho parties agree the the initial
amoaumiany renewed an an annual basic, for an additiamd twelve (IS) month period. be a ntoxdr
6aitial tam tmpm paytaomn by Cuumaa ofthe too indicated in Section IiJL of fhb Asmomaru (sue
+by givbg the other panty written notice m last Wry (30) days past to time and cf Ono the
by Ctmoma. d any time following the initial lam, a written nobs to the other poly or lama
yea paled time may bo unewW mmuaily wdth tba muuW eonu m of both Fetch, aid, the
loan timbry (10) day+ Prior o tie and tithe the aarcm tam Tthin lfe Cad reserves the right o
Section comer by
ARBITRA 0 .. ANY CONTROVERSnotice to tho Compsq ve OR CLAIM ARISING OUT OPing r1
AGREEMENT BETWEEN THE PARTIES, INCLUDING BUT NOT LIMITED TO ANY I
PERSONAL INJURY OR PROPERTY DAMAGE, SHALL BE SETTLED BY BIN
OTHERWISE, THE ARBITRATION SMALL BE ADMINISTERED UNDER THE.CO1
ASSOCIATION ("AAA") OR, IF APPLICABLE, IT SHALL BE DE[ERMINED UNDI
DISPUTE& THE PARTIES EXPRESSLY AGREE THAT THE ARBITRATOR SHALi
TERMS AND CONDITIONS OF THiS AGREEMENT, AND THAT ANY ARBITRATION
CONSOLIDATED OR JOINED WITH ANY ACTION OR LEGAL PROCEEDING UNDEp
PREMISE& AND WILL NOT PROCEED AS A CLASS ACION, PRIVATE ATTORN
ACTION. FATHER PARTY HAS THE RIGHT TO REQUIRE A PANEL OF THREE Is) A!
RESPONSIBLE FOR THE COST OF THE ADDITIONAL ARBITRATORS. EITHER
HEARING THAT THE AWARD BE ACCOMPANIED BY A REASONED OPINION. THE
FINAL AND BINDING ON ALL PARTIES, EXCEPT THAT EITHER PARTY MAY W11
ARBTIKAL APPEAL TO A THREE McAIBRR APPEAL TRIG INAL. Tee AMPAuarr.
TO A TRANSACION
arm of this Agrecnmm� whfi be far ewdvo ((I2) months end win bar
wan of four (4) addidoal twelve (I2) asmOn Padods, following tiw
ed to adjaaanmt as provided In this subscatoo), unless dither pity
name$ term. This Agm enteat may be otmiatcd by to Company at
hirty (30) drys past to such termination. As the and of d m five (5)
040, either party may to ralasto the service with written notice at
memo the pea of savda. This Agreement may be terminated by
irR A tELATiNG TOfTHIS AGREEMENT OR ANY OTHER
ORT AND STATUTORY CLAIMS, AND ANY CLAIMS FOR
DING ARBITRATION. UNLESS THE PARTIES AGREE
IMERCiAL-RULES OF THE AMERICAN ARBITRATION
R THE AAA PROCEDURES FOR CONSUMER -RELATED
FOLLOW THE SUBSTANTIVE LAW, INCLUDING THE
PROCEEDING UNDER THIS AGREEMENT WILL NOT HE
ANY OTHER AGREEMENT OR INVOLVING ANY OTHER
3Y GENERAL ACf10N OR SIMILAR REPRESENTATIVE
UMTRATOR%AND THE REQUZMNG PARTY SHALL Be
PARTY AIAY REQUEST AT ANY TIME PRIOR TO THE
AWARD RENDERED BY THEARBMIATOR(S) SHALL BE
THIN JO DAYS OF THE ORIGINAL AWARD REQUEST AN
PARTY SHALL BE RESPONSIBLE FOR ALL APPELLATE
6 QUESTIONS OF LAW AND PACT UNDER A CLEARLY
NAL AND BINDING. JUDGMENT MAY BE ENTERED ON
D COMPANY ACKNOWLEDGE AND AGREE THAT THIS
INTERSTATE COMMERCE AND SHALL BE GOVERNED
AL WMITIVIY OR SPECIAL HEALTH CONDITIONS, if Comma bdbvm that Customer or other occupants of the anted Wnesun
tivo to pestieiduhamidddes or their odors or (0) lava other health Conditions that may he eifeaed by pmticideshermiticidos at tleir odaee
Oust you trot have on Initiator o ubsegsoat.savice performed d yaws promises; until you have smoked with your family p�ysIdm At your
novido Wommilon about the ehandesb to be be used in treathe promises. BY parch ft t a &wnsnt. Crammer aoumes Z ask and waives
A the Company In eonneaiaaa with such sensitivity atcand im At your request, the Company will provide Infarmdbn Bran the chemtab to
Sadva XIH. ASSICI4ABILITY. This Agroamem is trwdamblo to a raw owner of the pre" located at the Service Addrm provided Chet Ono new Gwen of the
P7ePa9r enters into an htwlidbn turd tanitoaag agrcamem with the Compsey. The Compuy raw= the tight o ahSgo a trwfa fee, adjug the swaw reeved
two. and ekonge do terms of tho Compamft obligddonsunder this Agreement we ay such uremia. Upon the dosing of tho Salo ofda property located m tho Service
Addrask *6 Agrmment will Unninmo.
