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CONTRACT 5460 One Page Service Agreement CLOSED Agreement No. 5460 . ... i'csAu �� �.. fs�ss� �;us�5 , INc• ' � �;�`R-►✓'Ptd � �� � �� tr � �"'��. CONTRACTOR: St-v-VP r�I-D Aau" t-i (� J st 4 " �;✓ � " E MAILED: 0110818 Below you will find a checklist relating to Insurance and other requirements that are required for doing business with the City of EI Segundo. Only those items checked-off are MANDATORY, however if your standard policies exceed the minimum requirements please include. Commercial general liability insurance must meet or exceed the requirements of ISO-CGL Form No.CG 20 10 1185 or equivalent. The amount of insurance set forth below will be a combined single limit per occurrence for bodily injury,personal injury,and property damage for the policy coverage. Liability policies will be endorsed to name the City, its officials, and employees as"additional insured's" under said insurance coverage and to state that such insurance will be deemed"primary"such that any other insurance that may be carried by the City will be excess thereto. Such insurance must be on an"occurrence,"not a"claims made,"basis and will not be cancelable or subject to reduction except upon thirty(30)days prior written notice to the City. Please find additional Terms and Conditions on the reverse side of this Services Agreement. This is not a purchase order or an authorization to begin work. ® mprehensive General Li billty,including coverage for premises,products and completed operations,independent contractors, personal injury and contractual obligations with combined single limits of coverage of at least$1,000.000 per occurrence. ® Auto Liabilitv, including owned, non-owned and hired vehicles with at least: 0 $1.000.000 per occurrence. El $100,000. 300,000 per occurrence. ❑ As required by State Statutes. A copy of your current policy must be submitted naming yourself and or your company. ® Workers"Compensation Insurance: as required by State Statutes with Waiver of Subrooation. (Not needed if Self-employed with no employees and CONTRACTOR signs statement to this effect.) ® Business License: The CONTRACTOR shall agree to have a current City of EI Segundo license on file at City Hall or purchase said license(at no cost to the City). ❑ Permits:Plans must be approved and permit(s)issued(no fee)by the Planning and Building Safety if appropriate. Call the Planning Manager @(310)524-2340 if you have questions, ❑ oov of valid picture I.D. (Drivers license etc.) PLEASE NOTE:ALL APPLICABLE INFORMATION LISTEDABOVE MUST BE OBTAINED AND ON FILE,PRIORTO THE ISSUANCE OF A CITY PURCHASE ORDER BEING SENT TO YOU MA FAX OR HARD COPY)BY THE PURCHASING AGENT,THUS AUTHORIZING COMMENCEMENT OF WORK FOR THE CITY. �I rnitted by(complete all blanksl; COLOR COPY REQUIRED BACK TO THE CITY Company Name: - B (Print name&title): CompanyStreet Address: Vendors Air o ed Signature required: City, Zip: Date buiCA- '9 0 tG� , . _.........�. ..w .._._....... ........ s� d: Phone: FAX: Vendor's Email address: Vendor's Web site: Mail original agreement and Insurance to:City of EI Segundo-City Clerk 350 Maln Street,Room 5,EI Segundo,CA 90245.3813 OdginatorlDepartment Contact: Date Initiated:_ Department Head Approval: Date Approved: P 6i2 Finance ApprovaL Lazi, a"' ! °9 Date Approved: nao•city Cork•Purchasing ent ualli Da . e cc:Business L � n9 Ao �� n0 Pt� _...m. .,_ City Attorney � p Citlana e'r Ca lea^ ." 1.GENERALLY. The materials, supplies, or services (collectively, &PAYMENT. City will pay Seller after receiving acceptable invoices for "Purchase") covered by this services agreement and purchase order materials and supplies delivered and accepted or services rendered and ("order") must be furnished by Seller subject to all the terms and accepted. City will not pay cartage, shipping, packaging or boxing conditions contained in this order which Seller, in accepting this order, expenses unless specified in this order. Drafts will not be honored. agrees to be bound by and comply with in all particulars. No other terms 9.INDEMNIFICATION. Seller agrees to indemnify and hold City or conditions are binding upon the parties unless subsequently agreed harmless from and against any claim,action,damages,costs(including, to in writing. Written acceptance or shipment of all or any portion of the without limitation, attorney's fees), injuries,or liability, arising out of the Purchase covered by this order constitutes unqualified acceptance of all Purchase or the order, or their performance. Should City be named in terms and conditions in this order. The terms of any proposal referred any suit, or should any claim be brought against it by suit or otherwise, to in this order are included and made a part of the order only to the whether the same be groundless or not, arising out of the Purchase or extent it specified the Purchase ordered,the price,and the delivery,and order,or their performance,Seller will defend City(at City's request and then only to the extent that such terms are consistent with the terms and with counsel satisfactory to City) and indemnify City for any judgment conditions of this