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2014 FL#
5739
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iS�archTRoaulti-
-'-1
t ons.:. - 5
FL5739-R3
Revision
Elixir Industries
category: Roofing
Subcategory: Metal Roofing
Thomas C. Williams, P.E.
(386) 427-8431
Approved
History
'Awmvm by oaM Pwovas W uams.w. ee revewet a,,u rain+, w us — o,w— um w ...... — „• - .
The State of Florida 6 an AA/890 employer r MMaM 2007-2013 Suite or Florida :: Privacy Statement :: e..�a� ;; Refura+„V,4 •terse
under Fodda hw, emal addresses are pubk records. IF you do net want yew e-mal add released in response m a pubfe-r rds repuest, do net send epRMnt Mal to this
army. tnatead, wroa the take by phone or by traditional mal. nyou tow any sue ns, please mntnct 950.ae2.1395.'Pursuart m Settbn 455.275(1), Fbraa Statutes,
effective Ormber 1, 2012, lramee; kissed under Chapter455, F.S. mist provide the Department with an emal address I uey have ore. The annals inewded may be used or
bl0tlal mmmunlmton wth to ks . towereremal addrtsses are putrlc record. Ewu do rot wth m supplya p mi addres, phase povae the DtPsrbnert with an
emal address whth on to Made avalal,le to tie pubR. Ta determine ryou are a loemme under Chapter 455, F.S., please dtll 0e-rt
Prof AppiovalAttapts:
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3/21/2017 9:11 AN,
Southey•
Florida Dlt:_-, an
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Southwest
Florida Division
A
MS
Licen528 &InSUfed
94t S.W. h Street
2331 Laurel Lena,
CCC042787
Pampano Beach, FL 33069
c
N.FL Mye rs,FL 33977
CGC033977
1-800-226-6677
7-800-522-3t 34
CUSTOMER
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ROLLS TO ORDER
Height
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EVERYTHING PR MISEDASPART OFTHIS GUNTHAGTI5GUVEHEo1N IHtAt5UVt.
CUSTOMER Signature -� O �,�/ �(�/71���— Date �- ��' t 7
INSTALLATION AGREI
TENT AMS, INC
Southeast
Southwest
Florida DlVision
Florida Division
941 S.W. eth Stfeel
2331 Laura] Lane,
Pompano Beech, FL 33069
N.Ft. Myers,FL 33917
1-900-226-6877
1-600-522-3134
CONTRI
AMK7044
DATE 6 - V-1 A-1 SOURCE P-f✓
PRODUCT 2oOPa.iOZ
PHONE # ( l�t
www.AMSOFFLA.com • CG C1505972 • CC C1328662 • CC C042787 E-MAIL
OWNER: Mr. kECZN'j & Mrs. irC 1ceJt, 1k LAST NAME fA J Rb S
Address \$Olin o�A CF A tZC City T r • P L Ems- Zip 3v�pj4gS Lot # Community
County .S"T_ L,-� C--C i~ HOME --nt- Own _ Rent LAND Own _ Rent R/P #
Address (out of Florida): City State_ Zip Phone #U
AMS, Inc. ("AMS") proposes to furnish all materials and labor for the job(s) specified below:
1.
2 r I S'h4l--L_ (�+MS I�l�E-r.rv�•'>i Est FSL6\�fILFr�t-��s�
3 MF'rAL PrW Nns rJ .M TrlSViA--t-f=r\ (�� ) 24>O tr Oyi_fZ
4.
S. Me Copy
6.
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9• V-Ll15WkrJ(® -ro \PA't o d- St-n-�sFr 2ez� --
10.
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12.
13. YH �a1°+-i-SCt i C4 W H -rT'
14.
15. P VF'RS'E AL-t-O✓ f;:!1 C:sr—� 1--k IJV-79n-4 c- V Pet L
16.
17.
18.
CONTRACT AMOUNT $ 'Ft>.r n" V9 .I s/.i. �t6 L+i 0-rJ �a *- �(• m (U.S. DOLLARS $) $ �SO®- ��
C501CONTRACT DOES NOT COVER DAMAGE OR CONDITIONS THAT MAY EXIST AND ARE NOT CC Sales Tax $
VISIBLE, INCLUDING, BUT NOT LIMITED TO, STRUCTURAL DE ; WALLS, CEILINGS,
URETHANE COVERINGS AND TARP COVERED ROOFS. (inldal) CK N �_ TOTAL $ yTCO- OO
0 ELIMINATE GAS VENT (InRiap,_
r-1 GAS BURNING UNIT HAS OR WILL BE REMOVED BY CUSTOMER (initial)_ CASH DepositAmt $ i 3 Do • on
AMS REQUIRES A 30% DEPOSIT, WITH THIS AGREEMENT
AND BALANCE DUE ON COMPLETION. Balance Due on Completion $ -3 s O D. c) O
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 Uwe 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 (he 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 low.
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 DAY AFTER YOU SIGN THIS
AGREEMENT. IF YOU CANCELTHIS AGREEMENT, THE SELLER MAY NOT KEEP ALL OR PART OF ANY CASH DOWN PAYMENT.
NOTIC ER: THE TERMS AND CONDITIONS ON THE BACK HEREOFARE PART OF THIS AGREEMENT.
(INTT.) XX EVERYTHING PROMISED AS PART OF THIS CONTRACT IS COVERED IN THE ABOVE.
ACCEPTED AND AGREED:
BUYERS SIGNATURE X Date 6 ^ 13- 1
BUYERS.. SIGNATURE X1-�'���1���/. Date BY AMS REPRESENTATIVE