Sea XIV. ENTIRE AGREEMENT AND SEVERABILITY. This Agmanut and the attached gmph mumltuto Oa edro sgrmtncas bahveen the parties.
Comma ra ref= warrmts and ropsesams thstea , In rning this Agnmaaem. Comma is not relying on any proaalm agtea cut a saarMIL Whether aml or values,
as�why and !idly as fonll ha this Agrcem m. H any part of this Agmcam Is held to be undid or vnaafaeesblC for any ressm tlm remodalneng geand
eo dick s of dda Ayamw veal assmier in fall fotm and sfka The tame of" Agneram mod heroin may not be emended w altered mite a written change is
sppneved min signed by o Corpotato OBdea of Comps aY. No other emptoyca of Dams of Company have outierity to amend or alga soy par of this AgramaL
Prorldede. howove . that a to No paragraph on ARBITRATION. If Mho sca esem Precluding Ole mbbmta from conducting on tabitratlen
=antalvo or private anotay general action is found o be Judd or cuadsrmable then to anti of the ARBIT TItNi praso e d m a dote
ddetod
Item lidsAgreement.
�' P+�+Ph shall be deemed to be
Section XV. ADDITIONAL COMMENT&
SMUWMOHamdy�PeoDefatm.la&m201) uadwaksofBmvArpeddaccsLLC Wssasymtill
J
PLEASE HAVE TM FOLLOWING ACKNOMMGFIVIEM NOTARIZED:
I CERTIFY THAT: (CHECK ONE)
A. I AM THE OWNER OF RECORD OF THE ABOVE DESCRIBED
PROPERTY AND WILL BE CONDUCTING THE WORK AS OWNER/BUILDER.
Olsdanrue 3btemerlC Sbta few tequ.'�s mr:sWaCon rn be dome bY�sad oanbacAvs You:heve i�pCed fibre penNt wader
an eremptlon to !rat law. The arempNcur allows yvv, as tre owneror)wrFvR&ly, to actasyvro•awn embed wwM oak4r
msWons even trough you do not have a.Qcur m You mustAVYW d14 ondte XFavialan of ft oansbuvVM yummy..
You may b:dld or ftrum a ata,famfy or twwwf iced&= or a farm oadtadWv� You may aisa baud or k pwm a
mmmerdal btrMia prw/ded your casts do not eared p73M. The burddag or redlesee nxat to J r your own we or
oozrp enry. !r meynot be bunt or substartdepy fmpioYed for sofa or kasec lryau mf arkm a bdft you haler butt ar
substantaUy Improved yourself wRhln 1 year aRer dre. evnsbrrt�n is oorrrpkb; The kw wx'presrrnw fret yti wont or
suds!ante/y/mprovedlttbrsa/eorlass� wh/ahlSavlo/atanofOri(seaempbars, Yau.mayi HAwanwfX=edPM=toad
as yourcondmotororto supevv/sb poop/e wa►Afit9 on yourbu9dlrrg. Rlr yvurrrspaR:�Plytomadvsrue butpeop/eenpdoyed
b3' you have QcBnses required by ante bar end bymurtty or mwYapal /krns/r(+/ ardwm= Yau may not delepto the
rasponsibinty rtg work to a /lcrnserl cr>rrtracmr who !c no!!ke[ssed peribms on woikbav done Any person
wafdng on -your bulidGrg who far rtatlfcerued must work under yorr direct supevlkfar and must be ernp:byed by yary whktr
means that you mtet deduct fi:GL am/•wfYrhefdtrrg b:t and.provhle wwlris aao;persrddron hr that entp/oy� aD as
pmsv►bedby/aw, Your arrtszrtreuon mustcvmplywld'iallapplka6k Paws; ord6�mrcd, bu�iq � a�rdmnlr;q ��
B. () I AM NOT THE OWNER OF RECORD OF.TIiE ABOVBD
DBSCRIBBD• PROPERTY; HOWBM I HAVE AUTHORITY TO ACT, AS, AOBNT
FOR THE OWNER OF RECORD. (St, Lucie County Colo and Compiled laws reguiras
that this, type of work be done by a licensed contractor. PLEASE PROVIDE
DOCUMENTATION). 1.,
I CERTIFY THAT ALL INFORMATION SUBI&TrBD'WITH' S APPLICATION IS TRUE AND
OMPLB'I'EYT HE BE OF MY KNOWLEDOB. ,
�`0��22 WN,B�R,/2,�1AGENTSION CONIRAMRSIONATURE
STATE OF FLORIDA, SfATF-0Mpip:
RIDA,
COUNTY OF ST, LUCIE COUNTYT. LUCIE
The foregoing instrument was acknowledged The foregstrumeat was eelmowledged
before me this "day ofQts3Dt� before m , &&LX&y of �. 202S
by . who is by - who is
to me or
(rk.
or Prin
Notary Public Title
2 Commission Number
to me or
as iden0cation.
Notary Public Title
CommissioaNumber
(sEAL): (SEAL):w`QP�'4���l�� - Commies on #. GG060876.
" P'wft saw 0 ,* : � Expires: January 9, 2021
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