order. rendered against it or any sums paid out in settlement or otherwise, For 2.INSPECTION. The Purchase furnished must be exactly as specified purposes of this section "City" includes City's officers, elected officials, in this order, free from all defects in Seller's performance, design, and employees. It is expressly understood and agreed that the foregoing workmanship, and materials, and, except as otherwise provided, is provisions will survive termination of this order. The requirements as to subject to inspection and test by City at all times and places. If, before the types and limits of insurance coverage to be maintained by Seller, final acceptance, any Purchase is found to be incomplete, or not as and any approval of such insurance by City,are not intended to and will specified,City may reject it,require Seller to correct it without charge,or not in any manner limit or qualify the liabilities and obligations otherwise require delivery of such Purchase at a reduction in price that is equitable assumed by Seller pursuant to this order,including,without limitation,to under the circumstances. If seller is unable or refuses to correct such the provisions concerning indemnification. items within a time deemed reasonable by City, City may terminate the 10.WARRANTY. Seller agrees that the Purchase is covered by the most order in whole or in part, Seller bears all risks as to rejected Purchases favorable commercial warranties the Seller gives to any customer for the and, in addition to any costs for which Seller may become liable to City same or substantially similar supplies or services, or such other more under other provisions of this order, must reimburse City for all favorable warranties as is specified in this order. Warranties will be transportation costs, other related costs incurred,or payments to Seller effective notwithstanding any inspection or acceptance of the Purchase in accordance with the terms of this order for unaccepted Purchases. by City. j Notwithstanding City's acceptance of any Purchase, Seller is liable for 11.ASSIGNMENT. City may assign this order. Except as to any latent defects,fraud,or such gross mistakes as constitute fraud. payment due under this order, Seller may not assign or subcontract the 3.CHANGES. City may make changes within the general scope of this order without City's written approval. Should City give consent,it will not order in drawings and specifications for specially manufactured supplies, relieve Seller from any obligations under this order and any transferee place of delivery, method of shipment or packing of the order by giving or subcontractor will be considered Seller's agent, notice to Seller and subsequently confirming such changes in writing. If 12.INSURANCE. Seller must provide the insurance indicated on the such changes affect the cost of or the time required for performance of face sheet of this Services Agreement. this order, an equitable adjustment in the price or delivery or both must 13.PERMITS. Seller must procure all necessary permits and licenses, be made. No change by Seller is allowed without City's written approval. and abide by all federal,state,and local laws,for performing this order. Any claim by Seller for an adjustment under this section must be made 14,INDEPENDENT CONTRACTOR. City and Seller agree that Seller in writing within thirty (30) days from the date of receipt by Seller of will act as an independent contractor and will have control of all work and notification of such change unless City waives this condition in writing. the manner in which is it performed. Seller will be free to contract for Nothing in this section excuses Seller from proceeding with performance similar service to be performed for other employers while under contract of the order as changed. with City. Seller is not an agent or employee of City and is not entitled 4. TERMINATION. City may terminate this order at any time, either to participate in any pension plan, insurance, bonus or similar benefits verbally or in writing, with or without cause. Should termination occur, City provides for its employees. Any provision in this order that may City will pay Seller as full performance until such termination the unit or appear to give City the right to direct Seller as to the details of doing the pro rata order price for the performed and accepted portion of the work or to exercise a measure of control over the work means that Seller Purchase. City may provide written notice of termination for Seller's will follow the direction of the City as to end results of the work only. default if Seller refuses or fails to comply with this order. If Seller does 15.WAIVER. City's review or acceptance of, or payment for, work not cure such failure within a reasonable time period,or fails to perform product prepared by Seller under this order will not be construed to the Purchase within the time specified (or allowed by extension), Seller operate as a waiver of any rights City may have under this Agreement will be liable to City for any excess costs incurred by City. or of any cause of action arising from Seller's performance. A waiver by 5.TIME EXTENSION. City