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FOR OFFICE USE ONLY:
<br /> Date Processed Neumann Construction&Roofing, LLC
<br /> Project Manager Assigned 24/7 Emergency Service Division
<br /> 30427 Commerce Drive
<br /> Processing Representative San Antonio, FL-33576
<br /> Insurance'Company Construction(813)782-9080
<br /> Neumann Job Number) eaNdreteCtat&�on6ury. .CC'e Roofing'(352)668-4875
<br /> Toll Free(877)162-6350
<br /> Division WWW.rifoc.net
<br /> CBC 058155
<br /> REPAIR AUTHORIZATION CCC 1326166
<br /> i
<br /> INVe, ` ` 0- ("Owner/Insured") hereby request and .authorize
<br /> { Neumann Constar tion Ro f' ; L C,and t e'r m to ees/representatives to enter the pr r>aj. es'If�r.,�te _at:
<br /> Stree Addr ss: �l b� . Phone: f l 1'�
<br /> �.
<br /> City: State:_- Zip Code:
<br /> j ("Pro ert '),to perform the following scope of services, repairs, labor and/or work (collectively, "Work"):
<br /> ❑ Emergency Services (circle):Water Extraction/Dry_-Out Board-Up Tarp
<br /> ❑. S�elr
<br /> irs Non
<br /> }-� : e-Roo Repair Shingle Color ��� f? Drip Edge k����Z�
<br /> o� O
<br /> Insurance Company & Policy Number: - ("Owner's Insurance Company'). .
<br /> j Neumann Construction & Roofing, LLC shall perform all Work, as identified above, on the Property for the amount of the estimate
<br /> agreed upon with the Owner and/or'Owner's Insurance,Company. Any supplements to the estimate for covered items will be paid by
<br /> i the Owners Insurance Company. Any work not covered by Owners insurance Company will be agreed to in the form of a change
<br /> order,-signed by the Owner and_Neumann Construction&Roofing,LLC prior to the commencement of such.additional work. Payments
<br /> for all Work performed under this Repair Authorization, including any additional work not related to the Owner's Insurance
<br /> Company ppqqe or estimate of repairs,is the;sole responsibility of the Owner,regardless of insurance coverage.
<br /> (Owner/Insured Initials}
<br /> I/We.hereby assign any and all interest in the proceeds frorn any payment from Own_ers Insurance Company to Neumann_Construction
<br /> &Roofing,LLC,and INVe further authorize and direct Owner's Insurance Company to issue payment directly to Neumann Construction
<br /> &Roofing, LLC for such Work,or,,to include Neumann Construction&Roofing,LLC-as an,additional payee on the face of any payment
<br /> draft for the Work performed on the Property. If any pay ent is made to th6 Owner;Owner agrees to immediately endorse same and
<br /> furnish to Neumann Construction&Roofing,LLC. (Owner/insured Initials)
<br /> INVe understand that I am individually, jointly and severally, liable to Neumann Construction & Roofing, LLC for full payment in
<br /> connection with Work performed on the Properly. .INVe acknowledge that this Repair Authorization and the Work required hereunder is
<br /> subject to Florida's Construction Lien Law,and that should INVe fail to make f font to Neumann Construction&Roofing, LLC,as
<br /> provided in.this Repair Authorization,alien will be placed on the Property. d' (Owner/insured Initials)
<br /> INVe understand that Itwe are ;solely responsible for the following expenses: (1) Any insurance deductible or non-recoverable
<br /> } depreciation in accordance with the. Owners Insurance Company to be collected at the start of the repairrprocess; (2) Any and all
<br /> repairs or work performed on the Property by Neumann Construction & Roofing, LLC, which.are not authorized by:this Repair
<br /> i Authorization; (3) Any and all.code upgrade items that are not covered under the Owner's Insurance Company; (4) Any.and all
<br /> additional work requested by any change order; and (5) Emergency services, in the event that no insurance coverage'is available for
<br /> any repairs made to the Property. (6) Neumann Construction & Roofing, LLC collects in dr t sF yment throughout the process: 1/3
<br /> upon work commencing,_113 at 50%job completion,final payment at 100%job completion. � (Owner/Insured Initials)
<br /> INVe understand .that should. I/we choose to .cancel this Repair Authorization prior to completion of the. Work, I/we will remain
<br /> responsible to pay Neumann'Construction&Roofing,LLC all actual expenses associated with Neumann Construction&Roofing,LLC's
<br /> performance of the Work,which includes any overhead and profit payments agreed to by the ow rs nsurance.Company, regardless
<br /> of the quantity or completeness of Work performed by Neumann Construction&Roofing,LLC. (Ownerllnsured Initials]
<br /> REMEDIES-FOR NON-PAYMENT: Neumann Construction& Roofing, LLC shall have all rights to payment and enforcement provided
<br /> by Chapter 713, FLORIDA STATUTEs,'which_is incorporated.Herein by this reference. In the event it is necessary to collect any amount of
<br /> money owed hereunder by referral to an attorney, collection.agency, or court proceeding, it is agreed that the prevailing party (or
<br /> substantially prevailing) in such matter will reimburse the.other party for its reasonable attorneys' fees and enforcement costs at all
<br /> tribunal levels and'in all dispute resolution proceedings, including bankruptcy and post-judgment collection, whether or not suit be
<br /> brought. A service charge of 1.5%per-month will be due on all invoices ten(10).days past due,along with all collection costs incurred.
<br /> Work-may I e suspended or terminated by Neumann Construction&Roofing, LLC if not paid in full ten(10)days afterinvoice or billing,
<br /> In the event of termination by Neumann Construction & Roofing, LLC as a result of delinquent payment or non-payment, Neumann
<br /> Construction & Roofing,..LLC shall be entitled'to compensation for lost profit'and. unabs-rbed overhead for all'Work not preformed.
<br /> j Neumann Construction & Roofing, LLC shall also be entitled to collection from the Owner/Insured of any monies withheld by a lien
<br /> holder as party to a co-payee,check as a result of default or delinquency by-the Owner/Insured on a mortgage or other obligation on the
<br /> property. It is expressly understood that Neumann Construction'& Roofing, LLC pre-construction services including but not limited to
<br /> i estimating, site visits, planning,permitting and similar activities shall be payable at a minimum of 10% of total value of the estimated
<br /> i
<br /> repairs if the Work is not performed by Neumann Construction&Roofing,LLC.
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