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Gale Force Roofing and Restoration <br /> 3902 Henderson Blvd, Ste 208#337 <br /> Tampa,FL 33.629 <br /> GALEFORCE (0) 813.805:8096 <br /> ROOFING h RESTORATION <br /> Lic: CCC 1331253 <br /> ACCEPTANCE OF CONTRACT <br /> The Company is hereby authorized to perform at their discretion all insurance prescribed repairs for the price of <br /> the full scope of insurance proceeds. We will complete only the work approved by the insurance company. The <br /> terms and specifications state, I hereby, authorize my insurance company and/or mortgage company to make <br /> payment for completed repairs directly to the Company. The Company is entitled to all taxes,depreciation,permit <br /> and tarping reimbursements, supplements or staged payments and the full amount of General Contractor's, <br /> Overhead and Profit and any additional payments from the insurance company. <br /> Insurance Company: �„ }; (��-1 Policy#: S'fl?SI o 01 SO ON 'G 9 <br /> Insurance Company PH: l m e 722- en 9,,�E Claim#: Jyrl,0r AD 3.49 73 <br /> Insurance Adjuster: Adjuster Phone: <br /> Mortgage Company: <br /> Mortgage Company Phone: Loan#: <br /> Customer agrees to hold the Company harmless for any of the following: Damage of any kind, caused by any <br /> third party service provider, such as dumpster companies or material suppliers. Any damages caused by <br /> vibrations, i.e.: falling pictures, or light fixtures,small cracks or nail pops in drywall. Initial(s) S Xc <br /> The Company will clean up and remove all job-related debris including any salvage material. All salvage <br /> material becomes property of the Company. Initial(s)—.;�: <br /> The Customer agrees to pay the Company their initial check for the Actual Cash Value amount as a good faith <br /> deposit for the work to be performed and any taxes, depreciation,permit or tarping reimbursements, supplements <br /> or staged payments, or overhead and profit from the insurance company are to be paid upon receipt from the <br /> insurance company. Initial(s) - <br /> I have read and agree to all terms and conditions listed on each page of this legally binding agreement. <br /> Initial(s) ;ff> p <br /> ACCEPTANCE BY OWNER/BUYER: ��1/fiTi�L J�-n�/eW?4 g-se 01 ,<DATE: 1<1 <br /> (PRINTED NAME) <br /> SIGNATURE: <br /> ACCEPTANCE BY OWNER/BUYER: DATE: <br /> (PRINTED NAME) <br /> SIGNATURE: <br /> This Contract Agreement respectfully submitted by: DATE: <br /> Gale Force Signature <br /> Page 2 of 6 <br />