may extend the time for completion if, in City of any breach of any term,covenant, or condition contained in this City's sole determination,Seller was delayed because of causes beyond order will not be deemed to be a waiver of any subsequent breach of the Seller's control and without Seller's fault or negligence. In the event same or any other term,covenant, or condition contained in this order, delay was caused by City, Seller's sole remedy is limited to recovering whether of the same or different character. money actually and necessarily expended by Seller because of the %INTERPRETATION. This Agreement was drafted in,and will be delay;there is no right to recover anticipated profit. construed in accordance with the laws of the State of California,and &REMEDIES CUMULATIVE. City's rights and remedies under this exclusive venue for any action involving this agreement will be in Los order are not exclusive and are in addition to any rights and remedies Angeles County. provided by law. 7.TITLE. Title to materials and supplies purchased under this order pass directly from Seller to City upon City's written acceptance following an actual inspection and City's opportunity to reject, ServPro Onsite Services agreement.docx 1/8/18 Agreement No. 5460 Servpro of Santa Monica/Marina Del Rey SERVPRO of Santa Monica&Marina Del Rey Franchises 8907&9966 P.O.Box 7545 Santa Monica,CA 90406 (310)395-9050/(310) 333-0654 TAX ID#11-3650729 Client: CITY OF EL SEGUNDO(CARROL LYNN) Home: (310)524-2235 Property: 314 Main Street-Fire Department Station#1 El Segundo,CA 90245 Operator: LUIS Estimator: Luis Sanchez Business: (310)395-9050 Company: Servpro of Santa Monica&Marina Del Rey Business: P.O.Box 7545 Santa Monica,CA 90406 Type of Estimate: Other Date Entered: 12/21/2017 Date Assigned: Price List: CALA8X DEC 17 Labor Efficiency: Restoration/Service/Remodel Estimate: 314 MAIN STREET File Number: SELF-PAY PLEASE KEEP IN MIND THIS IS JUST AN ESTIMATE AND THE PRICE CAN CHANGE DURING THE DURATION OF THE JOB. RECONSTRUCTION IS ALSO NOT INCLUDED IN THIS PRICE. ANY QUESTIONS PLEASE CALL OUR OFFICE AT(310)395-9050. THANK YOU Agreement No. 5460 w Servpro of Santa Monica/Marina Del Rey SERVPRO of Santa Monica&Marina Del Rey Franchises 8907&9966 P.O.Box 7545 Santa Monica,CA 90406 (310)395-9050/(310) 333-0654 TAX I13#11-3650729 314_1eMAIN-STREET Main Level Main Level CAT SEL ACT DESCRIPTION CALC QTY REMOVE REPLACE TAX TOTAL ................................................ ......................................._........................................................................... � 1.WTR ESRVD + Service call-during business hours 1 1.00 EA 0.00+ 150.01= 0.00 150.01 2.WTR EQ + Trip Charge 1.5*3 4.50 EA 0.00+ 53.99= 0.00 242.96 Estimating visits. 3.CLN MISC + Cleaning materials and supplies 1 1.00 EA 0.00+ 400.00= 0.00 400.00 Includes terry towels,windex,,wood polish,floor cleaning, paper towels,trash bags,vacuum bags etc... Total: Main Level 0.00 792.97 i---2T6" T- ... ... ...................�.................................. , Fire Truck Garage __ Height: 14 1630.58 SF Walls 1014.75 SF Ceiling Fire Truck Garage 2645.33 SF Walls&Ceiling 1014.75 SF Floor 112.75 SY Flooring 103.42 LF Floor Perimeter VoTi vo, M'71-45'2" 129.17 LF Ceil.Perimeter Door 8' 4" X 7' Opens into Exterior Door 9' 11" X 7' Opens into Exterior Door 2' 6" X 6' 8" Opens into Exterior Door 21611 X 61811 Opens into CONFERENCE-R Door 2' 6" X 6' 8" Opens into HALLWAY CAT SEL ACT DESCRIPTION CALC QTY REMOVE REPLACE TAX TOTAL 4.CLN LABS + Cleaning-Supervisory/Administrative-per hour 16 16.00 HR [*] 0.00+ 55.00= 0.00 880.00 1 Supervisor @ 8 hours for 2 days.Hourly rate for a supervisory/administrative cleaning technician. Note:The cleaning-supervisor/administrator typically supervises or administrates in various cleaning,remediation,and restoration techniques to clean structural items such as doors,trim,windows,walls,and ceilings,etc. Courtesy Rate 5.WTR LABC + Cleaning Technician-per hour 4*8*2 64.00 HR [*] 0.00+ 35.00= 0.00 2,240.00 4 techs @ 8 hours ea for 2 days.Includes cleaning all walls,floor,ceiling,light fixtures,doors,windows,cabinets. Courtesy Rate 314 MAIN„.STREET 12/26/2017 Page:2 Agreement No. 5460 M° Servpro of Santa Monica/Marina Del Rey SERVPRO of Santa Monica&Marina Del Rey Franchises 8907&9966 P.O.Box 7545 Santa Monica,CA 90406 (310)395-9050/(310) 333-0654 TAX I13#11-3650729 CONTINUED-Fire Truck Garage CAT SEL ACT DESCRIPTION CALC QTY REMOVE REPLACE TAX TOTAL Totals: Fire Truck Garage 0.00 3,120.00 0'4" Hallway Height: 8' IT 960.00 SF Walls -.,,.,.273.24 SF..,.Celli............mm�..m.. ...._...._____^ ng 1233.24 SF Walls&Ceiling 273.24 SF Floor 30.36 SY Flooring 117.50 LF Floor Perimeter ,v„YR 132.50 LF Ceil.Perimeter �;'oa u,acr'ocx A�dluitl9rarwconu 9) ,°. p.RUr' Door 2' 6" X 6' 8" Opens into FIRE—TRUCK G Door 21611 X 61811 Opens into DINING_ROOM Subroom: Bedroom(1) Height: 8' 431.33 SF Walls 184.33 SF Ceiling Bedroom(1) z1vd 615.66 SF Walls&Ceiling 184.33 SF Floor 20.48 SY Flooring 53.50 LF Floor Perimeter 56.00 LF Ceil. Perimeter .............. .... .... .....�e,o. Door 21611 X 61811 Opens into HALLWAY Subroom: bedroom2(2) .HHight:...g.. '. 