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<br /> 1�ESTOIZATIOl�T SPECIALISTS �
<br /> "Good People To Turn To"
<br /> General Contractors-State Certified-License#CGC 042165
<br /> 244 N.W 9th Street,Ocala,Florida 34475•(352)732-2322•Fax(352)732-8950
<br /> 2315 Griffin Road Unit 3,Leesburg,Florida 34748•(352)78?-4223•Fax(352)314-9320
<br /> 224 N.W 8thAvenue,Suite B•Gainesville,Florida 32601•(352)376-0721•Fax(352)373-0341
<br /> 36 W Gulf to Lake Highway,Lecanto,Florida 34461 •(352)746-4878•Fax(352)746-4128
<br /> A division of Preusler&Associates,Inc. 13441 Chambord St.•Brooksville,FL 34613•(352)754-1142•Fax(352)597-4090
<br /> 144 SW Waterford Ct.#107•Lake City,FL 32025•(386)487-0297• Fax(386)755-2726
<br /> www.restorationspecialists.com
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<br /> Insured Name ��.�^�c,�.� ��� C -� Home Phone ��3� �g�-F - 3�� �
<br /> Loss Address (�a p0 (a-�-� ��-. Z��:�.rl�, FI. �35`l 3 Work Phone
<br /> Residence Address 5�l(� �r�,-�-�,T��`,�.,�.,,,,�(n�l(s F0.33�1N3 Cell Phone
<br /> ,
<br /> Temporary Address Alternate Phone
<br /> Email Address Birthday,Month&Day Only
<br /> Insurance Company�.�c,,,,_„ T„���r;-�-.� ��S . Claim# G}�� p p�( ���S
<br /> Agent Name �.e,� .� ���,f ���_ Adjuster Name
<br /> Mortgage Company Phone#
<br /> I Address Loan#
<br /> We,the properry owner,the insured,or their agent (Insur ) authorize Restoration Specialists (Contractor) to perform the work outlined below to our property at the
<br /> above address. The damage was caused by (��� on or about �` � ,20J�. By signing below,the Insured agrees to all
<br /> "Terms and Conditions"on the front and back of this authorization.
<br /> • The Contractor agrees to proceed with the work as described in the original estimate and any supplemental estimates which are incorporated herein by
<br /> reference,plus any change orders approved by the Insured and Contractor. Due to the nature of the work,no completion date is specified.
<br /> • The Insured hereby gives authorization to the Contractor to proceed with the work and appoints the adjuster or insurance company as their agent for all work
<br /> covered byinsurance.
<br /> • The Insured authorizes the insurance company to pay all proceeds due Contractor payable under Insured's policy directly to Contractor. If Insured's name is
<br /> included on the payment,Insured agrees to promptly endorse and deliver said payment to Contractor.
<br /> • The Insured fully understands that he/she has the right to select a contractor,and in doing so,Restoration Specialists is acting solely for the undersigned and
<br /> not for any insurance company or any third party.
<br /> • The Insured understands that the price of work will be based on the existing quality of items to be repaired or replaced.
<br /> • The Insured thoroughly understands that payment in full is due and payable immediately upon substantial completion. The Insured agrees that any
<br /> payments not made in accordance with this agreement shall be considered delinquent after 10 days from due date. Default interest will accrue at the highest
<br /> rate allowed by law on any delinquent payment.
<br /> • Tlie Insured agrees when the job exceeds$8000,that the insurance company will be requested to issue"draws"so that payment may be issued to Contractor
<br /> under the schedule of 1/3 upon commencement, 1/3 midway throu h the job,and 1/3 within 10 days of substantial completion.
<br /> • The Insured agrees to pay the deductible portion of$ i�_�� at the time of signing this contract.
<br /> AN I TANT DOCUM 1VT PLEASE READ IT BEFORE SIGNING IT
<br /> � X '2�� 7
<br /> Insured,or Authorized Agent for Insured ate Insured,or Authorized Agent for Insured
<br /> �. !��,�Q1'l Authorized Contractor Signature
<br />' WORK PERFORMED BYRestoration Specialists IS GUARANTEED FOR THE PERIOD 1�F THREE(3)�S FROM THE DATE OF COMPLETION PROVIDED PAYMENT HAS
<br /> BEEN MADE IN A TIMELY MANNER. MATERIALS ARE WARRANTEED BY THE MANUFACTURER ONLY.
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<br /> Comments � � � 4�-� t[� S
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<br /> ANY CLAIII�YS FOR CONSTRUCTION DEFECTS ARE S�IBJECT TO THE NOTICE ANID CURE
<br /> PROVISIONS OF CHAPTER 558,FLORIDA STATUTES
<br /> Ro�.�a.I F171 t11�R
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