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ELMIt Yvne / Nianufac4vrer Validated av
Status
&57M-114 -Affirm onElixir Industries Thomas C. Williams, P.E.
Approved
History category: Roofing (386) 427-8431
Subcategory: Metal Roofing
'Approved by DBPR. Approvals by DBPR shall be reviewed and ratdied by the POC and/or the commission ff
necessary.
The State of Florida is an AA/EEO employer. Collynght 2007-20I3 State of Fbrida.:: Privacy Statement ;:Access v Statement :: Refund Statement
under Florida law, email addresses are public records. If you do not want youre-mail address released In response to a pubk-records request, do not send
electronic Tail to this entity. Instead, contact the office by phone or by traditional mai. If you have any questions, please contact 850.487.139S. 'Pursuant to
Section 4S5:275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address i
they have/one. The emails provided maybe used for official communication with the licensee. However email addresses are public record. Ir you do not wish to
supply a personal address, please provide the Department with an email address whirh can be made available to the pubic. To determine If you are a licensee under
Chapter 455, F.S., please crick heN .
Product Approval Accepts:
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ST. LUCIE COUNTY BUILDING DIVISION
REVIEWED FOR COMPLIANCE .�
DATE /
PLANS/AND PERMIT MUST BE K ON JOB
SITE /OR NO INSPEC770N(S) WILL BE MADE
THESE PLANS AND ALL PROPOSED WORK
ARE SUBJECT TO ANY CORRECTIONS
REQUIRED BY FIELD INSPECTORS THAT
COMPLNECESSARY
WI ET ALLAPPPL ICABLRETCOODES.
CONCEALED FASTENERS OR ATTACHMI
ARE THE RESPONSIBILITY OF THE
CONTRACTOR OR RECORD
FILE CO
of 1 / 1/1
INSTALLATION AGREEMA& AMS JNC
Southeast Southwest
Florida Division Florida Division
941 S.W. 8th Street 2331 Laurel Lane,
Pompano Beach, FL 33069 N.Ft. Myers,FL 33917
1-800-226-6677 1-800-522-3134
www.AMSOFFLA.com • CG�C1505972 • CC C1328662 • CC C042787
CONTRACT �� AMK8 0 51
DATE S- N%-1$ SOURCE
PRODUCT
PHONE # ( DI.) sig I g1GP'
E-MAIL
OWNER: Mr`Af�bL.AI- &Mrs. 54-}�sfr,i� A - LAST NAME '��'L�C=1�
wl-+t.Si3r=.�cr►6 zXzz--z\
Address �t ,§ LyL\ 13taLfl City Zip 3 g . Lot # M Community _ 'Co -c1►
M3� - 'Soil - �t 53
County .5t - 1Ak 1 � HOME _ Own Rent LAND _ Own Rent R/P # ot-v 7
Address (out of Florida): City State Zip Phone #(�
AMS, Inc. ("AMS") proposes to furnish all. materials and labor for the job(s) specified below:
2. _ ors C >�L f�► rl W l S ` l -ram L� �� , \ram\ f�► i LGy _ 5 � 2 <kx-r c�-�
3. V40\ r p ('—OCD
4.
5.
6. ^�-a.f Lt_�t> CS=L_�45{.l lryh is SC f �t<� �Lcaorv\
7. S E1>/lt L — e� t= f"t or.f r o-[= V r•l �t—
8. w tiAsckA cA�
9. � t C3, 1.1
10. LJs�rLLLANi+/
11. V 15.1Z t— t -r—
12.
13. f�(3\r416 - r4 (�b
14.
15. AL -A _-
15. V4 ljQ CIJ-V- '-1,m. u, W ��1�.5 Sock— -Z� l—L�
17.
* Please contact your local AMS office for your approximate installation date.
CONTRACT AMOUNT$3tk.+--Q,'s�tC3ct� WAQr4l rzr,�—cl-1tm--JU.S.DOLLARS$)$ �3t�o, cry
CONTRACT DOES NOT COVER DAMAGE OR CONDITIONS THAT MAY EXIST AND ARE NOT
VISIBLE, INCLUDING, BUT NOT LIMITED TO, STRUCTURAL DE . C WALLS; CEILINGS,
URETHANE COVERINGS AND TARP COVERED ROOFS.`(Inith
(� ELIMINATE GAS VENT (initial)
0 GAS BURNING UNIT HAS OR WILL BE REMOVED BY CUSTOMER (initial)
AMS REQUIRES A 30% DEPOSIT, WITH THIS AGREEMENT
AND BALANCE DUE ON COMPLETION.
CC Sales Tax S
CK # 9LAk, TOTAL $ 33 ac- • ao
CASH DepositAmt S ( t>Do . o0
Balance Due on Completion S X300 . , c>
IF AMS IS UNABLE TO OBTAIN A PERMIT DUE TO ANY REASON BEYOND ITS CONTROL, THE,PERMIT AND ENGINEERING COST WILL BE DEDUCTED FROM YOUR DEPOSIT.
TOTAL CONTRACT AMOUNT INCLUDES ALL ADVERTISED DISCOUNTS. AMS will furnish all materials and labor required to complete the above job and I1We agree to pay the
full amount specified in accordance with all terms of this Agreement.
THE UNDERSIGNED ACKNOWLEDGES THAT BEFORE SIGNING HE HAS READ, UNDERSTOOD, AND RECEIVED A COMPLETED, LEGIBLE COPY OF
THIS AGREEMENT AND OF EVERY OTHER DOCUMENT INITIALED OR SIGNED BY ME DURING CONTRACT NEGOTIATIONS, AND AGREES TO BE
BOUND BY ALL THE TERMS THEREOF, INCLUDING THE TERMS AND CONDITIONS ON THE REVERSE SIDE.
This Agreement shall be binding upon the Buyer's written acceptance hereof in the space provided below or upon the AMS's commencing performance. Upon such
acceptance or commencement of performance, this Agreement shall constitute the entire contract and be binding upon the parties hereto, there being no covenants,
promises, warranties or agreement, written or oral, express or implied, except as herein set forth or as created by applicable law.
BUYERS RIGHT TO CANCEL
THIS IS A HOME SOLICITATION SALE, AND IF YOU DO NOT WANT THE GOODS OR SERVICES, YOU MAY CANCEL THIS AGREEMENT BY PROVIDING
WRITTEN NOTICE TO THE SELLER IN PERSON, BY TELEGRAM, OR BY MAIL. THIS NOTICE MUST INDICATE THAT YOU DO NOT WANT THE
GOODS OR SERVICES AND MUST BE DELIVERED OR POSTMARKED BEFORE MIDNIGHT OF THE THIRD BUSINESS DAYAFTER YOU SIGN THIS
AGREEMENT. IF YOU CANCEL THIS AGREEMENT, THE SELLER MAY NOT KEEP ALL OR PART OF ANY CASH DOWN PAYMENT.-
NOTI TOP BUYER: THE TERMS AND CONDITIONS ON THE BACK HEREOF ARE PART OF THIS AGREEMENT.
(INIT.) X EVERYTHING PROMISED AS PART OF THIS CONTRACT IS COVERED IN THE ABOVE.
ACCEPTED AND AGREED: v d /J` ��
BUYERS SIGNATURE X-��Jy�'1_ "L_ ' G,PJ�`�f�,Dates'\\�\$
BUYERS SIGNATURE X - Date BY AMS REPRESENTATIVE