430.00 SF Walls 182.88 SF Ceiling 9) bedroom2(2) ''jgvA 612.88 SF Walls&Ceiling 182.88 SF Floor 20.32 SY Flooring 53.33 LF Floor Perimeter 55.83 LF Ceil.Perimeter Door 21611 X 61811 Opens into HALLWAY 314 MAIN_STREET 12/26/2017 Page: 3 Agreement No. 5460 Servpro of Santa Monica/Marina Del Rey SERVPRO of Santa Monica&Marina Del Rey Franchises 8907&9966 P.O.Box 7545 Santa Monica,CA 90406 (310)395-9050/(310)333-0654 TAX ID#11-3650729 ~.,°tlb ~ Subroom: bedroom3(3) Height: 8' G 422.00 SF Walls 174.17 SF Ceiling z> uNok'.ENO c,J' 596.17 SF Walls&Ceiling 174.17 SF Floor 19.35 SY Flooring 52.33 LF Floor Perimeter II 54.83 LF Ceil. Perimeter Door 2' 6" X 6' 8" Opens into HALLWAY I'"`7"� Subroom: mens bathroom(4) Height: 8' �""-7eq 380.00 SF Walls 140.88 SF Ceiling 1� )m9 mensbnthroom(4) 520.88 SF Walls&Ceiling 140.88 SF Floor 15.65 SY Flooring 47.50 LF Floor Perimeter 47.50 LF Ceil.Perimeter -9 z' Subroom: womens bathroom(6) Height: 8' ' 254.67 SF Walls 62.83 SF Ceiling Wemenyhathroom(6) 317.50 SF Walls&Ceiling 62.83 SF Floor 6.98 SY Flooring 31.83 LF Floor Perimeter 1 31.83 LF Ceil.Perimeter I Subroom: paramedic room(5) Height: 8' 338.00 SF Walls ......................... ............. ...... ........................................... ........................... .................122.73.._..SF....Ceiling................ ............ ...... ................. 460.73 SF Walls &Ceiling 122.73 SF Floor W' 13.64 SY Flooring 41.83 LF Floor Perimeter 44.33 LF Ceil.Perimeter Door 2' 6" X 6' 8" Opens into HALLWAY CAT SEL ACT DESCRIPTION CALC QTY REMOVE REPLACE TAX TOTAL _....._ ........... ............................_......,.............. ...................._....__......................__.._.................. ....................................... 6.CLN LABS + Cleaning-Supervisory/Administrative-per hour 16 16.00 HR [*] 0.00+ 55.00= 0.00 880.00 314 MAIN_STREET 12/26/2017 Page:4 Agreement No. 5460 Servpro of Santa Monica/Marina Del Rey SERVPRO of Santa Monica&Marina Del Rey Franchises 8907 &9966 P.O.Box 7545 Santa Monica,CA 90406 (310)395-9050/(310) 333-0654 TAX I13#11-3650729 CONTINUED-Hallway CAT SEL ACT DESCRIPTION CALC QTY REMOVE REPLACE TAX TOTAL 1 Supervisor @ 8 hours for 2 days.Hourly rate for a supervisory/administrative cleaning technician. Note:The cleaning-supervisor/administrator typically supervises or administrates in various cleaning,remediation,and restoration techniques to clean structural items such as doors,trim,windows,walls,and ceilings,etc. Courtesy Rate 7.WTR LABC + Cleaning Technician-per hour 4*8*2 64.00 HR [*] 0.00+ 35.00= 0.00 2,240.00 4 techs @ 8 hours ea for 2 days.Includes cleaning all walls,floor,ceiling,light fixtures,doors,windows,cabinets,tub and toilet. Courtesy Rate Totals: Hallway 0.00 3,120.00 Conference Rooml Height: 8' 320.67 SF Walls 110.21 SF Ceiling (.,t,1,fl.,0qo„w,rRoom I t m 430.88 SF Walls&Ceiling 110.21 SF Floor 12.25 SY Flooring 39.67 LF Floor Perimeter I 42.17 LF Ceil.Perimeter l � Door 2' 6"X 6' 8" Opens into FIRE—TRUCK G CAT SEL ACT DESCRIPTION CALC QTY REMOVE REPLACE TAX TOTAL 8.CLN LABS + Cleaning-Supervisory/Administrative-per hour 16 16.00 HR [*] 0.00+ 55.00= 0.00 880.00 1 Supervisor @ 8 hours.Hourly rate for a supervisory/administrative cleaning technician. Note:The cleaning-supervisor/administrator typically supervises or administrates in various cleaning,remediation,and restoration techniques to clean structural items such as doors,trim,windows,walls,and ceilings,etc. Courtesy Rate 9.WTR LABC + Cleaning Technician-per hour 2*8 16.00 HR [*] 0.00+ 35.00= 0.00 560.00 4 techs @ 8 hours each.Includes cleaning all walls,floor,ceiling,light fixtures,doors,windows,cabinets. Courtesy Rate -..._........... .-..... ........ .-._.................................................-................................................................................................................. Totals: Conference Rooml 0.00 1,440.00 314__MAIN_STREET 12/26/2017 Page: 5 Agreement No. 5460 Servpro of Santa Monica/Marina Del Rey SERVPRO of Santa Monica&Marina Del Rey Franchises 8907&9966 P.O. Box 7545 Santa Monica,CA 90406 (310)395-9050/(310)333-0654 TAX I13#11-3650729 Kitchen Height: 10' 616.67 SF Walls 250.00 SF Ceiling Kitchen rJ, 866.67 SF Walls&Ceiling 250.00 SF Floor 27.78 SY Flooring 60.83 LF Floor Perimeter 63.33 LF Ceil.Perimeter ie x" ®om g I 11 Subroom: Dining Room (1) Height: 8' ..........................__...............ww...................................................�......._._.......... ............................ ..mm.....� .....�.... 438.67 SF Walls 213.89 SF Ceilin g c;n;ng Rcv,n(<) =: 652.56 SF Walls &Ceiling 213.89 SF Floor 23.77 SY Flooring 54.00 LF Floor Perimeter 1 .t.•�„ ,�q 59.00 LF Ceil.Perimeter �t Door 2' 6” X 6' 8" Opens into KITCHEN Door 2' 6" X 6' 8" Opens into HALLWAY CAT SEL ACT DESCRIPTION CALC QTY REMOVE REPLACE TAX TOTAL ............ 10.CLN LABS + Cleaning-Supervisory/Administrative-per hour 16 16.00 HR [*] 0.00+ 55.00= 0.00 880.00 1 Supervisor @ 8 hours.Hourly rate for a supervisory/administrative cleaning technician. Note:The cleaning-supervisor/administrator typically supervises or administrates in various cleaning,remediation,and restoration techniques to clean structural items such as doors,trim,windows,walls,and ceilings,etc. Courtesy Rate 11.WTR LABC + Cleaning Technician-per hour 4*8 32.00 HR [*] 0.00+ 35.00= 0.00 1,120.00 4 techs @ 8 hours each.Includes cleaning all walls,floor,ceiling,light fixtures,doors,windows,cabinets. Courtesy Rate Totals: Kitchen 0.00 2,000.00 Total:Main Level 0.00 10,472.97 wrrrrr r_................................................................................... Line Item Totals:314_MAIN_STREET 0.00 10,472.97 314—MAIN--STREET 12/26/2017 Page: 6 Agreement No. 5460 Servpro of Santa Monica/Marina Del Rey SERVPRO of Santa Monica&Marina Del Rey Franchises 8907&9966 P.O.Box 7545 Santa Monica,CA 90406 (310)395-9050/(310) 333-0654 TAX ID#11-3650729 Grand Total Areas: 6,222.58 SF Walls 2,729.90 SF Ceiling 8,952.48 SF Walls and Ceiling 2,729.90 SF Floor 303.32 SY Flooring 655.75 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 716.50 LF Ceil.Perimeter 2,729.90 Floor Area 2,898.06 Total Area 6,222.58 Interior Wall Area 3,110.25 Exterior Wall Area 285.83 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length 314 MAIN__STREET 12/26/2017 Page: 7 Authorization to Perform Services and Direction of Pa*greatnent No. 5460 X Customer Name: Date of Loss X Loss Address: ........................ X City: State. Zip. Xinsurance Company: Claim Number(if available}� The undersigned Custorner, heing ffita builrfirxj vvvner mvner-s ropresont�,Rrve, or resiidunt, O'Lith0f)ZOS ffi(i Pl'oAdir;r iak-',witified beiaw to porloin"i, any �,,jnd <akll neccissar), cle31"girgi andIor rewora0cn servOes the I,Iropnrty addrusm,,, above, and with pec ith re�. t 0erns thal nec"'d to be, t,°,,aned at as rernote lc:pcabori K) teruovi'., ,,And clean Such items as necessary, Customer. authorizes Insurance Company, herein referred to as "lns,-urance Cornparvy,"to pay Provider sralely and directly tzar that porbon of the work covered by Customer's insurance policy, If, for i-iny reasion, Crostartrior receivt-,s a c�heck Insurance- Corm�any rn,"At,, pitysIlle lo C'usturrier Iri,,,Yy Prov,ider 41°1110dNWGIV Upon rece'ip't of tr'le cheick, ln to expedite pzlyrneu ut to Pruvkdet Pirovoisq, as i'rlwfnct, authorizing Prroodur W C2,1)001( Q CLPStOO)Pr $ rlM)L' C9 Inw,urvrce Company :ll ei',+s olf f r, �end to rjeposia hi*urance C()jrj)pjrjy oi jraftw'a ir,uc Prov,,der 11 0 S Customer,agrees to pay Customer's de6..potible in the apnount of $ - - that lu 01is If °.Iry amor , )y ws�,aance,, Cl�istotrii ON 4,V'DOU!qt�� i..wts owing to ProvGder for Provider semues are not covereal t J r, e # @ Provider within fifteen (15) days of Customer's revel rt of invrx;P it a� ft�y und��r�.I(xo Inal and ""ilf"Jimls, 4,,, asigrls, and hu�rs are persormgy ni,,,pot a6o0,ple k�jr ai�y and al� and any no; by, V�� P insu,ance, Interest and finarwe charg�,,,-� yoll be charqu,d at V'i& I t� "IGa 4;ritrl v�hi<;hevere is lrs4, cin DCCOU. 'JtS o%,er thirty t30) days past duv, Time its of v w essenc,-,!r Cuslom,er agrees that Provider is working for the Custorner and not Customer's insurance, company or any agentiadjusterr X Property Owned By: ........ ........ ............... Remarks: I HAVE READ THIS AUTHORIZATION TO PERFORM SERVICES AND DIRECTION OF PAYMENT, INCLUDING THE TERMS AND CONDITIONS OF SERVICE ON THE REVERSE SIDE HEREOF, AND AGREE TO SAME, Customer Reviewed Customer Information ForSwam WiWws Provider's Signature. .......... X Customer's Signaturw Franchise Legal Name: A. Nissan Enterprises, Inc. X Printed Name: d/b/a SERVPRdeofi Santa Monica & Marina Del Rey ................ XDate; .......... Date XE-mail Address: Contractor License#: ............... WNW SERVPRO Yellow: Claims Professional Pink: Customer �-26ERVPRCt INTELLECTUAL PROPERTY,Inc, ALL RIGHTS RESERVED FE-051707 10 fv ,��) � 1;uNtl�lY a ry i h NP itlr.8 CJIVCy Authorization to Perform Services __--Agreement--No.- 5460- - Terms and Conditions of Service READ CAREFULLY NoW: This Contact includes a knitation of liability and lirnitation of remedies. u"i0vownQ COawg old HnWMWu HacCNIQ 2jYMS 0 Me U"Id MAV 'At WMVn A i FMVQc gMc:! C01,009i; se"tbs) MaeK not pop hi Inn Serys, pwwail w Weoww dnri Kafmams, Se Wa6van in: on sivirciso; is nn,a oanv to any nympm.r Kh chvi a MW 0 ymisirow W we pm"W, sawyc wo 6 no nbi= z Pawdx S rwommou W t"-,e So xv.a himy"q arnowu who Tings 40 Ivoex swig zones 10.W1 n„{-a_,"+'mk5 a He P,"no my�", x,,er PR'D%PTER KMWESAY ENSCiUMn ANY REAWNS8111 Y OR Anou F Y FNQ AN V PROL KGTK',, GONDTTIDW; Qyn! w,,4A am nowl,bt hock or K ekwu m mia conu i4cesswy K,nwrvi wwLh Gonrwr& moudig by my 0"Xw9 e wo MA OWN-31 tho coriddhos 15=00 oakm Prom jet nw,Q; it so=mwyVon, a oSM Tworah Or rem;eiWn? ~3 m wah, QR WCOWWY bit ANNA np,5 On y SK:I I z- SRO,I QR STAt*J RS�IOOVAI AN,'-) rNES",OR 11"!r,-V-N't ION f"W•­ 1AR APHE A ECEAM A nNN Proydix DOES NOT QAh=EE mo wav ano cnilhy,3 1 ,3%X.,X the ongma;Cow-to Pat wA 1011rax e,c,'l Nn oil All falwnr�s are ce"Quove to z warxi F"r---.6,1n ihil use fnin"HEX 6901S n asisis a at 0 OW now.*was W"I Min to wosyyj famnvn doe to the naRre ofn;VOIN7 at aoQ rvo%i PROWDER COES NOT 01,JAVANTEF IHAT SUnR LATEP51 3 CAN BF OHTH ,T 71 1� UE NO AbYERSK EFFE1 16 WOM ANY At I0APT 11)m EAN 71 A 11 Row In A A=44 0 mme"% as avo m We mam"MmPY upo VvY U—=Aw-POWS1 I hue= kws mOr" 01&wq-wvq Wor alher unkiown:;{:instances thN may cause Ott– erfois it)we Wce"WaNd! W dulerrrOo whm-nch anersu efla=May neaw aln PROMDER DOES NOT GUARANTEE AGAINST SUL H ALk EHNE EFRA4,,,', le) Mmm acknoveledges!inct Ithal rnr7i!J is ccwiin-x�rhy found IhP environrueN ani thn it s iripw;G til [r) PROVICIER DOES NOT GUARANTEC T-4 IE REr,1,-D5"•'AL,1,',R OF 11,4 .i.r.) 3 PROVIDER SPECIFICALLY DISCLAIMS ANY AND ALL QTHLR WARRAit.TIES AND ALL INIFILIED INARRAMNIIES pFO`H1-R IN FA,,'l OR RY OPERATION OF LAW)MCLUDING, BUT NOT LIMITED TO.ANY WPLMD WAnIRMITHES or MURCHANTAWLITY AND FITMESS FOR A PARTMULAR PURPOSE OR ANY IMPLIED WARRANTY AFNSMG OUT OF A COURSE OF DEALING.CUST(W4 Ot�� OF TPNADE TICS CONTRACT PROVIDES FOR THE PRQVQK3N OF SERVICITS AND DOES NOT PROVIDE POR A S,,*!-C CF(3001,lr; 144 NO EVENT SHALL PROVIDLR,ITS 014"04ePS,A14Y OIX9;CERS, OR. I FRANCHISOR,OR AFRUANS HE RESPONSIBLE FOR INDIRECt SPECIAL NOMINAL INCIDENTAL, PUNITiVE CK CONSUOUENIIAL, LOSSES OR DAMAGES,OR FC*� ANY PENALIGS, REGARDLESS OF IHE LIGAL OR EQUAAWLE TnEURY ASSLNTKq MCLUDM(l CONTRACT, NEGLIGENCE,WARRANTY,STRICT LIAFLOTY,STATUIE OR OVIERWISF, EVEN IF IT HAD VC-Fn A1,1.1APF or ToE POSMSTITY OF SUCH DAMAGES OR 7HEY ARE FORESEEAUI.z', OR FOR CLAIMS BY A THIRD PART Y.THE MAXMIIJI'A AGGR[GATF LIABILITY SHALL NOT EEC LED THREEL I INIES THE AMOWn PAW BY CUSTOMER FOR THE SERVICES OR ACI UAL PROVEN DAMAGE&WHICHEVER IS LESSIT I$ CXPRESSLY AaREEO THAI CUSTOMER'S REMEDY EXPnESSED HERFM IS CUSTOMER's EXCLUSIVE REMEDY. 1146 LMMTKUUNS SET FORT" HEREIN SHALL APPLY EVEN i'r, ANY OTHER REMECALS FAN rV i'f IL-DR ESSENTIAL PURPOSE.Some sfates!Cotlr it rn;%?.,Io not allow the exchmion or NwhinHion of MiNdental or consequenbail darnagvs,so the above irmay not apply to you. 5, .ho dd ProVdcr n"g 5gM avon to sivAul momes dLe won do coimwn Cr shosim we noner no bgrea ove cylany; 11 ryin kma I n to the fo;osl sMent pena 1110 ummir oajo WAXIMble da, w ints .")v{°. 's of PIV so a M :00an MIT" M as A 0 r 0 . owl&owns onedbyCont Tit 0HOnmy%epronswin shall is!to vlonve oemynDw, "I �i: C,Iwwrat is I're!'eb`,r Pon 59Mg MnneoailkL�5Iii a,L,� i4sp000in.y is pe0otm�,.�if Pv,^.ir,"er qs il:ct I*od, a A"wvM morniala w omy woo ny=d on cam"I in this CaMor Awl rwAis a woWn mmNawrl to M,CoVon arn wil innih ir, crowwW=,narges, ? Any dam by Giieml fix%M? Pi0mTown ko "Implohowne W bmaG4 wwdbr ti')�2'iX,w'r-jc*.lot kitiviges s0+)on mon ii &Nip I j Ormwn,r wdhn SMY MO;clays Aul nurphl an A hymKow Fmww W ma"sul a mooKhm fir any rii,,initer MraNi zoi,ljj :,,; by Pi,,,"'irr NO ACTION, REGARDLES5 OF FORM,RELATING TO THE SUBJECT MATTER 0d- MAY 06 HROLGHT MORE THAN ONEL a!It YEAR AV I E Ft THE CILA;PA",iG PAR I"Y YNILV%,OR SHOULD HAVE fNCANN ACTION, a, A WWre of either party to exercise any n;ht Drovidied for herein shall not be deemecim ae a wGiver of any ryhl hutunds, 9. Cc,IENTAND PROVIDER EAMI WAIVE I HE;R RESPECTIVE RIGH IS TO A TMM.BY JURY VOTH RESPECT TO ANY A,N0 4t L CLAOAS OR CAUSES OF ACTION kINCLUGING t';OVNTERMAIIOS; RELATE.)70 OR AR;SINCS 0 XIT r OF OR dN ANY VVAY(-,0NNi-,.t,-,TED TO THIS CONTRACT AND AGREE THAT ANY CLARA ORCAUSE OF ACTON WILL BE TRIED EW A COURT TRIAL VPTHOUT A J'. R', 10 If any PmAsion 04 this Contras,, i"~found:to be wellective,unentorceablo ut flegal for any reason under pmserq or knuwt~dws,sum;"Ofs%snail be fully s,everablo WW Chas Ccinlractshafl be cariwfrued and orKicea as K mxh pinswun never ovrpirlsed a pal DF Wis Conknu.The rtnwhing pmus.0 MA Cormn",owkwurr r"A Nino elfrct lin",shol,rw no afecmd ay we memo",inwhin"we 0 dqw po"Islon or by 11,,a se'veranco Wm this conflix:1 11 No Movimotiol or w1crywc waiver of As CcOrad Ka"a vdd to in unting and signed by t°{e pans'against v,hom,he sin,*ir; ,5ougnt to bQ enforced. SERVPRC-��Franchisees are always looking for motivated employees. SERVPRD% MdNicluaUy owned and operated franchise's aflker a variety of positions inclUding crew cklief, production technician marketing repremantative, adrin0istrative assistant,,and many more. 28401 08/14 Ach 5ER)TRO' Frmichiso e.-.hedependowly 0,vnedai:d opee aeu0 Agreement No. 5460 -daimtow- Customer Information Form—Water Damage 0 1. A NATIONWIDE SERVICE PROVIDER.SERVPRO®is 0 Measure I emperature/Humidity for Drying Analysis: 0 Guns and Ammunition; Our crews are instructed a Franchise system with over 1,600 independently The process of drying will use equipment to remove NEVER to touch guns or ammunition. For this owned and operated locations nationwide. Servpro moisture from the structure and contents of your reason we request you remove any such items Industries, Inc, the Franchiser, may be reached at home or place of business. This controlled reduction from the areas we are cleaning. 1-800-SFRVPRO, of the relative humidity level helps minimize 0 Jewelry,Valuables, and Heirlooms: Please remove 0 2. WORK AUTHORIZATION.To start our mitigation property damage and slow mold growth, any valuable items from the areas we are cleaning and restoration service, you must sign the 0 Emergency Water Extraction: Our next step is to before the job is started. We are not responsible Authorization to Perform Services form.This allows remove as much water as possible from the affected for those items. List any special heirlooms or us to take action immediately.We do not know your area This will be completed with our Specialized collectibles that should be given extra special or insurance coverage;therefore,it is impossible for us extraction equipment. especially delicate treatment due to their value. to know exactly what Your insurance will cover.It is 0 Furniture Moved and Blocked: This is done to List: important for you to understand imji linancialty protect carpet and furnishings In the affected area. hir t Your deductible is Will you be removing any personal items, guns, payable before we start work If for any reason ® Floor Service: We will check to see what type of ammunition,jewelry,valuables,or heirlooms prior insurance coverage cannot be verified at the time of floors you have. Carpet will be lifted to inspect to the Franchisee beginning work? O Y O N Our emergency services, an additional deposit may flooring. As much water as possible will be i emoved. 0 8. OVERLOOKED ITEMS.Although our supervisors X he feciidied 0 Carpet Pad: Pad acts like a sponge and holds water. inspect all work, ynu should accompany the If the pad is exposed to excess water, it may be supervisor on the final walk-through and bring any X Insurance/Client: necessary to remove the pad to protect the sulafloor overlooked items or concerns to the supervisor's X Policy it: and speed the drying process. attention. X Deductible Amount: 0 Carpet: Carpet will be checked for restorability, 0 9. INSURANCE ADJUSTERS OR AGENTS. We are delamination,visible mold and mildew,etc. In some neither insurance adjusters nor agents.We cannot 0 3. REFERENCES,The Franchisee would be pleased to water damage situations,the carpets may need to authorize anything to be replaced, repaired, or provide references upon request. be removed. This can include door removal,cutting painted. Our job is preserving and protecting, seams,and metal threshold removal. stopping further damage from occurring, and 0 4. HOW WE PROCEED.The Franchisee will attempt restoring damaged items to their prior condition to "preserve and protect" your structure and ® Treatments: Our process may include the when possible contents.The following steps may be completed in application of EPA-registered disinfectants. 0 10. EMERGENCY CHARGES. The exact price of the emergency service, as determined to be 0 Equipment: Drying equipment will be used to dry restoring your property following water damage is applicable by the Franchisee: your property, The equipment's purpose is to virtually impossible to determine on our first visit.A • Survey the Extent of Damage and Inspect the remove excess moisture and bring relative humidity verbal briefing will be provided to you and/or your Premises: Our initial inspection of the premises is levels back to normal. it is Important all equipment insurance adjuster.The scope of work can change designed to identify how much damage has be kept running, unless a safety hazard arises. due to unforeseen circumstances.The final bill will occurred and plan the necessary emergency work, Excessive moisture can Still be present even when all be forwarded to you and/or your insurance carrier The inspection is also done for safety reasons. We visible surfaces seem dry,which may lead to mold upon completion check the affected area for bad flooring, ceiling growth or other damage. We will monitor moisture in wet materials. 0 11. HEALTH AND SAFETY. Maintaining your darnage,visible electrical hazards,contents damage, personal health and safety is of great concern to us. wall and baseboard damage,sewage water, visible 0 Disposal: Any refuse items such as carpet pad will be All occupants and pets should stay away from work mold,etc removed and disposed of properly. areas to protect their health and safety during the Are you aware of any potential safety hazards In the 0 5, WHAT IS RESTORABLE,Determining exactly what work process Material Safety Data Sheets(MSDS) structure? O Y O N can be saved before everything is dry is usually for our products are available upon request Lost.. impossible.We will set a follow-up date so we can Would you like any copies of the MSDS? O Y O N ® Identify Source / Type of Water; Contaminated monitor the drying process. Additionally, the Exposure to certain molds may cause health water sources(like sewage,etc.)require specialized restoration process will be scheduled when the problems. If you have any concerns,you should restoration processes. Additionally, the source of drying is complete. This can include floor consult a physician. water Should be completely stoppedprior to starting preparation,tack strip replacement,carpet and pad installation,scanning,carpet cleaning and restoring,ng, if you desire additional information,please request any work other than the removal process, and furniture and contents cleaning. A scope of the SERVPRO® Understanding Mold brochure, and Source of water intrusion: services will be provided. contact your local or state health department. Has the source of water been stopped? O Y O N Has anyone in the structure experienced reactions 0 65. PREEXISTING OR PRELOSS CONDITIONS. During to the water intrusion? O Y O N • Identify Visible Mold Growth; It is impo.,tans for us the course of cleaning we will likely remove day-to- to know if visible mold growth is present. While day Soiling that existed prior to your loss. We are Do you have any health concerns about the water molds may be found in small amounts almost happy to do so. If, however, the removal of intrusion? O Y O N anywhere,larger growths of mold rinay create health preexisting soil requires significant extra effort,our 0 12, APPROXIMATE COMPLETION. The actual time concerns depending on occupants'reaction to mold, crews will be instructed to move on to the next item required to complete the restoration process is Have you seen signs of mold growing anywhere in Preexisting damage, including visible mold growth, difficult to estimate. We estimate approximately the structure or Its Lontents? O Y O N will also lie noted days. Seen mold growth at any time in the past? 0 Y 0 N Has the structure sustained leaks or water I HAVE READ AND UNDERSTAND THE ABOVE Noticed any odors or musty smells? 0 Y 0 N intrusions in the past? 0 Y 0 N STATEMENTS AND INFORMATION CONTAINED HEREIN. • Specialized procedures are required for materials 0 7. PERSONAL ITEMS.In the course of our survey MY ANSWERS TO THEA VE QUESTIONS ARE like mold,lead paint,asbestos,Chinese drywall,etc. and cleaning, we will sometimes be required to ACCURATE AND COMPLETE. If we notice a Significant presence of these types of open doors, cupboards, etc., to qualify and/or XCustomer Name: materials,or believe there is a likelihood that such restore the damage. If you prefer to remove 'i,�imvwg Slgnatuwe� materials exist in the structure, we will notify the personal items and personal or financial X­ involved parties So they may determine an information from these areas before we start, ilrovlder',y 5,xit'i"ov, appropriate course of action. please let us know XDate: Are you aware of any materials in the structure Franchise Legal Name:k-Niss,3o-E!ftrPf0m- Inc. which might require specialized cleaning procedures (mold,lead paint,asbestos,Chinese drywall,etc)? d/b/a SERVPRO of Einta Monica&_Marina Del-Rey OYON @SERVPRO*INTELLECTUAL PROPERTY,Inc. ALL RIGHTS RESERVED FE-051707 1.0 28501 11/12 tach SERVPRO' Franchise is Indupenderilly Owned and Opetaled Agreement No. 5460 • Customer Equipment Responsibility Form X Customer Name; Date of Loss: Loss Address: City: State; Zip: Insurance/Client: _ Claim Number(if available): Conventional Dehumidifiers LGR Dehumidifiers Desiccant Dehumidifiers _ . Air Movers _._ Specialty Drying Equipment(Iist): Power Distribution Center, ._ Odor Control Devices(list): __.... Additional Equipment On-Site(list): Customer has been informed of the following requirements regarding equipment placed on the job site. 1. The equipment should be left operating at all times. Do not move equipment unless you contact the SERVPRO", Franchise identified below regarding handling procedures.Turning equipment off will increase time required to dry structure and contents and may cause damage. 2. A water-damaged dwelling should maintain a temperature setting that promotes ideal drying conditions. Leaving windows or doors open during dehumidification or setting air conditioning too low may increase drying time and damage structure and/or contents. 3. Should customer have any problems with the equipment,shut it off immediately and call our office at ,(310)395-9050 �as soon as possible. 4. Customer is responsible for damage to, and/or loss of,this equipment while it is in customer's care and custody, including but not limited to loss caused by theft,vandalism or disappearance. 5. It is the customer's responsibility to allow personnel access to customer's location to check on and pick up the equipment. 6. The above equipment may be picked up between the hours of 8 a.m. and 5 p.m. Monday through Friday excluding holidays. 7. The equipment will be connected to the electrical system in customer's dwelling/structure, Customer warrants the integrity and safety of the electrical system in the dwelling/structure. It shall be the customer's responsibility to have the electrical system inspected and serviced by a qualified electrician if necessary. 8. The customer agrees to hold the SERVPRO° Franchise below, its Franchisor and their respective officers, directors,employees,agents and affiliates harmless and indemnify it from any and all claims,including costs, expenses and attorney's fees, resulting from the improper use of the equipment by the customer and/or any defects in the electrical system or plumbing system in customer's dwelling/structure. X Customer, _.._ _.._._.__.. and Provider(SERVPRO of ,Santa._Monica & Marina Del Rey ) acknowledge receipt of the above documented equipment in good working order. X Customer's Signature: X Date: Provider's Signature: a�Na Date: QSERVPRO'INTELLECTUAL PROPERTY,Inc. ALL RIGHTS RESERVED FE-051707 1.0 28509 12/10 £- c1,sI'i;Y7lkF�s'Fmnrbim 6 indeprndently Owned and Operated.